Center on the Family, University of Hawai'i at Mānoa, Honolulu, HI, United States.
Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, United States.
Front Public Health. 2022 Dec 16;10:977846. doi: 10.3389/fpubh.2022.977846. eCollection 2022.
Although physical activity (PA) is crucial for health, the literature is mixed about how individuals' PA decisions are affected by their spouses. To fill this gap, we examined the extent to which providing care for one spouse affects the PA of the other spouse among those aged 50 or older in the United States.
We analyzed 9,173 older adults living with their spouses or partners from the 2004 to 2016 waves of the Health and Retirement Study. To identify the causal effect of spousal caregiving on the PA of older adults, we estimated individual-fixed effects models using a two-stage least squared instrumental variable approach with spousal falls as our instrument. We also estimated the models by splitting the sample by gender and race/ethnicity to identify heterogeneous impacts of spousal caregiving on PA decisions among subgroups.
We found that a one percentage point increase in the probability of providing care to spouses led to an increase in the probability of initiating moderate or vigorous PA (MVPA) by 0.34-0.52 percentage points. This effect was salient, especially among female and non-Hispanic white older adults.
Caregiving experience might provide opportunities to learn about caregiving burdens and trigger an emotional response about the salience of an event (i.e., they need care in the future). Older caregivers might start MVPA in an effort to improve or maintain their health and avoid burdening their families for caregiving in the future. This study demonstrated spousal influence on PA. Instead of delivering PA-promotion information (e.g., the harm of sedentary lifestyle and benefits of regular PA) to individuals, risk communication and education efforts on PA promotion might be more effective considering the family context. Family events such as health shocks or the emergence of caregiving needs from family members provide windows of opportunities for intervening. Subgroup differences should also be considered in targeted interventions.
尽管身体活动（PA）对健康至关重要，但关于配偶如何影响个人 PA 决策的文献却存在差异。为了填补这一空白，我们研究了在美国，50 岁及以上的人群中，照顾一个配偶会在多大程度上影响另一个配偶的 PA。
我们分析了来自 2004 年至 2016 年健康与退休研究（Health and Retirement Study）的 9173 名与配偶或伴侣同住的老年人数据。为了确定配偶照顾对老年人 PA 的因果影响，我们使用两阶段最小二乘法工具变量法，以配偶跌倒为工具变量，估计个体固定效应模型。我们还按性别和种族/族裔对样本进行了划分，以确定配偶照顾对 PA 决策的异质影响。
我们发现，配偶照顾概率每增加一个百分点，开始进行中等强度或剧烈强度身体活动（MVPA）的概率就会增加 0.34-0.52 个百分点。这种影响尤其在女性和非西班牙裔白人老年人中更为明显。
照顾经验可能提供了解照顾负担的机会，并引发对事件重要性的情感反应（即他们将来需要照顾）。老年照顾者可能会开始进行 MVPA，以改善或维持他们的健康，并避免将来因照顾而给家庭带来负担。本研究表明配偶对 PA 有影响。与其向个人提供 PA 促进信息（例如，久坐生活方式的危害和定期 PA 的益处），考虑到家庭背景，风险沟通和教育努力可能更有利于 PA 促进。家庭事件，如健康冲击或家庭成员出现照顾需求，为干预提供了机会窗口。在有针对性的干预措施中，还应考虑到亚组差异。
