• Increase in aerobic physical activity measured by the Stanford 7-Day Physical Activity Recall [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]
• decrease in saturated fat measured by the Block food frequency questionnaire [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]

• Increase in aerobic physical activity measured by the Stanford 7-Day Physical Activity Recall
• decrease in saturated fat measured by the Block food frequency questionnaire

• Physical performance on a symptom-limited, graded exercise treadmill test [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]
• quality of life and psychological questionnaires measuring physical functioning [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]
• sleep [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]
• perceived stress [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]
• depressive symptoms [ Time Frame: baseline, 4 months, 8 months, and 12 months ] [ Designated as safety issue: No ]

• Physical performance on a symptom-limited, graded exercise treadmill test
• quality of life and psychological questionnaires measuring physical functioning
• sleep
• perceived stress
• depressive symptoms

The purpose of this study is to evaluate the effects of a 12-month telephone-supervised, home-based physical activity and dietary intervention, conducted in either a sequential or simultaneous fashion, on improving physical activity and dietary patterns in a high-stress population.

This study combines elements of two previous studies--Teaching Healthy Lifestyles for Caregivers (TLC2) and Counseling Advice for Lifestyle Management (CALM)--to compare exercise and diet interventions in caregivers and non-caregivers. Two hundred and forty healthy men and women ages 50 and older, half caregivers and half non-caregivers, will be randomly assigned to one of four conditions:

• a 12-month physical activity intervention and a 12-month dietary counseling intervention delivered simultaneously;
• a 12-month counseling intervention first focusing on physical activity followed by the addition of dietary counseling;
• a 12-month counseling intervention first focusing on dietary counseling followed by the addition of physical activity counseling; or
• a 12-month attention-control condition focusing on stress-management skills training.

Data on physical activity participation, saturated fat consumption, and related quality of life indicators (e.g., improved physical functioning, fitness, sleep, and psychological well-being) will be collected at baseline, 4 months, 8 months, and 12 months post-test. The primary hypotheses are:

• participants assigned to the physical activity and dietary counseling conditions will show greater improvements in physical activity participation and saturated fat consumption at 12 months compared to the attention-control condition; and
• participants in the sequentially-delivered counseling interventions will show greater improvements in physical activity and saturated fat consumption compared to participants in the simultaneously-delivered interventions.

• Health Behavior
• Psychological Stress
• Healthy

• Wilcox S, King AC, Castro C, Bortz W. Do changes in physical activity lead to dietary changes in middle and old age? Am J Prev Med. 2000 May;18(4):276-83.
• King AC, Baumann K, O'Sullivan P, Wilcox S, Castro C. Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2002 Jan;57(1):M26-36.
• Castro CM, Wilcox S, O'Sullivan P, Baumann K, King AC. An exercise program for women who are caring for relatives with dementia. Psychosom Med. 2002 May-Jun;64(3):458-68.

Inclusion Criteria:

• Men and women ages 50 and older
• Current family caregiver
• Currently experiencing significant psychological stress
• Free of any medical condition that would limit participation in independent exercise
• Not currently engaged in a regular pattern of physical conditioning
• Current dietary pattern includes suboptimal total fat, saturated fat and vegetable and fruit consumption
• Free of chronic clinical psychopathology
• Stable on current medications
• Planning to remain in the geographic area throughout the duration of the trial
• Able to read and speak English sufficiently to understand protocol materials
• Able to use the telephone unaided
• Willing to accept random assignment to any study condition

Exclusion Criteria:

• Under the age of 50
• Currently under treatment for an acute, serious medical condition (e.g. cancer, heart disease, stroke)
• Physically active on a regular basis (i.e. performing more than 60 minutes per week of aerobic physical activity of at least a moderate intensity)
• Dietary patterns meet current recommendations for saturated fat and vegetable and fruit consumption
• Unstable and/or uncontrolled on medications for chronic medical conditions
• Unable or unwilling to use a telephone unaided
• Unwilling to accept random assignment to study condition