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School of Medicine
GAINING HEALTH WHILE GIVING BACK TO THE COMMUNITY
Older adults who volunteer in troubled urban schools not only improve the educational experience of children, but realize meaningful improvements in their own mental and physical health, say researchers at the Johns Hopkins Medical Institutions.
The Johns Hopkins investigators base their conclusion on the first randomized clinical trial testing the health benefits of participating in an established volunteer program called Experience Corps in Baltimore.
"While our results are preliminary, what we found is a 'win-win' for everyone involved," says the study's lead author, Linda P. Fried, M.D., director of the Center on Aging and Health at Johns Hopkins. "Giving back to your community may slow the aging process in ways that lead to a higher quality of life in older adults," she adds.
"Physical, cognitive and social activity increased in volunteers, suggesting potential for Experience Corps and similar programs to improve health for an aging population, while simultaneously improving educational outcomes for children," she said. "It potentially could have great social impact if taken to a large scale."
The study is published in the April issue of the Journal of Urban Health, which also includes companion studies by Johns Hopkins researchers that found Experience Corps to be cost effective and detailed the educational boon to students.
Started in 1996, Experience Corps is an award-winning program that places teams of older adults in urban public schools as tutors and mentors. Currently, more than 1,000 Experience Corps members are volunteering in 100 elementary and middle schools in 18 cities across the country. But the program was also designed to help adults keep healthy, say the Johns Hopkins researchers.
"Evidence is mounting that remaining active and engaged is beneficial as one ages, but our society has not developed approaches that support such activity for the broad spectrum of older adults," says Fried. "That's why we were eager to see if this program might work to provide such benefits."
To test, in a scientifically valid method, whether Experience Corps improves key aging risk factors declines in physical, cognitive, and social activity a research team designed a two-year pilot study that compared 128 Experience Corps volunteers, ages 60 to 86, to a comparable control group.
Participants in the study, predominantly African-American women, volunteered at six Baltimore public schools, helping children in kindergarten to grade three. The volunteers were organized into teams and worked in the schools 15 hours per week, usually over three to four days. They were trained to help children improve their reading skills, to support library operations and help pick out books and read, to solve problems and play cooperatively. A small stipend of $150 to $200 a month was offered to the volunteers to reimburse for expenses.
Volunteers signed up for "generative," not health-related reasons, says Fried. The majority, almost 88 percent, either said they loved children, or wanted to help them. Of the rest, about 11 percent said they wanted to make a difference in their own lives, or help themselves "feel good," and only 2 percent said they volunteered to "stay active."
Most of the volunteers, 71 percent, had a high school education, and 14 percent used a cane.
To determine any health advantages that came with participation, the researchers evaluated the control and intervention groups before and after the trial. They found that 98 percent of participants in the intervention group reported being satisfied with their experience, and 80 percent returned the following year. Such a high retention rate reflects the "health promotion potential" of Experience Corps, the researchers say.
The investigators also found evidence for short-term change in health outcomes. Among them:
- At follow-up, 44 percent of Experience Corps participants reported feeling stronger, compared with 18 percent of controls, and there was a 13 percent increase in those who reported their strength as very good to excellent, versus a 30 percent decline among controls.
- Cane use decreased in 50 percent of users in the intervention group, compared with 20 percent in the control group. Falls also decreased.
- In terms of social activity, Experience Corps volunteers reported a significant increase, compared to a decline in the control group, in the number of people they felt they could turn to for help.
- In measuring cognitive benefit, the researchers say that increases in cognitive activities in the school were not offset by a decrease in book reading and other such mental activities at home in participants. TV viewing, considered the "most common low intensity activity," declined by 4 percent in volunteers and increased by 18 percent in the control group. "In contrast to other programs that target health care beneficiaries, the Experience Corps program is designed to attract all adults, including those less likely to participate in formal health-promotion programs," says Fried. "We show it can lead to meaningful short-term improvement in healthy behaviors for older adults while they, at the same time, offer social capital that is highly valued," says Fried.
While Experience Corps may be expensive for the short-term health improvements it offers volunteers, when potential benefits for students and possible long-term benefits are factored in, the program could be highly cost-effective, say Johns Hopkins researchers.
This study, published in the same issue of the journal as a companion to the Johns Hopkins pilot study of the health benefits inherent in the Experience Corps program, found cost per volunteer (assuming 500 volunteers were enrolled) was $3,613, or about $7 per hour of volunteer time. Short-term improvements in older adult health resulted in medical care cost savings of $273 per volunteer.
When long-term benefit for students was factored in, the program became fiscally sound, says lead author Kevin Frick, Ph.D., of the Johns Hopkins Bloomberg School of Public Health. "If only 12 students who would not have graduated otherwise eventually graduate, the program becomes cost-effective
In yet another related study, the Experience Corps program was found to lead to selective improvements in student reading, academic achievement and classroom behavior while not burdening the school staff, say researchers who studied 1,194 children from six urban elementary schools who
participated in this phase of the pilot trial.
At follow-up, third-grade children whose schools were randomly selected for the program had significantly higher scores on a standardized reading test than children in the control schools, and office referrals for classroom misbehavior decreased by about half in the Experience Corps schools but
remained the same in the control schools.
"Taken together, the results from this pilot trial lead us to conclude that the Experience Corps Baltimore program can potentially make an important difference in the lives of young children and their schools, even after a relatively brief exposure period," says the study's lead researcher, George W. Rebok, Ph.D., of the Johns Hopkins Bloomberg School of Public Health.
The lead study was funded by The Retirement Research Foundation, the Erickson Foundation, the State of Maryland, the State of Maryland Department of Education, the Baltimore City Public Schools, the Baltimore City Commission on Aging and Retirement Education, the Johns Hopkins Prevention Center and the Corporation for National Service. Co-authors include Michelle Carlson, Ph.D., Kevin Frick, Ph.D., Joel Hill, M.S.,George Rebok, Ph.D., James Tielsch, Ph.D., Scott Zeger, Ph.D., Barbara Wasik, Ph.D., from Hopkins; Teresa Seeman, Ph.D., from the University of California at Los Angeles; Marc Freedman, from Civic Ventures Inc.; and Sylvia McGill from The Greater Homewood Community Corporation, an umbrella community organization in northern Baltimore.
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