Ruth E Taylor-Piliae

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• Taylor-Piliae, R. E. (2008).

  The Effectiveness of Tai Chi Exercise in Improving Aerobic Capacity: An Updated Meta-Analysis

  . In Tai Chi Chuan: State-of-the-Art in International Research(pp Medicine and Sport Science, 52: 40-53.). Basel, Switzerland: S. Karger AG. doi:10.1159/000134283
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  To determine if Tai Chi exercise is effective in improving aerobic capacity.A computerized search of seven databases was conducted using the mesh term 'Tai Ji', published between January 1, 2000, and June 1, 2007, in order to update a previous meta-analysis examining the effect of Tai Chi on aerobic capacity. Effect sizes (ESs) and 95% confidence intervals were calculated using D-STAT software. The ES for each study was weighted by the sample size and pooled variance. The effects of Tai Chi exercise on aerobic capacity were calculated including study design, gender, age, and type of comparison group.A total of 170 citations were obtained, with 7 new studies meeting the inclusion criteria and added to studies from the previous meta-analysis. Large significant effects of Tai Chi on aerobic capacity were found for subjects enrolled in the cross-sectional studies (ES = 1.33), in both women and men (1.09 and 0.86, respectively), among adults > or =55 years old (ES = 1.07), and when comparing sedentary subjects with those in Tai Chi exercise groups (ES = 0.99). Small to moderate effects, though nonsignificant, were found for subjects enrolled in the experimental studies (ES = 0.38), adults or =55 years old.

Journals/Publications

• Dolan, H., & Taylor-Piliae, R. (2023). Expanding the Health Belief Model for exploring inpatient fall risk perceptions: A methodology paper. Journal of advanced nursing.
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  Inpatient falls among older adults are a relentless problem, and extant inpatient fall prevention research and interventions lack the older adults' perspectives and experiences of their own fall risk in the hospital. Theory-guided research is essential in nursing, and the purpose of this paper was to describe the process of developing a theoretical framework for a phenomenological nursing study exploring older adults' lived experiences of being at risk for falling in the hospital.
• Hodgson, C., Godfrey, T., DeCoteau, R. N., Allison-Burbank, J. D., & Taylor-Piliae, R. (2023). Social-Ecological Resilience of Indigenous Adolescents in the United States and Canada: A Situation-Specific Nursing Theory. ANS. Advances in nursing science.
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  For the past decade, resilience research with American Indian/Alaska Native and First Nations/Métis/Inuit adolescents has improved our understanding of how adolescents overcome mental health challenges. A new situation-specific theory is presented to guide nurses in applying the evidence to their practice with Indigenous adolescents in the United States and Canada. The social-ecological resilience of indigenous adolescents (SERIA) theory was derived from integrating (a) existing social-ecological frameworks by Bronfenbrenner, Ungar, and Burnette and Figley, (b) findings from a systematic review of 78 studies about resilience factors for mental health of Indigenous adolescents, (c) clinical experience, and (d) Indigenous knowledge.
• Hodgson, C., Taylor-Piliae, R., & Rainbow, J. (2023). Understanding the resilience of children living on an American Indian reservation: A mixed methods participatory study. Journal of advanced nursing, 79(11), 4411-4424.
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  To explore the resilience of children, six to thirteen years old, living on a Northern Plains American Indian Reservation using a situation specific nursing theory.
• Dolan, H., Rishel, C., Rainbow, J. G., & Taylor-Piliae, R. (2022). Relying on myself: The lived experience of being at risk for falling in the hospital among older adults. Geriatric nursing (New York, N.Y.), 47, 116-124.
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  Inpatient fall rates have not significantly decreased the last decade. Older adults have an estimated 50% greater inpatient fall rate than younger adults. How older adults perceive their own fall risk affects their adherence to fall prevention recommendations. The aim of this phenomenological study was to understand the lived experiences of being at risk for falling in the hospital among older adults. Nine participants (N=9) aged 65 years and older (female=55%) were interviewed twice using online video-conferencing after hospital discharge, and interview data was analyzed using van Manen's interpretive phenomenological method. Five major interpretive themes emerged: Relying on Myself, Managing Balance Problems in an Unfamiliar Environment, Struggling to Maintain Identity, Following the Hospital Rules, and Maintaining Dignity in the Relationships with Nursing Staff. Hospitalized older adults employed their self-efficacy to manage balance problems in the hospital. Additional fall prevention interventions supporting hospitalized older adults' self-management of fall risk are needed.
• Marupuru, S., Bell, M. L., Grandner, M. A., & Taylor-Piliae, R. E. (2022). The Effect of Physical Activity on Sleep Quality among Older Stroke Survivors: Secondary Analysis from a Randomized Controlled Trial. International journal of environmental research and public health, 19(20).
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  Poor sleep quality constitutes one of the most common difficulties faced by stroke survivors. Physical activity has been shown to improve sleep quality among healthy adults. The study objective was to examine the effect of physical activity on sleep outcomes in community-dwelling stroke survivors previously enrolled in a randomized clinical trial (RCT). Secondary analysis of data collected in the RCT was used to examine the effects of physical activity (PA) on sleep outcomes using the Pittsburgh Sleep Quality Index (PSQI), compared to usual care (controls). Unadjusted and adjusted mixed effects models were used to model changes in sleep quality between groups. At baseline, poor sleep quality (PSQI > 5) was reported by about half of the participants (PA group = 48.5%, n = 47/97; controls = 56.3%, n = 27/48). Results from the unadjusted and adjusted models for sleep quality were similar and showed no statistically significant differences between groups ( > 0.05). In the unadjusted model, the difference between groups (change from baseline to 24 weeks) showed that the PA group had better sleep quality than the controls (difference= -1.02 points, 95% CI -2.12, 0.07, = 0.07). In the model adjusted for age, social support, and marital status, the difference between groups (change from baseline to 24 weeks) showed that the PA group had better sleep quality than the controls (difference= -1.07 points, 95% CI -2.19, 0.05, = 0.06). PA did not significantly improve sleep quality in older community-dwelling stroke survivors. Further research is needed to confirm or refute these findings.
• Morrison, H. W., White, M. M., Rothers, J. L., & Taylor-Piliae, R. E. (2022). Examining the Associations between Post-Stroke Cognitive Function and Common Comorbid Conditions among Stroke Survivors. International journal of environmental research and public health, 19(20).
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  A considerable complication for stroke survivors is the subsequent development of cognitive decline or dementia. In this study, the relationship between the inflammation-centered comorbidity burden on post-stroke cognitive function among community-dwelling stroke survivors capable of independent living was examined. Data for this secondary analysis were collected from stroke survivors (n = 97) participating in a randomized clinical trial. Participants provided baseline responses, regarding cognitive function (mini-mental status exam, MMSE; Montreal cognitive assessment, MoCA), history of stroke comorbid conditions, and the Stroke Prognosis Instrument-II (SPI-II), an index of stroke comorbidity and recurrent stroke risk within the next two years. Relationships and differences between groups were tested for significance using Spearman's correlation, Kruskal-Wallis, or Mann-Whitney U tests. Most stroke survivors (69%) had multiple comorbidities. Total SPI-II scores were negatively correlated to both MoCA and MMSE scores (r = -0.25, = 0.01; r = -0.22, = 0.03, respectively), and differences in MoCA scores among SPI-II risk groups (low, medium, high) were evident ( = 0.05). In contrast, there were no differences in MoCA or MMSE scores when comorbid conditions were examined individually. Lastly, no gender differences were evident in cognitive assessments. Our data support the premise that comorbidity's burden impacts post-stroke cognitive decline, more than a single comorbid condition. Inflammation may be an important component of this comorbidity burden. Future studies that operationalize this concept will better illuminate the complex phenomenon of post-stroke cognitive decline for improved clinical rehabilitation modalities.
• Taylor-Piliae, R. E., Loescher, L. J., & Webber-Ritchey, K. J. (2022).

  Recruiting African American parents of school-aged children in a physical activity study: Lessons learned

  . Chronic Illness. doi:10.1177/1742395320928389
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  To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge.Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment.We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers (n = 87, 69%) and males/fathers (n = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust.Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.
• Vandegrift, M. A., & Taylor-Piliae, R. E. (2022). Selecting a theoretical framework for chronic cardiovascular disease self-management among rural dwelling adults. Applied nursing research : ANR, 65, 151585.
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  A paucity of research has examined the factors and perceptions of self-management among individuals living rurally with chronic cardiovascular disease (CCVD). Exploration of this population is prudent as CCVD continues to be the leading cause of mortality within the United States (US). As the US population ages, increased rates of CCVD and the process of managing the disease will continue to challenge patients and the health care system. Rural dwelling adults are faced with additional complexities to manage a chronic disease, resulting in higher rates of chronic disease as compared to urban dwellers. It is essential for nurses working with adults living with CCVD in rural areas to promote self-management strategies derived from a theoretical perspective. The purpose of this paper is to examine theories and models that facilitate self-management of CCVD among rural dwelling adults. Three established self-management theories and models from psychology and public health were evaluated using Walker and Avant's framework for theory analysis. Social cognitive theory was selected as a best fit for self-management of CCVD among rural dwelling adults, due to the symbiosis of chronic disease, and applicability of ruralness within the triadic reciprocal causation of person-behavior-environment of the model.
• Dolan, H. R., Alvarez, A. A., Freylersythe, S. J., Penaloza, I., Grijalva, S., Taylor-Piliae, R., & Crane, T. E. (2021). Barriers and facilitators for adopting a healthy lifestyle among Latina cancer survivors: A qualitative descriptive study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer.
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  Cancer is the leading cause of death among Hispanics/Latinos in the USA. Latina cancer survivors experience higher symptom burden than other cancer survivors. A healthy lifestyle can decrease recurrent cancer risk, increase well-being, and may decrease symptom burden in cancer survivors. The purpose of this study was to explore the barriers and facilitators for adopting healthy lifestyle behaviors among Latina cancer survivors.
• Dolan, H., Slebodnik, M., & Taylor-Piliae, R. (2021). Older adults' perceptions of their fall risk in the hospital: An integrative review. Journal of clinical nursing.
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  The objectives of this review are to determine what is currently known about older adults' perceptions of their own fall risk in the hospital and associated factors and explore how perceived fall risk in the hospital is assessed.
• Grandner, M., Morrison, H. W., Taylor-Piliae, R. E., Hsu, C. (., & Whitman, S. (2021). The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression. Evidence-Based Complementary and Alternative Medicine, 2021, 1-12. doi:10.1155/2021/8600443
• Hellem, T., Benavides-Vaello, S., & Taylor-Piliae, R. (2021). National Internet-Based Survey of the Use, Barriers, Reasons and Beliefs of Mind-Body Practices During the Early Months of the COVID-19 Pandemic. Journal of Evidence-Based Integrative Medicine, 26, 2515690X211006332. doi:10.1177/2515690X211006332
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  The purpose of this study was to learn about the use, barriers, reasons and beliefs regarding mind-body practices among adults living in the United States during the beginning months of the 2019 novel coronavirus disease (COVID-19) pandemic. An on-line survey was developed following the Checklist for Reporting Results of Internet e-Surveys (CHERRIES) guidelines and using the online survey software program, Qualtrics , platform. Pilot testing of the survey was conducted for usability and functionality. The final 24-item survey was distributed via email and social media. A total of 338 adults responded to the survey, with 68.8% indicating that they participated in mind-body activities since the start of the pandemic. Physical activity was the most frequently (61.5%, n = 227) used mind-body practice. Further, 2 of the common barriers to engaging in mind-body practices were lack of motivation and wandering mind. Frequently listed reasons for using mind-body practices were to promote health, reduce stress and relaxation. Respondents believed that mind-body practices resulted in less stress. These findings may be applicable for reducing psychological stress related to the pandemic, as the pandemic continues to impact many areas of the United States.
• Liu, T., Chan, A. W., Taylor-Piliae, R. E., Choi, K. C., & Chair, S. Y. (2021). Psychometric Properties of the Translated Tai Chi Exercise Self-Efficacy Scale for Chinese Adults with Coronary Heart Disease or Risk Factors. International journal of environmental research and public health, 18(7).
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  Tai Chi is an effective exercise option for individuals with coronary heart disease or its associated risk factors. An accurate and systematic assessment of a Mandarin-speaking adults' self-efficacy in maintaining Tai Chi exercise is lacking. Mandarin Chinese has the most speakers worldwide. This study aimed to translate the Tai Chi Exercise Self-Efficacy scale and examine its psychometric properties. The 14-item Tai Chi Exercise Self-Efficacy scale was translated from English into Mandarin Chinese using a forward-translation, back-translation, committee approach, and pre-test procedure. Participants with coronary heart disease or risk factors ( = 140) enrolled in a cross-sectional study for scale validation. Confirmatory factor analysis indicated a good fit of the two-factor structure (Tai Chi exercise self-efficacy barriers and performance) to this sample. The translated scale demonstrated high internal consistency, with a Cronbach's α value of 0.97, and good test-retest reliability, with an intra-class correlation coefficient of 0.86 ( < 0.01). Participants with prior Tai Chi experience reported significantly higher scores than those without ( < 0.001), supporting known-group validity. A significant correlation was observed between the translated scale and total exercise per week (r = 0.37, < 0.01), providing evidence of concurrent validity. The Mandarin Chinese version of the Tai Chi Exercise Self-Efficacy scale is a valid and reliable scale for Chinese adults with coronary heart disease or risk factors.
• McNair, N. D., Taylor-Piliae, R. E., & Fink, A. M. (2021). Council on Cardiovascular and Stroke Nursing Liaison Report: Updates From the Stroke Nursing Committee. The Journal of Cardiovascular Nursing, 36(1), 4-5.
• Miller, S. M., & Taylor-Piliae, R. E. (2021). Perceptions of the Eight Active Ingredients of Tai Chi Exercise among Older Adults. Journal of the International Society of Chinese Health Practices., 2(1), 1-9.
• Taylor-Piliae, R. E., Morrison, H. W., Hsu, C. P., Whitman, S., & Grandner, M. (2021). The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression. Evidence-based complementary and alternative medicine : eCAM, 2021, 8600443.
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  Depression is prevalent among one-third to two-thirds of acute and chronic stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even for 5-10 years after stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms. Thus, the feasibility of Tai Chi, alongside conventional care, to manage poststroke depression was investigated using a single-group pre-post intervention design. Recruitment and retention, intervention adherence, safety, acceptability, and fidelity were assessed. Symptoms of depression, anxiety, and stress were assessed using standardized questionnaires, objective sleep was assessed via a research-grade triaxial accelerometer, and blood samples were taken to measure oxidative stress, inflammatory markers, and a neurotrophic growth factor using commercially available kits per manufacturer's protocol. Pre-post intervention changes were assessed using paired -tests. We enrolled stroke survivors ( = 11, mean age = 69.7 ± 9.3) reporting depression symptoms. After the intervention, we observed significant reductions in symptoms of depression (-5.3 ± 5.9, =0.01), anxiety (-2.2 ± 2.4, =0.01), and stress (-4.6 ± 4.8, =0.01), along with better sleep efficiency (+1.8 ± 1.8, =0.01), less wakefulness after sleep onset (-9.3 ± 11.6, =0.04), and less time awake (-9.3 ± 11.6, =0.04). There was a 36% decrease in oxidative stress (=0.02), though no significant changes in the other biomarkers were found (all values >0.05). Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage poststroke depression, aid in reducing symptoms of anxiety and stress, and improve sleep.
• Taylor-Piliae, R., Dolan, H., & Yako, A. (2021). Stroke Survivors' Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study. International journal of environmental research and public health, 18(24).
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  Prior qualitative research conducted among stroke survivors to explore the potential benefits and challenges of participating in tai chi exercise during stroke recovery is limited to those without depression. A qualitative descriptive approach was used. Social Cognitive Theory and Complex Systems Biology provided the theoretical framework, with focus group interview data collected from stroke survivors after participation in a tai chi intervention. Due to COVID-19, the focus group interview was conducted via online video conferencing. Content analysis of the de-identified transcript was conducted with a-priori codes based on the theoretical framework and inductive codes that were added during the analysis process. Lincoln and Guba's criteria were followed to ensure trustworthiness of the data. Community-dwelling stroke survivors ( = 7) participating in the focus group interviews were on average 68 years old, mainly retired (71%, = 5), married women (57%, = 4) with >13 years education (86%, = 6). The three major themes were: personal efficacy beliefs, tai chi intervention active ingredients, and outcome expectations. Social Cognitive Theory underscored stroke survivors' personal efficacy beliefs, behavior, and outcome expectations, while Complex Systems Biology highlighted the active ingredients of the tai chi intervention they experienced. Participation in the 8-week tai chi intervention led to perceived physical, mental, and social benefits post stroke.
• Taylor-Piliae, R., Dolan, H., & Yako, A. (2021). Stroke survivors personal efficacy beliefs and outcomes expectations of tai chi exercise: a qualitative descriptive study. European Journal of Cardiovascular Nursing, 20(Supplement_1). doi:10.1093/eurjcn/zvab060.083
• Taylor-Piliae, R., Hellem, T., & Benavides-Vaello, S. (2021). National Internet-Based Survey of the Use, Barriers, Reasons and Beliefs of Mind-Body Practices During the Early Months of the COVID-19 Pandemic. Journal of Evidence-Based Integrative Medicine, 26, 2515690X2110063. doi:10.1177/2515690x211006332
• Taylor-Piliae, R., Rainbow, J., Rishel, C., & Dolan, H. (2021). Relying on Myself: The Lived Experience of Being at Risk for Falling in the Hospital Among Older Adults. Innovation in Aging, 5(Supplement_1), 950-950. doi:10.1093/geroni/igab046.3431
• Taylor-Piliae, R., Yao, Y., Ge, L., Yu, Q., Du, X., Zhang, X., & Wei, G. (2021). The Effect of Tai Chi Chuan on Emotional Health: Potential Mechanisms and Prefrontal Cortex Hypothesis. Evidence-Based Complementary and Alternative Medicine, 2021, 1-12. doi:10.1155/2021/5549006
• Yao, Y., Ge, L., Yu, Q., Du, X., Zhang, X., Taylor-Piliae, R., & Wei, G. X. (2021). The Effect of Tai Chi Chuan on Emotional Health: Potential Mechanisms and Prefrontal Cortex Hypothesis. Evidence-based complementary and alternative medicine : eCAM, 2021, 5549006.
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  Deep involvement in the negative mood over long periods of time likely results in emotional disturbances/disorders and poor mental health. Tai Chi Chuan (TCC) is regarded as a typical mind-body practice combining aerobic exercise and meditation to prevent and treat negative mood. Although there are an increasing number of TCC studies examining anxiety, depression, and mental stress, the mechanisms underlying these negative emotions are not fully understood. This review study examined TCC studies related to emotional health from both clinical patients and healthy individuals. Next, several potential mechanisms from physiological, psychological, and neurological perspectives were evaluated based on direct and indirect research evidence. We reviewed recent functional magnetic resonance imaging studies, which demonstrated changes in brain anatomy and function, mainly in the prefrontal cortex, following TCC practice. Finally, the effects of TCC on emotion/mental health is depicted with a prefrontal cortex hypothesis that proposed "an immune system of the mind" indicating the role of the prefrontal cortex as a flexible hub in regulating an individual's mental health. The prefrontal cortex is likely a key biomarker among the multiple complex neural correlates to help an individual manage negative emotions/mental health. Future research is needed to examine TCC effects on mental health by examining the relationship between the executive control system (mainly prefrontal cortex) and limbic network (including amygdala, insula, and hippocampal gyrus).
• Carlson, G., Crane, T. E., & Taylor-Piliae, R. E. (2020). Selecting a theoretical framework to explore the social and cognitive uncertainty that hepatitis C treatment represents for people who inject drugs. Applied Nursing Research, 56, 151339. doi:10.1016/j.apnr.2020.151339
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  Emerging research models for hepatitis C eradication suggest a social network-based treatment approach among people who inject drugs. It is essential for nurses to critically examine the influence of these social networks among people who inject drugs and the impact on their hepatitis C treatment decisions. The purpose of this paper is to describe the process of selecting a theoretical framework to guide a mixed methods study exploring the perceived uncertainty of individual hepatitis C treatment behaviors existing within the social networks of people who inject drugs. Using Walker and Avant's framework for theory analysis, four established theories and models from nursing science and psychology were reviewed. Aspects of both the Social Cognitive Theory and Uncertainty in Illness Theory were combined to form a theoretical framework, the Socio-Cognitive Uncertainty Model. This new theoretical framework describes the social and cognitive uncertainty that hepatitis C virus treatment represents for people who inject drugs. Taken together, social influence and social selection can inform the nurse's understanding of hepatitis C treatment acceptability among this high-risk social network- an important consideration in the pursuit of disease eradication.Carlson G, Crane TE, Taylor-Piliae RE. Selecting a theoretical framework to explore the social and cognitive uncertainty that hepatitis C treatment represents for people who inject drugs. Appl Nurs Res. 2020 Dec;56:151339. doi: 10.1016/j.apnr.2020.151339. Epub 2020 Aug 3. PMID: 32907767.
• Dolan, H. R., & Taylor-Piliae, R. E. (2020). Embarrassment Experienced by Older Adults in Relation to Accidental Falls: A Concept Analysis.. Geriatric Nursing, 41(6), 769-775. doi:10.1016/j.gerinurse.2020.05.007
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  Dolan H, Taylor-Piliae R. Embarrassment experienced by older adults in relation to accidental falls: A concept analysis. Geriatr Nurs. 2020 Nov-Dec;41(6):769-775. doi: 10.1016/j.gerinurse.2020.05.007. Epub 2020 Jun 8. PMID: 32522426.
• Finley, B. A., & Taylor-Piliae, R. E. (2020). Abstract P229: Benefits of Tai Chi Exercise Among Adults With Chronic Heart Failure: A Systematic Review and Meta-analysis. Circulation, 141(Suppl_1). doi:10.1161/circ.141.suppl_1.p229
• Finley, B. A., & Taylor-piliae, R. E. (2020). Tai Chi exercise for psychological well-being among adults with cardiovascular disease: A systematic review and meta-analysis.. European journal of cardiovascular nursing, 19(7), 580-591. doi:10.1177/1474515120926068
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  Regular exercise is beneficial for adults with cardiovascular disease to improve psychological well-being. Tai Chi is a mind-body exercise thought to promote psychological well-being..Examine the efficacy of Tai Chi in improving psychological well-being among persons with cardiovascular disease..An electronic literature search of 10 databases (AMED, CINAHL, Embase, OpenGrey, PsycARTICLES, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science) was conducted. Clinical trials that examined one or more aspect of psychological well-being, incorporated a Tai Chi intervention among cardiovascular disease participants, and were published in English or German languages were included. Comprehensive Meta-Analysis version 2.0 software (Biostat, Inc.) was used to calculate the effect sizes (i.e. Hedges' g) and the 95% confidence intervals using random effects models..A total of 15 studies met the inclusion criteria, enrolling 1853 participants (mean age = 66 years old, 44% women). Outcomes included: quality of life (QOL), stress, anxiety, depression, and psychological distress. When Tai Chi was compared with controls, significantly better general QOL (Hedges' g 0.96; p=0.02, I2=94.99%), mental health QOL (Hedges' g=0.20; p=0.01, I2=15.93) and physical health QOL (Hedges' g=0.40; p=0.00, I2=0%); with less depression (Hedges' g=0.69; p=0.00, I2=86.64%) and psychological distress (Hedges' g=0.58; p=0.00, I2=0%) were found..Few Tai Chi studies have been conducted during the past decade examining psychological well-being among older adults with cardiovascular disease. Further research is needed with more rigorous study designs, adequate Tai Chi exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Chi.
• Hayman, L. L., Taylor-Piliae, R. E., & Fink, A. M. (2020). Council on Cardiovascular and Stroke Nursing Liaison Report on Global Engagement Activities. The Journal of Cardiovascular Nursing, 35(1), 4-5.
• Lambert, L. M., Pike, N. A., Taylor-Piliae, R. E., & Fink, A. M. (2020). Council on Cardiovascular and Stroke Nursing Liaison Report: Pediatric Cardiovascular Nursing Committee. The Journal of Cardiovascular Nursing, 35(5), E15-E17.
• Miller, S. M., Hui-Lio, C., & Taylor-Piliae, R. E. (2020). Health Benefits of Tai Chi Exercise: A Guide for Nurses. The Nursing Clinics of North America, 55(4), 581-600.
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  Tai chi is an ancient Chinese internal martial art that has increased in popularity across the United States over the past 2 decades. Tai chi combines gentle physical movement, mental imagery, and natural, relaxed breathing. There is increasing scientific evidence showing the impact of tai chi exercise on multifaceted areas of health and well-being, including positive effects on cognition, depression, anxiety, sleep, cardiovascular health, and fall prevention. A review of the health benefits of tai chi exercise is presented, as well as recommendations for nurses seeking to answer patient questions about tai chi.Miller SM, Hui-Lio C, Taylor-Piliae RE. Health Benefits of Tai Chi Exercise: A Guide for Nurses. Nurs Clin North Am. 2020 Dec;55(4):581-600. doi: 10.1016/j.cnur.2020.07.002. Epub 2020 Oct 13. PMID: 33131634.
• Taylor-Piliae, R. E., & Dolan, H. (2020).

  Embarrassment experienced by older adults in relation to accidental falls: A concept analysis

  . Geriatric Nursing. doi:10.1016/j.gerinurse.2020.05.007
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  • The feeling of embarrassment is associated with accidental falls and being at risk for falling in older adults. • Embarrassment can be a barrier for adopting fall prevention strategies in older adults. • This concept analysis offers a definition of embarrassment in relation to older adults at risk for falling. • Recognition of embarrassment and improved management strategies of this emotion can increase older adults’ adherence to fall prevention. • Including assessment of embarrassment in fall prevention can promote adherence and may reduce falls among older adults. Embarrassment is commonly felt by older adults experiencing a fall, and embarrassment may cause older adults to adopt maladaptive behaviors by not implementing fall prevention strategies. Clarifying the concept of embarrassment for nursing and defining the concept as it relates to accidental falls and fall prevention among older adults was conducted using Walker and Avant's eight-step concept analysis process. The proposed definition of embarrassment experienced by older adults in relation to accidental falls is: The feeling of physical discomfort and exposure in a social situation due to the loss of control and self-esteem, as well as the inconsistency between one's personal identity as an independent and dignified person and the accidental fall or near fall behavior that threatens independence and dignity leading to emotional distress. Nurses recognizing older adults’ potential fall-related embarrassment may increase older adults’ adherence to fall prevention strategies and improve health outcomes.
• Taylor-Piliae, R. E., & Finley, B. A. (2020). Benefits of Tai Chi Exercise among Adults with Chronic Heart Failure: A Systematic Review and Meta-Analysis.. Journal of Cardiovascular Nursing, 35(5), 423–434. doi:10.1097/JCN.0000000000000703
• Taylor-Piliae, R. E., & Finley, B. A. (2020). Tai Chi Exercise for Psychological Well-Being among Adults with Cardiovascular Disease: A Systematic Review and Meta-Analysis.. European Journal of Cardiovascular Nursing, 19(7), 580-591. doi:10.1177/1474515120926068
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  Taylor-Piliae RE, Finley BA. Tai Chi exercise for psychological well-being among adults with cardiovascular disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2020 Oct;19(7):580-591. doi: 10.1177/1474515120926068. Epub 2020 Jun 9. PMID: 32515204.
• Taylor-Piliae, R. E., Zeimantz, M. A., Dolan, H., & Rosenfeld, A. G. (2020). Stroke Survivors' Feelings and Perceptions of Their Recovery After a Tai Chi Exercise Intervention: A Qualitative Descriptive Study. The Journal of Cardiovascular Nursing, 35(5), 468-474. doi:10.1097/JCN.0000000000000667
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  Most tai chi studies conducted among stroke survivors have focused on physical functioning, whereas inclusion of stroke survivors' feelings and perceptions of participating in tai chi is lacking.
• Taylor-piliae, R. E., & Dolan, H. (2020). Embarrassment experienced by older adults in relation to accidental falls: A concept analysis.. Geriatric nursing (New York, N.Y.), 41(6), 769-775. doi:10.1016/j.gerinurse.2020.05.007
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  Embarrassment is commonly felt by older adults experiencing a fall, and embarrassment may cause older adults to adopt maladaptive behaviors by not implementing fall prevention strategies. Clarifying the concept of embarrassment for nursing and defining the concept as it relates to accidental falls and fall prevention among older adults was conducted using Walker and Avant's eight-step concept analysis process. The proposed definition of embarrassment experienced by older adults in relation to accidental falls is: The feeling of physical discomfort and exposure in a social situation due to the loss of control and self-esteem, as well as the inconsistency between one's personal identity as an independent and dignified person and the accidental fall or near fall behavior that threatens independence and dignity leading to emotional distress. Nurses recognizing older adults' potential fall-related embarrassment may increase older adults' adherence to fall prevention strategies and improve health outcomes.
• Tong, B. Y., Taylor-piliae, R. E., Shaffer, R. B., & Fink, A. M. (2020). American Heart Association/American Stroke Association Cardiovascular and Stroke Nursing Council: Liaison Report From the Cardiovascular Nursing Clinical Symposium Planning Committee. Journal of Cardiovascular Nursing, 35(6), E115-E116. doi:10.1097/jcn.0000000000000751
• Webber-Ritchey, K. J., Taylor-Piliae, R. E., & Loescher, L. J. (2020). Recruiting African American parents of school-aged children in a physical activity study: Lessons learned. Chronic illness, 1742395320928389.
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  To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge.
• Davis, L. L., Fink, A. M., & Taylor-Piliae, R. E. (2019). American Heart Association Council on Cardiovascular and Stroke Nursing Liaison Report From the Development Committee. The Journal of cardiovascular nursing, 34(5), 361-363.
• Dolan, H., & Taylor-Piliae, R. (2019). Selecting a theoretical framework to guide a research study of older adults' perceptions and experiences of falling in the hospital. Applied nursing research : ANR, 47, 38-40.
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  A paucity of research has explored the older adult's experience of falling in the hospital. Understanding the central concepts associated with a fall while hospitalized is essential for further fall prevention research and practice. The purpose of this paper is to describe the process of selecting a theoretical framework to guide a qualitative study exploring the older adult's experience of falling while hospitalized. An analysis of six established illness self-management theories and models from nursing and psychology was conducted using Walker and Avant's framework for theory analysis. The Health Belief Model was selected as the most appropriate theoretical framework, as it entails concepts applicable to the experience of falling and captures the complexity of the phenomenon of inpatient falls, which is important for nursing.
• Fink, A. M., & Taylor-Piliae, R. E. (2019). Council on Cardiovascular and Stroke Nursing Liaison Report. The Journal of cardiovascular nursing, 34(1), 9-10.
• Gallek, M., Taylor-piliae, R. E., Taylor-piliae, R. E., Ritter, L. S., Pace, T. W., & Gallegos, J. L. (2019). Abstract P024: Hidden Risks: Relationship Among Visceral Adipose Tissue, Interleukin-18, and Adiponectin in the Development of Type 2 Diabetes in Filipino Americans. Circulation, 139(Suppl_1). doi:10.1161/circ.139.suppl_1.p024
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  Background and Aims: Filipino Americans (FAs) are at high risk for developing type 2 diabetes however little research exists as to why this occurs. There is evidence that pro-inflammatory Interleuk...
• Leung, L. Y., Chan, A. W., Sit, J. W., Liu, T., & Taylor-Piliae, R. E. (2019). Tai Chi in Chinese adults with metabolic syndrome: A pilot randomized controlled trial. Complementary therapies in medicine, 46, 54-61.
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  To determine the feasibility, acceptability and effects of a 12-week Tai Chi exercise program on cardiometabolic risk factors and quality of life in community-dwelling Chinese adults with metabolic syndrome.
• Rosenfeld, A. G., Zeimantz, M. A., & Taylor-piliae, R. E. (2019).

  Abstract WP509: Stroke Survivors’ Perceptions of Well-Being and Recovery After a Tai Chi Exercise Intervention

  . Stroke, 50(Suppl_1). doi:10.1161/str.50.suppl_1.wp509
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  Background: Tai Chi exercise is known to improve health and well-being among older adults. Most Tai Chi studies conducted among stroke survivors have focused on physical functioning, whereas inclusion of stroke survivors’ feelings and perceptions of Tai Chi is lacking. Understanding the benefits and difficulties of participating in Tai Chi exercise from stroke survivors’ perspectives is important for healthcare providers to investigate. Objective: Using storytelling, we sought to identify stroke survivors’ feelings and perceptions of participating in a Tai Chi intervention during their post-stroke recovery. Methods: This descriptive qualitative study examined stories from community-dwelling stroke survivors, collected as part of a larger randomized clinical trial. Participants (n=17) were on average 71 years old (range=54-87 years) mainly men (65%); and had the option of writing their own story or having someone write it for them. To examine these stories, an inductive content analysis approach was used with a priori theoretical codes (and sub-codes): 1.) Feelings (confidence, enjoy, hopeful, helpful, other), and 2.) Perceptions of Impact (physical abilities, mental/cognitive abilities, challenges, other). Lincoln and Guba’s criteria were followed to ensure trustworthiness of the data. Results: When examining these stories, the majority of stroke survivors felt that participating in a Tai Chi intervention was helpful and enjoyable, and some felt improved confidence. Further, they perceived the impact of Tai Chi on their post-stroke recovery led to improved physical abilities, such as better balance and walking, along with fewer falls. Likewise, stroke survivors perceived that their mental and cognitive abilities improved due to learning a sequence of Tai Chi movements. There were no perceived challenges. Overall, they perceived the impact of Tai Chi helped them to be more independent, move forward, develop friendships and make connections in their communities again. Conclusions: Using storytelling, healthcare providers can discuss the benefits of Tai Chi and then relate the feelings and perceptions of other stroke survivors’ experiences to encourage engagement in regular physical activity to aid in the post-stroke recovery process.
• Taylor-Piliae, R. E., Bell, M., & Marupuru, S. (2019).

  PND8 THE EFFECT OF PHYSICAL ACTIVITY ON SLEEP QUALITY AMONG OLDER STROKE SURVIVORS: SECONDARY ANALYSIS FROM A RANDOMIZED CONTROLLED TRIAL

  . Value in Health. doi:10.1016/j.jval.2019.04.1281
• Taylor-Piliae, R. E., Hsu, C., Toosizadeh, N., & Mohler, M. J. (2019). A Novel Dual-Task Balance Challenge to Prevent Falls in Older Adults: A Randomized Pilot Study. Journal of Geriatric Medicine and Gerontology, 5, 075. doi:Doi:10.23937/2469-5858/1510075
• Taylor-piliae, R. E., Hsu, C. H., Toosizadeh, N., Taylor-piliae, R. E., Mohler, J., & Hsu, C. H. (2019). Abstract P258: Novel Dual-task Balance Challenge to Prevent Falls in Older Adults With Cardiovascular Disease Risk Factors. Circulation, 139(Suppl_1). doi:10.1161/circ.139.suppl_1.p258
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  Background: Fall injuries are responsible for significant health care utilization, disability, loss of independence, and high costs among community-dwelling older adults with cardiovascular disease risk factors (CVD-RF). A Matter of Balance (MOB) is a national community-based fall prevention program, which focuses on cognitive restructuring to manage concerns about falling, but does not include a balance-training component. We hypothesize if MOB added to a dual-task balance challenge (DTBC) comprising weight transfer using fixed and random ordering of ankle reaching tasks, while simultaneously challenging attention—would lead to reduced fall risk. Objectives: To assess participants’ acceptance and satisfaction with the 4-week MOB and MOB plus DTBC interventions, safety and adherence, and examine changes in fall risk (balance, gait, and fear of falling) post-intervention. Methods: A single-blind, two-group, randomized pilot study, among community-dwelling older adults with CVD-RF at high fall risk. MOB classes were 2-hours, 2x/week for 4 weeks, with 15 minutes of social time. MOB+DTBC classes followed the same curriculum with 15 minutes of ankle reaching tasks while simultaneously challenging attention. Acceptability and satisfaction were obtained by self-report, study staff monitored safety and adherence during class. Balance and gait were objectively assessed using LEGSys™ (BioSensics, LLC), while the Falls Efficacy Scale International (FES-I) assessed fear of falling. We used t-tests for continuous variables and Fisher’s exact test for categorical variables. Results: At high fall risk older adults (n=16, mean age=74±8 years), mainly retired (95%, n=15), women (88%, n=14), with >13 years education (81%, n=13), diabetes (25%, n=4), dyslipidemia (70%, n=12), and hypertension (63%, n=10) completed the study (drop-outs, n=1). Participants reported high levels intervention acceptability and satisfaction (mean score=9±1.3, 1=least, 10=most), no safety issues (0%), with very high adherence rates (>94%), regardless of group assignment. Participants in the MOB group (n=7) had no significant within group changes in fall risk post-intervention (p>0.05). Conversely, participants in the MOB plus DTBC group (n=9) had significant improvements in balance (eyes open test=ankle sway, p=0.02; eyes closed test=hip sway, p=0.03 and center of mass, p=0.01) and gait (fast pace=stride time, p=0.04 and double support, p=0.02), with less fear of falling (p=0.04) post-intervention, when compared to baseline. Conclusions: Reducing fall risk factors and preventing falls are essential for older adults with CVD-RF, to ensure that they continue to live safely and independently. The addition of DTBC to the nationally-used standard MOB curriculum may enhance both balance and cognitive function, and lead to reduced fall risk among community-dwelling older adults with CVD-RF.
• Wang, Q., Chair, S. Y., Wong, E. M., Taylor-Piliae, R. E., Qiu, X. C., & Li, X. M. (2019). Metabolic Syndrome Knowledge among Adults with Cardiometabolic Risk Factors: A Cross-Sectional Study. International journal of environmental research and public health, 16(1).
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  Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors. Many people may be unaware of their risk for MetS. A cross-sectional, descriptive study was conducted among hospitalized patients with at least one cardiometabolic risk factor in Mainland China. This study assessed the MetS knowledgelevel(through MetS Knowledge Scale, MSKS) and examined the potential predictors by regression analysis. A total of 204 patients aged 58.5 ± 10.1 years (55% males) participated in this study. The majority of participants had no history of hypertension (54%), dyslipidemia (79%), or diabetes (85%). However, 56% of these participants had at least three cardiometabolic risk factors, indicating the presence of MetS. The average MSKS was very low (mean = 36.7±18.8, possible range = 0⁻100), indicating the urgent needs of MetS education in current practice. Predictors of better MetS knowledge included higher educational level, history of dyslipidemia, and normal high-density lipoprotein cholesterol (F (8, 195) = 9.39, adjusted R² = 0.192, p< 0.001). In conclusion, adults with cardiometabolic risk factors are at risk of developing MetS, but with a low level of knowledge. Specific health education on MetS should be provided, particularly for those with limited formal education or inadequate lipid management.
• Wang, Q., Chair, S. Y., Wong, E. M., Taylor-Piliae, R. E., Qiu, X. C., & Li, X. M. (2019). Metabolic Syndrome Knowledge among Adults with Cardiometabolic Risk Factors: a cross-sectional study.. International Journal of Environmental Research and Public Health, 16(1), 159. doi:doi:10.3390/ijerph16010159
• Chair, S. Y., Chan, C. W., Yu, D. S., & Taylor-Piliae, R. E. (2018). Changes in nursing education in Hong Kong - Progressive or regressive?. Nurse education today, 64, 150-152.
• Chan, A. W., Chair, S. Y., Lee, D. T., Leung, D. Y., Sit, J. W., Cheng, H. Y., & Taylor-Piliae, R. E. (2018). Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial. International journal of nursing studies, 88, 44-52.
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  Physical inactivity is a major modifiable lifestyle risk factor associated with cardiovascular disease. Tai Chi is a safe and popular form of physical activity among older adults, yet direct comparisons are lacking between Tai Chi and brisk walking in their ability to reduce cardiovascular disease risk factors and improve psychosocial well-being.
• Chan, A. W., Tang, F. W., Choi, K. C., Liu, T., & Taylor-Piliae, R. E. (2018). Clinical learning experiences of nursing students using an innovative clinical partnership model: A non-randomized controlled trial. Nurse education today, 68, 121-127.
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  Clinical practicum is a major learning component for pre-registration nursing students. Various clinical practicum models have been used to facilitate students' clinical learning experiences, employing both university-based and hospital-based clinical teachers. Considering the strengths and limitations of these clinical practicum models, along with nursing workforce shortages, we developed and tested an innovative clinical partnership model (CPM) in Hong Kong.
• Miller, S., & Taylor-Piliae, R. E. (2018). The association between Tai Chi exercise and safe driving performance among older adults: An observational study. Journal of sport and health science, 7(1), 83-94.
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  Age-related cognitive and physical decline can impair safe driving performance. Tai Chi exercise benefits cognitive and physical function and may influence safe driving performance in older adults. The primary aim of this observational study was to compare cognitive processes and physical function related to safe driving performance among older adult Tai Chi practitioners to normative reference values. Secondary aims were to examine relationships between Tai Chi exercise habits, cognitive processes, and physical function related to safe driving performance and to explore potential predictors of safe driving performance.
• Taylor-Piliae, R. E., & Fink, A. M. (2018). Council on Cardiovascular and Stroke Nursing Liaison Report. Journal of Cardiovascular Nursing, 33(3), 202-203.
• Taylor-Piliae, R. E., & Fink, A. M. (2018). Council on Cardiovascular and Stroke Nursing Liaison Report. Journal of Cardiovascular Nursing, 33(4), 304-305. doi:10.1097/JCN.0000000000000502
• Taylor-Piliae, R. E., Fink, A. M., & Kitko, L. (2018). Council on Cardiovascular and Stroke Nursing Liaison Report. Journal of Cardiovascular Nursing, 33(3), 202-203. doi:10.1097/JCN.0000000000000479
• Taylor-piliae, R. E., Liu, Y. H., Liu, T., & Chan, A. W. (2018). Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis.. European journal of cardiovascular nursing, 17(4), 368-383. doi:10.1177/1474515117749592
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  Tai Chi is an attractive exercise to improve cardiovascular health. This review aimed to synthesize articles written both in Chinese and in English to evaluate the effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being and cardiovascular diseases risk reduction for coronary heart diseases patients..PRISMA guidelines were used to search major health databases to identify randomized controlled trials or non-randomized controlled clinical trials that evaluated Tai Chi intervention compared with active or non-active control groups in coronary heart disease patients. When suitable, data were pooled using a random-effects meta-analysis model..Thirteen studies met the inclusion criteria. Tai Chi groups showed a large and significant improvement in aerobic endurance compared with both active and non-active control interventions (standard mean difference (SMD) 1.12; 95% confidence interval (CI): 0.58-1.66; p
• Taylor-piliae, R. E., Sit, J. W., Leung, D. Y., & Chan, A. W. (2018). Abstract MP34: Tai Chi Exercise is More Effective Than Brisk Walking in Reducing Cardiovascular Disease Risk Factors. Circulation, 137(suppl_1). doi:10.1161/circ.137.suppl_1.mp34
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  Background: Physical inactivity is one of the major modifiable lifestyle risk factors associated with cardiovascular disease (CVD). Tai Chi (TC) is safe and popular among older adults; yet direct c...
• Toosizadeh, N., Tirambulo, C. V., Taylor-piliae, R. E., Sutherland-mills, C., Mohler, J., & Hsu, P. (2018).

  ENHANCING A MATTER OF BALANCE FALL INTERVENTION WITH A PILOT DUAL TASK BALANCE CHALLENGE

  . Innovation in Aging, 2(suppl_1), 517-517. doi:10.1093/geroni/igy023.1916
• Webber-Ritchey, K. J., Taylor-Piliae, R. E., & Loescher, L. J. (2018). Physical Activity in Parents of Young African American Children: The Application of Social Cognitive Theory. Research and Theory for Nursing Practice, 32(1), 63-81. doi:10.1891/0000-000Y.32.1.63.
• Liu, T., Chan, A. W., Liu, Y. H., & Taylor-Piliae, R. E. (2017). Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. doi:doi: 10.1177/1474515117749592
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  Tai Chi is an attractive exercise to improve cardiovascular health. This review aimed to synthesize articles written both in Chinese and in English to evaluate the effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being and cardiovascular diseases risk reduction for coronary heart disease patients.
• Sit, J. W., Chair, S. Y., Choi, K. C., Chan, A. W., Qiu, X., & Taylor-Piliae, R. E. (2017). Strategies for Enhancing Stroke Self-management Among Older Stroke Survivors: A Mixed Methods Inquiry.. Stroke, 48, ANS7.
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  Sit, J.W., Chair, S.Y., Choi, K.C., Chan, C.W., Chan, A.W., Qiu, X. & Taylor-Piliae, R.E. Strategies for Enhancing Stroke Self-management Among Older Stroke Survivors: A Mixed Methods Inquiry. Stroke, 48:ANS7, 2017.
• Taylor, E., & Taylor-Piliae, R. E. (2017). The effects of Tai Chi on physical and psychosocial function among persons with multiple sclerosis: A systematic review. Complementary therapies in medicine, 31, 100-108.
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  Conduct a systematic review to evaluate the effects of Tai Chi on physical and psychosocial function among individuals with Multiple Sclerosis.
• Taylor-Piliae, R. E., Peterson, R., & Mohler, M. J. (2017). Clinical and Community Strategies to Prevent Falls and Fall-Related Injuries among Community-Dwelling Older Adults.. Nursing Clinics of North America, 52(3), 489-497.
• Taylor-Piliae, R. E., Sit, J. W., Chair, S. Y., Choi, K. C., Chan, C. W., Chan, A. W., & Qiu, X. (2017). Abstract NS7: Strategies for Enhancing Stroke Self-management Among Older Stroke Survivors: A Mixed Methods Inquiry. Stroke, 48(suppl_1). doi:10.1161/str.48.suppl_1.ns7
• Ćwiękała-Lewis, K. J., Gallek, M., & Taylor-Piliae, R. E. (2017). The effects of Tai Chi on physical function and well-being among persons with Parkinson's Disease: A systematic review. Journal of Bodywork and Movement Therapies, 21(2), 414-421.
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  Current medical treatments for Parkinson's disease (PD) are mainly palliative, though research indicates Tai Chi exercise improves physical function and well-being. An electronic database search of PubMed, CINAHL, Web of Science, Cochrane Library, PsycINFO and Embase was conducted, to examine current scientific literature for potential benefits of Tai Chi on physical function and well-being among persons with PD. A total of 11 studies met the inclusion criteria: 7 randomized clinical trials and 4 quasi-experimental studies. PD participants (n = 548) were on average age 68 years old and 50% women. Overall, participants enrolled in Tai Chi had better balance and one or more aspect of well-being, though mixed results were reported. Further research is needed with more rigorous study designs, larger sample sizes, adequate Tai Chi exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Chi, before widespread recommendations can be made.
• Argenbright, C. A., Taylor-Piliae, R. E., & Loescher, L. J. (2016). Bowenwork for symptom management of women breast cancer survivors with lymphedema: A pilot study. Complementary therapies in clinical practice, 25, 142-149.
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  The objectives of this pilot study for women breast cancer survivors with lymphedema was 1) to evaluate recruitment rates, retention rates, adherence to Bowenwork (a noninvasive complementary therapy involving gentle muscle movements), home exercises, safety and comfort; 2) determine the effect of Bowenwork on quality of life (QOL), functional status, perceived pain, range of motion (ROM), arm/ankle circumference (to assess for localized and systemic changes).
• Giroud, X., Miramontes, M., Powell, M., Heasley, B., Taylor-Piliae, R. E., & Mohler, M. J. (2016). Dual Task Challenge- A Novel Addition to Community-Based Fall Intervention Programs.. Arizona Geriatrics Society Journal, 21(1), 8-11.
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  Giroud, X., Miramontes, M., Powell, M., Heasley, B., Taylor-Piliae, R. & Mohler, J. Dual Task Challenge- A Novel Addition to Community-Based Fall Intervention Programs. Arizona Geriatrics Society Journal, 21(1): 8-11, 2016.
• Miller, S. M., Taylor-Piliae, R. E., & Insel, K. C. (2016). The Association of Physical Activity, Cognitive Processes and Automobile Driving Ability in Older Adults: A Review of the Literature.. Geriatric Nursing, 37(4), 313-20. doi:10.1016/j.gerinurse.2016.05.004.
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  Miller, S.M., Taylor-Piliae, R.E. & Insel, K. C. The Association of Physical Activity, Cognitive Processes and Automobile Driving Ability in Older Adults: A Review of the Literature. Geriatric Nursing, 37(4):313-20, 2016.
• Mohler, M. J., Wendel, C. S., Taylor-Piliae, R. E., Toosizadeh, N., & Najafi, B. (2016). Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology. Gerontology, 62(6), 654-664.
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  Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately.
• Sit, J. W., Chair, S. Y., Choi, K. C., Chan, C. W., Lee, D. T., Chan, A. W., Cheung, J. L., Tang, S. W., Chan, P. S., & Taylor-Piliae, R. E. (2016). Do empowered stroke patients perform better at self-management and functional recovery after a stroke? A randomized controlled trial. Clinical interventions in aging, 11, 1441-1450.
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  Self-management after a stroke is a challenge because of multifaceted care needs and complex disabling consequences that cause further hindrance to patient participation. A 13-week stroke patient empowerment intervention (Health Empowerment Intervention for Stroke Self-management [HEISS]) was developed to enhance patients' ability to participate in self-management.
• Taylor-Piliae, R. E. (2016). Tai Chi Exercise for Fall Prevention in Older Adults.. Arizona Geriatrics Society Journal, 21(1), 14-20.
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  Taylor-Piliae, R.E. Tai Chi Exercise for Fall Prevention in Older Adults. Arizona Geriatrics Society Journal, 21(1): 14-20, 2016.
• Taylor-Piliae, R. E., Mohler, M. J., Najafi, B., & Coull, B. M. (2016). Objective fall risk detection in stroke survivors using wearable sensor technology: a feasibility study. Topics in stroke rehabilitation, 23(6), 393-399.
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  Stroke survivors often have persistent neural deficits related to motor function and sensation, which increase their risk of falling, most of which occurs at home or in community settings. The use of wearable technology to monitor fall risk and gait in stroke survivors may prove useful in enhancing recovery and/or preventing injuries.
• Taylor-piliae, R. E., Webber-ritchey, K. J., Taylor-piliae, R. E., & Loescher, L. J. (2016). Abstract P135: Predictors of Physical Activity Among African American Parents of Young Children: Personal and Environmental Factors. Circulation, 133(suppl_1). doi:10.1161/circ.133.suppl_1.p135
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  Introduction: Regular physical activity (PA) is associated with decreased risk of cardiovascular disease (CVD). Prior research efforts to increase PA among African Americans (AAs) have not been effective in achieving recommended levels. Understanding factors that influence PA using a theory-based approach is needed. Methods: Cross-sectional study using social cognitive theory as the framework. Data were collected using an online survey from 96 AA parents of young children aged 6-12 years, living in Chicago, IL (average age=36 years, 59% women, 72% college-educated, 60% annual income>$75,999) to describe PA (International Physical Activity Questionnaire-short form, IPAQ-S), personal (PA Knowledge, Exercise Self-Efficacy-ESE and Outcome Expectations-OE) and environmental factors (social economic status-MacArthur Subjective Social Status, neighborhood safety-Physical Activity Neighborhood Environmental Scale, and culture-African American Acculturation Scale). Spearman’s rho (rs) identified associations among...
• Webber-Ritchey, K. J., Taylor-Piliae, R. E., Insel, K. C., & Loescher, L. J. (2016). Physical Activity among African American Parents of Young Children: Roles of Personal and Environmental Factors.. International Journal of Sport Psychology, 47(6), 523-544. doi:doi: 10.7352/IJSP 2015.46.523
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  OBJECTIVES: To assess the factors that influence self-reported physical activity(PA).METHODS: African American (AA) parents/caregivers (n=96; M age=36years) completed an online survey to describe PA, personal (PA knowledge, exerciseself-efficacy-SE and outcome expectations-OE) and environmental factors (socialeconomic status-SES, neighborhood safety-NS, and culture).RESULTS: Moderate (30%, n=29) to high (54%, n=52) levels of PA werereported. There were significant correlations between PA and NS (rs=.25) and PAknowledge and PA (rs =-.30). Significant predictors of PA included SE (β=.21,t(84)=2.20, p=.030), NS (􀀀=.33, t(84)=3.56, p=.001), and an unexpected inverse ofPA knowledge (β=-.25, t(84)=-2.42, p=.018).CONCLUSIONS: Unlike prior studies, we found AA parents of young childrenwere physically active, knowledgeable of the PA guidelines, with moderate-highexercise SE, high SES, felt safe in their neighborhoods with a positive cultural identity.Future research examining the influence of AA parents’ PA on health indicatorsamong their children is needed next.
• Yip, C. W., Taylor-piliae, R. E., Tang, S. W., Sit, J. W., Choi, K. C., & Ching, R. (2016). Abstract NS7: The Effects of a Theory-based Health Empowerment Intervention on Self-management and Functional Recovery Post-stroke. Stroke, 47(suppl_1). doi:10.1161/str.47.suppl_1.ns7
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  Introduction: Self-management post-stroke is challenging due to its sudden and complex sequela. Identification of an effective intervention to foster self-management post-stroke is needed. We devel...
• Kraus, W. E., Bittner, V., Appel, L., Blair, S. N., Church, T., Després, J. P., Franklin, B. A., Miller, T. D., Pate, R. R., Taylor-Piliae, R. E., Vafiadis, D. K., Whitsel, L., & , A. H. (2015). The National Physical Activity Plan: a call to action from the American Heart Association: a science advisory from the American Heart Association. Circulation, 131(21), 1932-40.
• Schwenk, M., Mohler, J., Wendel, C., D'Huyvetter, K., Fain, M., Taylor-Piliae, R., & Najafi, B. (2015). Wearable sensor-based in-home assessment of gait, balance, and physical activity for discrimination of frailty status: baseline results of the Arizona frailty cohort study. Gerontology, 61(3), 258-67.
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  Frailty is a geriatric syndrome resulting from age-related cumulative decline across multiple physiologic systems, impaired homeostatic reserve, and reduced capacity to resist stress. Based on recent estimates, 10% of community-dwelling older individuals are frail and another 41.6% are prefrail. Frail elders account for the highest health care costs in industrialized nations. Impaired physical function is a major indicator of frailty, and functional performance tests are useful for the identification of frailty. Objective instrumented assessments of physical functioning that are feasible for home frailty screening have not been adequately developed.
• Taylor-Piliae, R. E., Keller, M. L., & Gallek, M. J. (2015). Predictors of Stroke Survivors’ Enrollment in an Exercise Study.. Healthy Aging Research, 4, 18-. doi:doi:10.12715/har.2014.4.18
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  Keller, M.L, Gallek, M.J. & Taylor-Piliae, R.E. Predictors of Stroke Survivors’ Enrollment in an Exercise Study. Healthy Aging Research 4:18, 2015. (doi:10.12715/har.2014.4.18)
• Hepworth, J. T., Najafi, B., Latt, L. D., Taylor-piliae, R. E., Latt, L. D., Hoke, T. M., & Coull, B. M. (2014).

  Abstract P428: Effects of Tai Chi on Physical Function and Quality of Life in Chronic Stroke

  . Circulation, 129(suppl_1). doi:10.1161/circ.129.suppl_1.p428
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  Background: Poor physical function and quality of life are ubiquitous post-stroke. Effective interventions to improve physical function and quality of life for stroke survivors are critically needed. Objective: Examine the effect of a Tai Chi (TC) intervention on physical function and quality of life. Methods: In a single-blind randomized clinical trial community-dwelling stroke survivors, aged ≥ 50 years and ≥ 3 months post-stroke, were assigned to: Yang style 24-posture TC (n=53), SilverSneakers® (SS, n=44) strength and range of movement exercise, or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Standardized measures for Physical Function were the Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest; and for Quality of Life were the Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. Results: A total of 145 stroke survivors (47% women, mean age=70 year...
• Hepworth, J. T., Najafi, B., Taylor-piliae, R. E., Latt, L. D., Hoke, T. M., & Coull, B. M. (2014). Abstract P428: Effects of Tai Chi on Physical Function and Quality of Life in Chronic Stroke. Circulation, 129(suppl_1). doi:10.1161/circ.129.suppl_1.p428
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  Background: Poor physical function and quality of life are ubiquitous post-stroke. Effective interventions to improve physical function and quality of life for stroke survivors are critically needed. Objective: Examine the effect of a Tai Chi (TC) intervention on physical function and quality of life. Methods: In a single-blind randomized clinical trial community-dwelling stroke survivors, aged ≥ 50 years and ≥ 3 months post-stroke, were assigned to: Yang style 24-posture TC (n=53), SilverSneakers® (SS, n=44) strength and range of movement exercise, or Usual Care (UC, n=48) for 12 weeks. TC and SS attended a 1-hour class 3 times/week, while UC had weekly phone calls. Standardized measures for Physical Function were the Short Physical Performance Battery (SPPB), Fall Rates and 2-Minute StepTest; and for Quality of Life were the Medical Outcomes Study SF-36, Center for Epidemiological Studies Depression and Pittsburgh Sleep Quality Index. Results: A total of 145 stroke survivors (47% women, mean age=70 years, time post-stroke=3 years, ischemic stroke=66%, hemiparesis=73%) enrolled. During the intervention, TC participants had 2/3 fewer falls (n=5 falls), than the SS (n=14 falls) and UC (n=15 falls) groups (χ2=5.60, p=0.06). All groups had improvements in the SPPB score (F 1,142 =85.29, p
• Miller, S. M., & Taylor-Piliae, R. E. (2014). Effects of Tai Chi on cognitive function in community-dwelling older adults: A review. Geriatric Nursing, 35(1), 9-19.
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  Abstract: As the population of the United States ages, activities to maintain or improve cognitive function will become increasingly important to preserve functional ability, independence and health-related quality of life. This article is a review of recent research on Tai Chi and cognitive function in community-dwelling older adults. Of the 12 studies reviewed, 10 reported improvement in measures of executive function, language, learning, and/or memory. Several design features make comparisons across studies challenging. As a moderate-intensity, low-impact form of exercise, Tai Chi is appropriate for older adults and seems to offer positive cognitive benefits. Recommendations for future research are provided. © 2014 Mosby, Inc.
• Najafi, B., Taylor-piliae, R. E., & Coull, B. M. (2014).

  Abstract NS18: Objective Fall Risk Detection in Stroke Survivors

  . Stroke, 45(suppl_1). doi:10.1161/str.45.suppl_1.ns18
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  Background: Stroke survivors fall up to 7 times more annually than healthy adults. Clinical and laboratory-based measures have failed to accurately predict falls/fall risk. A wearable mobile device for objectively detecting falls/fall risk in stroke survivors has recently been developed. Purpose: Determine the feasibility of monitoring falls, fall risk and gait in naturalistic environments using a kinematic motion sensor (PAMSys™) in stroke survivors. Methods: Feasibility study using PAMSys™ worn in a comfortable t-shirt to detect falls, identify posture (gait, sitting, standing, lying), postural transitions (fall risk indicators: duration in seconds, and number of unsuccessful attempts) and gait (steps, speed, duration). A questionnaire assessed acceptability of the PAMSys™. Stroke survivors (n=10) wore the PAMSys™ for 48 hours during usual daily activities, and were age-matched with controls (n=10). Results: Stroke survivors were on average 70±8 years old and 42±25 months post-stroke. The majority were 60% Caucasian, 70% women, 70% college-educated, and 80% retired; reporting 60% ischemic stroke, 40% hemorrhagic stroke, 70% hemiparesis, and 70% 1st stroke. Stroke survivors (100%) reported that the PAMSys™ was comfortable to wear for the full 48 hours, did not interfere with normal everyday activities and were willing to wear it for another 48 hours. None reported any difficulty with the PAMSys™ while sleeping, removing/putting back on for showering/changing clothes or that it became wet/dirty. Although there were no falls during the study, when compared to age-matched controls, stroke survivors had significantly worse fall risk indicators and decreased gait duration (see Table). Conclusion: Since the majority of fall-related events occur at home, the use of wearable mobile technology in stroke survivors may be essential to enhance recovery and prevent injuries. This device could be of use as an outcome measure in certain types of clinical trials.
• Taylor-Piliae, R. E. (2014). Tai Ji Quan as an exercise modality to prevent and manage cardiovascular disease: A review. Journal of Sport and Health Science, 3(1), 43-51.
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  Abstract: Background: Regular exercise is beneficial for adults with cardiovascular disease (CVD) and CVD risk factors. Tai Ji Quan is popular among older adults and may offer additional exercise options. The present article aims to review the scientific literature published within the past decade on Tai Ji Quan as an exercise modality to prevent and manage CVD. Methods: An electronic literature search of four databases (PubMed, CINAHL, PsycINFO, and AMED) was conducted from April 2003 through March 2013. Studies that examined Tai Ji Quan, were published in English, and specified a target study population of participants with a known CVD condition (e.g., coronary artery disease, chronic heart failure, or stroke) or studies conducted among participants with a CVD risk factor (e.g., hypertension, dyslipidemia, or impaired glucose metabolism) were included. Results: A total of 20 studies met the inclusion criteria: 11 randomized clinical trials, seven quasi-experimental studies and two cross-sectional studies. The effect of Tai Ji Quan was examined on more than 20 different study variables among persons with coronary artery disease (n=5 studies), chronic heart failure (n=5 studies), stroke (n=4 studies), and CVD risk factors (n=6 studies). These studies were conducted primarily in Asia (n=9, 45%) or the United States (n=8, 40%). Overall, participants enrolled in Tai Ji Quan had better outcomes, though mixed results were reported. Conclusion: Collectively, these studies indicate that Tai Ji Quan is a safe form of exercise to prevent and manage CVD. Further research is needed with more rigorous study designs, larger sample sizes, adequate Tai Ji Quan exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Ji Quan, before widespread recommendations can be made. © 2014 Shanghai University of Sport.
• Taylor-Piliae, R. E., Boros, D., & Coull, B. M. (2014). Strategies to improve recruitment and retention of older stroke survivors to a randomized clinical exercise trial. Journal of Stroke and Cerebrovascular Diseases, 23(3), 462-468.
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  Abstract: Background: Relatively few exercise randomized clinical trials (RCTs) among stroke survivors have reported the effectiveness of recruitment and retention strategies, despite its central importance to study integrity. Objective: Our objective is to examine recruitment and retention strategies used among a group of older community-dwelling stroke survivors for an exercise RCT. Methods: Recruitment strategies were multidimensional using both paid (ie, newspaper, radio and, television) and unpaid advertisements (ie, staff visits, flyers, and brochures placed at outpatient rehabilitation centers, physician offices, and community facilities working with older adults; free media coverage of the study, presentations at stroke support groups, relatives/friends, and study Web site) to obtain referrals. Retention strategies centered on excellent communication, the study participants' needs, and having dedicated study staff. Attrition rates and adherence to the intervention were used to examine the effectiveness of these retention strategies. Results: A total of 393 referrals were received, 233 persons were screened, and 145 stroke survivors enrolled in the study. During 3 years of study recruitment, we achieved 97% of our enrollment target. We enrolled 62% of those screened. Study enrollment from paid advertising was 21.4% (n = 31), whereas unpaid advertisements resulted in 78.6% (n = 114) of our participants. Attrition was 10% (n = 14 dropouts), and adherence to the intervention was 85%. Conclusions: Recruitment and retention of participants in an exercise RCT are time and labor intensive. Multiple recruitment and retention strategies are required to ensure an adequate sample of community-dwelling stroke survivors. Many of these strategies are also relevant for exercise RCTs among adults with other chronic illnesses. © 2014 by National Stroke Association.
• Taylor-Piliae, R. E., Hickey, K., Hodges, E., Thomas, T. L., Coffman, M. J., Johnson-Mallard, V. M., Goodman, J. H., Jones, R. A., Kuntz, S., Galik, E., Gates, M., & Casida, J. M. (2014). Initial Outcomes of the Robert Wood Johnson Foundation Nurse Faculty Scholars. Nursing Outlook, 62(6), 394-401.
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  Hickey, K., Hodges, E., Thomas, T. L., Coffman, M.J., Taylor-Piliae, R.E., Johnson-Mallard, V.M., Goodman, J.H., Jones, R. A., Kuntz, S., Galik, E., Gates, M.G., & Casida, J.M. Initial Outcomes of the Robert Wood Johnson Foundation Nurse Faculty Scholars. Nursing Outlook, 62(6): 394-401, 2014.
• Taylor-Piliae, R. E., Hoke, T. M., Hepworth, J. T., Latt, L. D., Najafi, B., & Coull, B. M. (2014). Effect of Tai Chi on Physical Function, Fall Rates and Quality of Life Among Older Stroke Survivors. Archives of Physical Medicine and Rehabilitation.
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  Abstract: Objective: To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Design: Single-blind, randomized controlled trial. Setting: General community. Participants: Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke. Interventions: Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Main Outcome Measures: Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. Results: During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ2=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P
• Taylor-Piliae, R. E., Wayne, P. M., Walsh, J. N., Wells, R. E., Papp, K. V., Donovan, N. J., & Yeh, G. Y. (2014). Effect of Tai Chi on Cognitive Performance in Older Adults: Systematic Review and Meta-Analysis. Journal of the American Geriatrics Society, 62(1), 25-39. doi:10.1111/jgs.12611
• Taylor-Piliae, R., Wayne, P. M., Walsh, J., Wells, R., Papp, K., Donovan, N., & Yeh, G. (2014). The Impact of Tai-Chi on Cognitive Performance in Older Adults: A Systematic Review and Meta-Analysis. The Journal of Alternative and Complementary Medicine, 20(5), A10-A11. doi:10.1089/acm.2014.5024.abstract
• Wayne, P. M., Walsh, J. N., Taylor-Piliae, R. E., Wells, R. E., Papp, K. V., Donovan, N. J., & Yeh, G. Y. (2014). Effect of tai chi on cognitive performance in older adults: Systematic review and meta-analysis. Journal of the American Geriatrics Society, 62(1), 25-39.
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  Abstract: Objectives To summarize and critically evaluate research on the effects of Tai Chi on cognitive function in older adults. Design Systematic review with meta-analysis. Setting Community and residential care. Participants Individuals aged 60 and older (with the exception of one study) with and without cognitive impairment. Measurements Cognitive ability using a variety of neuropsychological testing. Results Twenty eligible studies with a total of 2,553 participants were identified that met inclusion criteria for the systematic review; 11 of the 20 eligible studies were randomized controlled trials (RCTs), one was a prospective nonrandomized controlled study, four were prospective noncontrolled observational studies, and four were cross-sectional studies. Overall quality of RCTs was modest, with three of 11 trials categorized as high risk of bias. Meta-analyses of outcomes related to executive function in RCTs of cognitively healthy adults indicated a large effect size when Tai Chi participants were compared with nonintervention controls (Hedges' g = 0.90; P =.04) and a moderate effect size when compared with exercise controls (Hedges' g = 0.51; P =.003). Meta-analyses of outcomes related to global cognitive function in RCTs of cognitively impaired adults, ranging from mild cognitive impairment to dementia, showed smaller but statistically significant effects when Tai Chi was compared with nonintervention controls (Hedges' g = 0.35; P =.004) and other active interventions (Hedges' g = 0.30; P =.002). Findings from nonrandomized studies add further evidence that Tai Chi may positively affect these and other domains of cognitive function. Conclusion Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning and in individuals without significant impairment. Larger and methodologically sound trials with longer follow-up periods are needed before more-definitive conclusions can be drawn. © Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.
• Coull, B. M., Hepworth, J. T., Taylor-piliae, R. E., & Latt, L. D. (2013). Abstract TP370: Tai Chi and SilverSneakers® Interventions Improve Aerobic Endurance in Older Stroke Survivors. Stroke, 44(suppl_1). doi:10.1161/str.44.suppl_1.atp370
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  Background: Physical activity reduces recurrent stroke risk, yet suitable community-based programs are lacking. Tai Chi (TC) and SilverSneakers® (SS) can be easily adapted for persons with disabilities. TC integrates physical movements with mindfulness, while SS focuses on strength and range of movement. Purpose: To examine the effects of TC and SS interventions on physical functioning compared to Usual Care (UC). Methods: A randomized trial was conducted among stroke survivors (n=145), aged ≥ 50 years, and at ≥ 3 months post-stroke (TC, n=53; SS, n=44; or UC, n=48). TC and SS groups attended a 1-hour class 3X/week for 12 weeks. The UC group received a weekly phone call along with written materials for participating in community-based physical activity. The Short Physical Performance Battery (SPPB) assessed balance, gait speed, and lower body strength; a two-minute step-in-place test (StepTest) assessed aerobic endurance. The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) assessed amount of self-reported physical activity. Clinically meaningful changes in SPPB (small=0.5 points, substantial=1.0 points), and gait speed (small=0.05 m/sec, substantial=0.10 m/sec) were examined. Data were analyzed using 2 (time) X 3 (group) ANOVAs. Results: Subjects (47% women) were on average 70±10 years old, and 37±48 months post-stroke. The majority were married (58%), White (79%), college educated (79%), retired (80%), reporting an ischemic stroke (66%) with hemiparesis (73%). All groups reported a similar amount of physical activity (PASIPD=14.8±11.0 MET hrs/day, F 2,142 =1.04, p=0.36); and had substantial improvements in SPPB score (F 1,142 =85.29, p
• Hepworth, J. T., Taylor-piliae, R. E., Latt, L. D., & Coull, B. M. (2013).

  Abstract TP370: Tai Chi and SilverSneakers® Interventions Improve Aerobic Endurance in Older Stroke Survivors

  . Stroke, 44(suppl_1). doi:10.1161/str.44.suppl_1.atp370
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  Background: Physical activity reduces recurrent stroke risk, yet suitable community-based programs are lacking. Tai Chi (TC) and SilverSneakers® (SS) can be easily adapted for persons with disabili...
• Najafi, B., Taylor-piliae, R. E., Hoke, T. M., & Coull, B. M. (2013).

  Abstract WP362: Stroke Survivors in a 12-Week Yang-Style Tai Chi Intervention Have Fewer Falls

  . Stroke, 44(suppl_1). doi:10.1161/str.44.suppl_1.awp362
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  Background: Compared to same age healthy adults, stroke survivors experience 7 times as many falls annually. Such falls often cause hip or other fractures, loss of mobility, and increased fear of f...
• Taylor-Piliae, R. E., Hepworth, J. T., & Coull, B. M. (2013). Predictors of depressive symptoms among community-dwelling stroke survivors. Journal of Cardiovascular Nursing, 28(5), 460-467.
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  PMID: 22710739;Abstract: Background: Depression is a common yet often unrecognized consequence of stroke, affecting between 25% and 70% of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. Objective: The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Methods: Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Results: Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78%), college educated (79%), and retirees (77%). Annual income was $50 000 or greater for 32%. Hemiparesis was common (right side, 39%; left side, 42%); 35% had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21% had a history of major depression. Approximately 64% of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P < .01). Only poor quality of life (t1,87 =-6.99, P < .01) and low social support (t1,87 =-2.14, P = .04) contributed uniquely and significantly to the severity of depressive symptoms among these stroke survivors. Conclusion: Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation efforts and promote wellness and community reintegration. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
• Taylor-piliae, R. E., & Hoke, T. M. (2013). Abstract TMP88: Slipping, Tripping, and Rapid Ambulation are Key Fall Triggers for Stroke Survivors. Stroke, 44.
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  Background: Stroke survivors fall up to seven times more annually than healthy adults of a similar age. The inability to recover balance from slipping, tripping, or rapid ambulation accounts for th...
• Latt, L. D., Taylor-piliae, R. E., Latt, L. D., & Coull, B. M. (2012).

  Abstract P276: Aerobic Endurance and Leg Strength are Predictive of Gait Velocity among Community-Dwelling Stroke Survivors

  . Circulation, 125(suppl_10). doi:10.1161/circ.125.suppl_10.ap276
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  Background: Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance and paretic leg strength, with one or both o...
• Taylor-Piliae, R. E., & Coull, B. M. (2012). Community-based Yang-style Tai Chi is safe and feasible in chronic stroke: A pilot study. Clinical Rehabilitation, 26(2), 121-131.
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  PMID: 21937523;Abstract: Objective: Examine the safety and feasibility of a 12-week Tai Chi intervention among stroke survivors.Design: Two-group, prospective pilot study with random allocation.Setting: Outpatient rehabilitation facility.Subjects: Stroke survivors ≥50 years and at ≥three months post-stroke.Interventions: Tai Chi subjects attended group-based Yang Style classes three times/week for 12-weeks, while Usual Care subjects received weekly phone calls along with written materials/resources for participating in community-based physical activity.Main outcome measures: Indicators of study safety and feasibility included recruitment rates, intervention adherence, falls or adverse events, study satisfaction, drop-outs, and adequacy of the outcomes measures.Results: Interested persons pre-screened by phone (n = 69) were on average 68 years old, (SD = 13) years old, 48% (n = 33) women, 94% (n = 65) were at least three months post-stroke. A total of 28 subjects aged 69 (SD = 11) years enrolled in this pilot study. Intervention adherence rates were very high (≥92%). There were no falls or other adverse events. The dose of Tai Chi exercise (≥150 minutes/week) was well tolerated. Overall study satisfaction was high (8.3 (SD = 1.9); 1 = not satisfied, 10 = most satisfied), while drop-outs (n = 3, 11%) were unrelated to study intervention. Score distributions for the outcome measures were approximately normal, sensitive to change, and seemed to favor the Tai Chi intervention.Conclusions: Tai Chi is a safe, community-based exercise program for stroke survivors. Our data suggest that recruitment and retention of an adequate sample is feasible, and that in a full-scale study 52 subjects/group are needed to detect statistically significant between group differences (alpha = 0.05, power = 0.80). © SAGE Publications 2011.
• Taylor-Piliae, R. E., Latt, L. D., Hepworth, J. T., & Coull, B. M. (2012). Predictors of gait velocity among community-dwelling stroke survivors. Gait and Posture, 35(3), 395-399.
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  PMID: 22119886;Abstract: Introduction: Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance or paretic leg strength affecting their walking ability. Other reported underlying factors affecting gait velocity include functional disability, balance, cognitive impairment, or the distance they are required to walk. Objective: To examine the relationship between gait velocity and measures of physical and cognitive functioning in chronic stroke. Methods: Cross-sectional design using baseline data from community-dwelling stroke survivors enrolled in an exercise intervention study. Functional disability (modified Rankin Scale), aerobic endurance (2-min step-test), leg strength (timed 5-chair stand test), balance (single-leg stance) and cognitive impairment (Mini-Mental Status Exam) were assessed. Gait velocity was assessed using a timed 4-m walk test. Multiple linear regression was used to explore potential independent predictors of gait velocity. Results: Subjects had an average gait velocity of 0.75±0.23m/s, categorized as limited community walkers. Approximately 37% of the variance in gait velocity, could be explained by the 5 independent variables, functional disability, aerobic endurance, leg strength, balance, and cognitive impairment (R 2=0.37, F 5,74=8.64, p
• Taylor-Piliae, R. E., Silva, E., & Sheremeta, S. P. (2012). Tai Chi as an adjunct physical activity for adults aged 45 years and older enrolled in phase III cardiac rehabilitation. European Journal of Cardiovascular Nursing, 11(1), 34-43.
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  PMID: 21095159;Abstract: Background: Cardiac rehabilitation improves physical, cognitive and psychosocial functioning, yet services are greatly underutilized with increasing patterns of attrition over time. Tai Chi has been suggested as a possible adjunct to cardiac rehabilitation exercise training. Aim: To describe differences in physical, cognitive and psychosocial functioning among adults ≥ 45 years old attending phase III cardiac rehabilitation, who have or have not self-selected Tai Chi exercise as an adjunct physical activity. Methods: A cross-sectional design compared subjects attending group-based Wu style Tai Chi classes plus cardiac rehabilitation, with cardiac rehabilitation only. Subjects had a battery of physical and cognitive functioning tests administered to examine aerobic endurance, balance, strength, and flexibility, verbal retrieval/recall, attention, concentration and tracking. Subjects completed a health survey to ascertain cardiac event information, medical history, and psychosocial functioning (i.e. health-related quality of life, stress, depressive symptoms, social support, and Tai Chi self-efficacy). Results: A total of 51 subjects (75% married, 84% college-educated, 96% White/European-American) participated. Subjects were on average 70 (± 8) years old and had attended cardiac rehabilitation for 45 (± 37) months. Approximately 45% (n = 23) attended Tai Chi classes plus cardiac rehabilitation, while 55% (n = 28) attended cardiac rehabilitation only. Subjects attending Tai Chi plus cardiac rehabilitation had better balance, perceived physical health, and Tai Chi selfefficacy compared to those attending cardiac rehabilitation only (p ≤ 0.03). Conclusion: Tai Chi can be easily implemented in any community/cardiac rehabilitation facility, and may offer adults additional options after a cardiac event. © The European Society of Cardiology 2012.
• Taylor-piliae, R. E., & Coull, B. M. (2012).

  Abstract 2351: Poor Quality of Life and Low Social Support are Predictive of Depressive Symptoms in Chronic Stroke

  . Stroke, 43(suppl_1). doi:10.1161/str.43.suppl_1.a2351
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  Background: Depression is a common yet often unrecognized consequence of stroke, affecting between 20-50% of all survivors. Reported underlying factors affecting depression in acute and chronic str...
• Taylor-piliae, R. E., & Keller, M. L. (2012). Abstract P272: Leg Strength and Gait Speed Predict Enrollment in an Exercise Study among Stroke Survivors with Mild-Moderate Disability. Circulation, 125(suppl_10). doi:10.1161/circ.125.suppl_10.ap272
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  Background: Stroke is the third leading cause of death in the United States and is the major contributor to physical and cognitive disability among this population. Exercise is an important aspect of stroke rehabilitation to reduce disability. Objective: To determine if functional disability, physical function, cognitive impairment, age or gender are predictive of enrollment in an exercise study among stroke survivors with mild-moderate disability. Methods: Cross-sectional design using data from stroke survivors (n=166) that consented to be screened for an exercise study, the “Tai Chi for Stroke Survivors Study.” All subjects completed a brief survey to determine eligibility, prior to screening. Screening tests included the Modified Rankin Scale (mRS, functional disability), Short Physical Performance Battery (SPPB, physical function), and Mini-Mental Status Exam (MMSE, cognitive function). First, we conducted bivariate logistic regression using mRS, SPPB-balance, gait speed and leg strength test times, MMSE, age and gender, as single predictors of study enrollment. Then, we conducted multiple logistic regression using significant predictors to determine the overall model. Results: Subjects (n=166) were on average 69±11 years old, and reported mild-moderate disability (mRS=2.0±0.8), had some impairments in physical functioning (SPPB=7.0±2.6), diminished leg strength (5-timed chair stands=19.3±7.2 seconds), and slow gait speed (0.76±0.3 meters/second) but, were without cognitive impairments (MMSE=27.8±3.3). Significant predictors of study enrollment were leg strength [X 2 (1)=16.37, p 2 (1)=6.89, p 2 (2)=22.38, p Conclusion: Physical function has been shown to predict disability and overall decline in health and well-being in stroke survivors with mild-moderate disability. The SPPB is simple to administer, taking 5–10 minutes to complete. This test readily identified stroke survivors with diminished leg strength and slower gait speed, and was predictive of enrollment in our exercise study.
• Coull, B. M., & Taylor-Piliae, R. E. (2011). Community-based Yang-style Tai Chi is safe and feasible in chronic stroke: a pilot study. Clinical Rehabilitation, 26(2), 121-131. doi:10.1177/0269215511419381
• Nguyen, P. K., Terashima, M., Fair, J. M., Varady, A., Taylor-Piliae, R. E., Iribarren, C., Go, A. S., Haskell, W. L., Hlatky, M. A., Fortmann, S. P., & McConnell, M. V. (2011). Physical activity in older subjects is associated with increased coronary vasodilation: The ADVANCE study. JACC: Cardiovascular Imaging, 4(6), 622-629.
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  PMID: 21679897;Abstract: Objectives: We investigated the association between physical activity and coronary vasodilation to nitroglycerin (NTG) in the ADVANCE (Atherosclerotic Disease, Vascular Function, and Genetic Epidemiology) cohort of older healthy subjects. Background: Physical activity may exert its beneficial effects by augmenting coronary responsiveness to nitric oxide. The relationship between physical activity and coronary vasodilatory response to NTG, an exogenous nitric oxide donor, has not been studied in a community-based population with typical activity levels. Methods: In 212 older adults (ages 60 to 72 years) without cardiovascular disease, we measured the coronary vasodilatory response to NTG using magnetic resonance angiography and physical activity using the Stanford Seven-Day Physical Activity Recall Questionnaire. The primary predictor measure was total physical activity (kcal/kg/day). The primary outcome measure was coronary vasodilatory response (percent increase of cross-sectional area post-NTG). Results: Coronary vasodilation was 27.6% in more active subjects (>35 kcal/kg/day, e.g., 1 h of walking per day) compared to 18.9% in less active subjects (p = 0.03). Regression analysis showed a significant positive correlation between coronary vasodilation and physical activity (p = 0.003), with a slope (beta) of 1.2% per kcal/kg/day. This finding remained significant after adjustment for cardiac risk factors, coronary calcium, the use of vasoactive or statin medications, and analysis of physical activity by quintiles (p < 0.05). Coronary vasodilation was also associated with physical activity intensity (p = 0.03). Conclusions: In an asymptomatic, community-based cohort of older adults, increased coronary vasodilatory response was independently associated with greater physical activity, supporting the benefits of exercise on the order of 1 h of walking per day. © 2011 American College of Cardiology Foundation.
• Payne, J. R., Taylor-piliae, R. E., & Coull, B. M. (2011).

  The Safety and Feasibility of a Tai Chi Intervention for Stroke Survivors: A Pilot Study: 1376

  . Medicine and Science in Sports and Exercise, 43(5), 282. doi:10.1249/01.mss.0000400776.28602.da
• Taylor-Piliae, R. E., & Hansen, C. (2011). What is Bowenwork^®? A Systematic Review. The Journal of Alternative and Complementary Medicine, 17(11), 1001-1006. doi:10.1089/acm.2010.0023
• Taylor-Piliae, R. E., Fair, J. M., Varady, A. N., Hlatky, M. A., Norton, L. C., Iribarren, C., Go, A. S., & Fortmann, S. P. (2011). Ankle brachial index screening in asymptomatic older adults. American Heart Journal, 161(5), 979-985.
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  PMID: 21570532;Abstract: Background: Screening for peripheral arterial disease (PAD) by measuring ankle brachial index (ABI) in asymptomatic older adults is currently recommended to improve cardiovascular disease risk assessment and establish early treatment, but it is not clear if the strategy is useful in all populations. We examined the prevalence and independent predictors of an abnormal ABI (
• Taylor-Piliae, R., Hansen, C., & Taylor-Piliae, R. E. (2011). What is Bowenwork®? A systematic review. Journal of alternative and complementary medicine (New York, N.Y.), 17(11).
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  The objectives of this study were to systematically review the literature available on the complementary approach to healing known as Bowenwork(®) and to examine reported research methods.
• Palaniappan, L. P., Rosario, M., Assimes, T. L., Barrett-Connor, E. L., Carnethon, M. R., Criqui, M. H., Fung, G. L., Narayan, K. V., Patel, H., Taylor-Piliae, R. E., Wilson, P. W., & Wong, N. D. (2010). Call to action: Cardiovascular disease in Asian Americans: A science advisory from the American heart association. Circulation, 122(12), 1242-1252.
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  PMID: 20733105;
• Taylor-Piliae, R. E., Fair, J. M., Haskell, W. L., Varady, A. N., Iribarren, C., Hlatky, M. A., Go, A. S., & Fortmann, S. P. (2010). Validation of the Stanford Brief Activity Survey: Examining psychological factors and physical activity levels in older adults. Journal of Physical Activity and Health, 7(1), 87-94.
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  PMID: 20231759;Abstract: Background: This study examined the construct validity and reliability of the new 2-item Stanford Brief Activity Survey (SBAS). Methods: Secondary analysis was conducted using data collected from the healthy older controls (n = 1023) enrolled in the Atherosclerotic Disease Vascular Function and Genetic Epidemiology (ADVANCE) study. Construct validity was examined by regression analyses to evaluate signifcant trends (P ≤.05) across the SBAS activity categories for the selected psychological health factors measured at baseline and year 2, adjusted for gender, ethnicity and education level. Test-retest reliability was performed using Spearman's rank correlation. Results: At baseline, subjects were 66 ± 2.8 years old, 38% female, 77% married, 61% retired, 24% college graduate, and 68% Caucasian. At baseline, lower self-reported stress, anxiety, depression, and cynical distrust, and higher self-reported mental and physical well-being were significantly associated with higher levels of physical activity (p trend ≤ 0.01). These associations held at year 2. The test-retest reliability of the SBAS was statistically significant (rs= 0.62, P
• Taylor-Piliae, R. E., Newell, K. A., Cherin, R., Lee, M. J., King, A. C., & Haskell, W. L. (2010). Effects of Tai Chi and Western exercise on physical and cognitive functioning in healthy community-dwelling older adults. Journal of Aging and Physical Activity, 18(3), 261-279.
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  PMID: 20651414;Abstract: To compare the effects of Tai Chi (TC, n = 37) and Western exercise (WE, n = 39) with an attention-control group (C, n = 56) on physical and cognitive functioning in healthy adults age 69 ± 5.8 yr, in a 2-phase randomized trial. Methods: TC and WE involved combined class and home-based protocols. Physical functioning included balance, strength, fexibility, and cardiorespiratory endurance. Cognitive functioning included semantic fuency and digit-span tests. Data were analyzed using intention-to-treat analysis. Results: At 6 mo, WE had greater improvements in upper body fexibility (F = 4.67, p =.01) than TC and C. TC had greater improvements in balance (F = 3.36, p =.04) and a cognitive-function measure (F = 7.75, p
• Taylor-Piliae, R. E., Silva, E., & Sheremeta, S. P. (2010). Tai Chi as an adjunct physical activity for adults aged 45 years and older enrolled in phase III cardiac rehabilitation. European Journal of Cardiovascular Nursing, 11(1), 34-43. doi:10.1016/j.ejcnurse.2010.11.001
• Gardner, C. D., Taylor-Piliae, R. E., Kiazand, A., Nicholus, J., Rigby, A. J., & Farquhar, J. W. (2008). Effect of Ginkgo biloba (EGb 761) on treadmill walking time among adults with peripheral artery disease: A randomized clinical trial. Journal of Cardiopulmonary Rehabilitation and Prevention, 28(4), 258-265.
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  PMID: 18628657;PMCID: PMC2748261;Abstract: ■ PURPOSE: Medical therapies for treatment of peripheral artery disease (PAD) are limited. Ginkgo biloba has been reported to increase maximal and pain-free walking distance among patients with PAD; however, the evidence is inconsistent. The objective of this study was to compare the effects of 300 mg/d of Ginkgo biloba (EGb 761) versus placebo on treadmill walking time and related cardiovascular measures among patients with PAD. ■ METHODS: A double-blind, placebo-controlled, parallel design trial with a 4-month duration was used. Participants were 62 adults, aged 70 ± 8 years (mean ± SD), with claudication symptoms of PAD. The primary study outcomes were maximal and pain-free walking time on a treadmill. Secondary outcomes included flow-mediated vasodilation, a measure of antioxidant status as assessed by determining antibody levels to epitopes of oxidized low-density lipoprotein, and questionnaires addressing walking impairment and quality of life. ■ RESULTS: Maximal treadmill walking time increased by 20 ± 80 and 91 ± 242 seconds in the placebo and the EGb 761 groups, respectively (P = .12). Pain-free walking time increased by 15 ± 31 and 21 ± 43 seconds, respectively (P = .28). No significant differences were detected between groups for any of the secondary outcomes. ■ CONCLUSIONS: In older adults with PAD, Ginkgo biloba produced a modest but insignificant increase in maximal treadmill walking time and flow-mediated vasodilation. These data do not support the use of Ginkgo biloba as an effective therapy for PAD, although a longer duration of use should be considered in any future trials. © 2008 Lippincott Williams & Wilkins, Inc.
• Taylor-Piliae, R., & Taylor-Piliae, R. E. (2008). The effectiveness of Tai Chi exercise in improving aerobic capacity: an updated meta-analysis. Medicine and sport science, 52.
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  To determine if Tai Chi exercise is effective in improving aerobic capacity.
• Lee, M. S., Pittler, M. H., Taylor-Piliae, R. E., & Ernst, E. (2007). Tai chi for cardiovascular disease and its risk factors: A systematic review. Journal of Hypertension, 25(9), 1974-1975.
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  PMID: 17762664;
• Taylor-Piliae, R. E., & Froelicher, E. S. (2007). Methods to optimize recruitment and retention to an exercise study in Chinese immigrants. Nursing Research, 56(2), 132-136.
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  PMID: 17356444;Abstract: BACKGROUND:: To counter pervasive disparities in healthcare and guide public health prevention programs, culturally sensitive recruitment and retention strategies for Chinese immigrants participating in health-related research studies are needed. OBJECTIVES:: The aim of this study was to develop and implement recruitment and retention strategies with Chinese immigrants in a Tai Chi exercise study. METHODS:: After substantial project planning and incorporating community-based research principles, a multidimensional approach was used to ensure minimal loss to follow-up. Recruitment strategies included partnering with a community-based agency, distributing study information using a multimedia approach, communicating in the native language, and demonstrating cultural sensitivity. Retention strategies included establishing a tracking method during recruitment, providing personalized feedback, maintaining the same location for all aspects of the study, eliminating potential linguistic barriers, providing personal attention and encouragement, monitoring attendance, utilizing a charismatic Tai Chi instructor, respecting Chinese culture, providing appropriate incentives, and maintaining good communication. RESULTS:: Sixty persons showed interest in the study, 52 persons were screened, and 39 persons were enrolled. Recruitment was completed within 3 weeks. An advertisement in the Chinese newspaper was the most fruitful recruitment source, yielding approximately 60% of the study participants. Retention in the study was also very high (97%, n ≤ 38). DISCUSSION:: The successful recruitment and retention of Chinese immigrants in this Tai Chi exercise study are due to a variety of factors on many levels, including the participants, study investigator, and community-based agency. Copyright © Lippincott Williams & Wilkins.
• Taylor-Piliae, R. E., & Haskell, W. L. (2007). Tai Chi exercise and stroke rehabilitation. Topics in Stroke Rehabilitation, 14(4), 9-22.
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  PMID: 17698454;Abstract: According to reported global estimates, 15 million people suffer from a stroke each year, resulting in 5.5 million deaths, with 5 million left permanently disabled. Typical disabilities following stroke include poor neuromuscular control, hemodynamic imbalance, and negative mood state. Tai Chi (TC) is associated with better balance, lower blood pressure, and improved mood, which are important for stroke survivors. An overview of the philosophy and principles of TC exercise is provided, followed by a literature review of reported TC studies examining balance, blood pressure, and mood. Finally, the potential application of TC exercise to stroke rehabilitation is discussed. © 2007 Thomas Land Publishers, Inc.
• Taylor-Piliae, R. E., Haskell, W. L., Iribarren, C., Norton, L. C., Mahbouba, M. H., Fair, J. M., Hlatky, M. A., Go, A. S., & Fortmann, S. P. (2007). Clinical utility of the stanford brief activity survey in men and women with early-onset coronary artery disease. Journal of Cardiopulmonary Rehabilitation and Prevention, 27(4), 227-232.
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  PMID: 17667019;Abstract: PURPOSE: To determine the utility of the Stanford Brief Activity Survey (SBAS) as a quick screening tool in a clinical population, where no other measure of physical activity was available. METHODS: The SBAS was administered to 500 younger cases in the Atherosclerotic Disease Vascular Function and Genetic Epidemiology (ADVANCE) study, a case-control genetic association study, between December 2001 and January 2004. Younger cases in the ADVANCE study included men (
• Taylor-Piliae, R. E., Haskell, W. L., & Froelicher, E. S. (2006). Hemodynamic responses to a community-based Tai Chi exercise intervention in ethnic Chinese adults with cardiovascular disease risk factors. European Journal of Cardiovascular Nursing, 5(2), 165-174.
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  PMID: 16314148;Abstract: Background: Cardiovascular disease (CVD) is the leading cause of death among older adults worldwide, including Europe, Asia, and North America. In the United States (US), CVD is also the leading cause of death among Asian-Americans. Physical activity has been shown to reduce CVD risk factors. Reduction in blood pressure (BP) in response to Tai Chi (TC) exercise in persons with CVD risk factors have been reported, though not in ethnic Chinese living in the US. Aim: Hemodynamic responses to a 12-week community-based TC exercise intervention among ethnic Chinese with CVD risk factors were examined. Methods: Quasi-experimental design. Ethnic Chinese > 45 years old with at least 1 major CVD risk factor, living in the San Francisco Bay Area, attended a TC intervention three times a week for 12 weeks. A 2-min step-in-place test assessed aerobic endurance. BP and heart rate were measured at rest, and within 1-min after the step-test. Data were collected at baseline, 6 and 12 weeks. Results: A total of 39 subjects (69% women), 66 ± 8.3 years old, with hypertension (92%), hypercholesteremia (49%), and/or diabetes (21%), and 1 current smoker participated. Adherence to the intervention was high (87%). Subjects were sedentary at baseline, though had a statistically significant improvement in aerobic endurance over-time (eta2 = 0.39). At baseline, the average BP at rest was 150/86, while BP in response to the step-test was 178/99. Clinically and statistically significant reductions in BP at rest (131/77), and in response to the step-test (164/82) were found over 12 weeks of TC (p < 0.01). No significant change in heart rate was observed. Conclusions: This innovative, culturally relevant, community-based 12-week TC exercise intervention, appealed to Chinese adults with CVD risk factors, with significant reductions in BP and improvement in aerobic endurance. Given the number of persons estimated to have HTN and other CVD risk factors, the identification of new approaches to improve health, combined with risk factor reduction is needed. This is particularly important, given the rise in HTN among adults in the US and the associated public health burden of HTN. TC has the potential to reduce expenditures associated with CVD by facilitating a lifestyle that promotes physical activity, while remaining a low-tech, low-cost alternative to exercise. © 2005 European Society of Cardiology.
• Taylor-Piliae, R. E., Haskell, W. L., Stotts, N. A., & Froelicher, E. S. (2006). Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Alternative Therapies in Health and Medicine, 12(2), 50-58.
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  PMID: 16541997;Abstract: Context: Declines in physical performance are associated with aging and chronic health conditions. Appropriate physical activity interventions can reverse functional limitations and help maintain independent living. Tai chi is a popular form of exercise in China among older adults. Objective: To determine whether tai chi improves balance, muscular strength and endurance, and flexibility over time. Design: Repeated measures intervention; data collected at baseline, 6 weeks, and 12 weeks. Setting: Community center in the San Francisco Bay Area. Participants: Thirty-nine Chinese adults with at least 1 cardiovascular disease (CVD) risk factor. Interventions: A 60-minute tai chi exercise class 3 times per week for 12 weeks. Main Outcome Measures: A battery of physical fitness measures specifically developed for older adults assessed balance, muscular strength and endurance, and flexibility. Results: Subjects were 65.7 (±8.3) years old, Cantonese-speaking (97%) immigrants, with 12 years or less of formal education (87%) and very low income (67%). Reported CVD risk factors were hypertension (92%), hypercholesteremia (49%), diabetes (21%), and 1 current smoker. Subjects were below the 50th percentile of fitness at baseline compared to age- and gender-specific normative US data. Statistically significant improvements were observed in all balance, muscular strength and endurance, and flexibility measures after 6 weeks, and they increased further after 12 weeks. Conclusions: Tai chi is a potent intervention that improved balance, upper- and lower-body muscular strength and endurance, and upper- and lower-body flexibility in these older Chinese adults. These findings provide important information for future community-based tai chi exercise programs and support current public health initiatives to reduce disability from chronic health conditions and enhance physical function in older adults.
• Taylor-Piliae, R. E., Haskell, W. L., Waters, C. M., & Froelicher, E. S. (2006). Change in perceived psychosocial status following a 12-week Tai Chi exercise programme. Journal of Advanced Nursing, 54(3), 313-329.
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  PMID: 16629916;Abstract: Aim. This paper reports a study to examine change in psychosocial status following a 12-week Tai Chi exercise intervention among ethnic Chinese people with cardiovascular disease risk factors living in the United States of America. Background. Regular participation in physical activity is associated with protection against cardioavascular disease, and improvements in physical and psychological health. Increasing amounts of scientific evidence suggests that mind-body exercise, such as Tai Chi, are related to improvements in mental health, emotional well-being, and stress reduction. No prior study has examined the effect of a Tai Chi exercise intervention on psychosocial status among people with cardiovascular disease risk factors. Methods. This was a quasi-experimental study. Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks. Data were collected at baseline, 6 and 12 weeks following the intervention. Psychosocial status was assessed using Chinese versions of Cohen's Perceived Stress Scale, Profile of Mood States, Multidimensional Scale of Perceived Social Support, and Tai Chi exercise self-efficacy. Results. A total of 39 participants, on average 66-year-old (±8·3), married (85%), Cantonese-speaking (97%), immigrants participated. The majority were women (69%), with ≤12 years education (87%). Statistically significant improvements in all measures of psychosocial status were found (P ≤ 0·05) following the intervention. Improvement in mood state (η2 = 0·12), and reduction in perceived stress (η2 = 0·13) were found. In addition, Tai Chi exercise statistically significantly increased self-efficacy to overcome barriers to Tai Chi (η2 = 0·19), confidence to perform Tai Chi (η2 = 0·27), and perceived social support (η2 = 0·12). Conclusions. Tai Chi was a culturally appropriate mind-body exercise for these older adults, with statistically significant psychosocial benefits observed over 12-weeks. Further research examining Tai Chi exercise using a randomized clinical trial design with an attention-control group may reduce potential confounding effects, while exploring potential mechanisms underlying the relaxation response associated with mind-body exercise. In addition, future studies with people with other chronic illnesses in all ethnic groups are recommended to determine if similar benefits can be achieved. © 2006 The Authors.
• Taylor-Piliae, R. E., Norton, L. C., Haskell, W. L., Mahbouda, M. H., Fair, J. M., Iribarren, C., Hlatky, M. A., Go, A. S., & Fortmann, S. P. (2006). Validation of a new brief physical activity survey among men and women aged 60-69 years. American Journal of Epidemiology, 164(6), 598-606.
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  PMID: 16840522;Abstract: The Stanford Brief Activity Survey (SBAS), a new two-item physical activity survey, and the Stanford Seven-Day Physical Activity Recall (PAR) questionnaire were administered to men and women, aged 60-69 years, in the Atherosclerotic Disease VAscular functioN and genetiC Epidemiology (ADVANCE) Study. Frequency distributions of SBAS activity levels, as well as a receiver operating curve, were calculated to determine if the SBAS can detect recommended physical activity levels of 150 or more minutes/week at moderate or greater intensity, with PAR minutes/week. Data were collected between December 2001 and January 2004 from 1,010 participants (38% women) and recorded. Subjects were 65.8 (standard deviation: 2.8) years of age, 77% were married, 55% were retired, 23% were college graduates, and 68% were Caucasian. SBAS scores related significantly in an expected manner to PAR minutes/week (p < 0.01), energy expenditure (kcal/kg per day) (p < 0.01), and selected cardiovascular disease risk biomarkers (p < 0.01). The SBAS of physical activity at moderate intensity had a sensitivity of 0.73 and a specificity of 0.61. The SBAS is a quick assessment of the usual amount and intensity of physical activity that a person performs throughout the day. The SBAS needs further validation in other populations but demonstrated the potential of being a reasonably valid and inexpensive tool for quickly assessing habitual physical activity in large-scale epidemiology studies and clinical practice. Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health. All rights reserved.
• Taylor-piliae, R. E., Norton, L. C., Mahbouba, M. H., Iribarren, C., Fortmann, S. P., & Fair, J. M. (2006). Abstract 2096: Cardiovascular Risk Factors and Heart Rate Variability in an Older Cohort. Circulation, 114.
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  Background: Lower heart rate variability (HRV) has been associated with CVD events in persons with CAD, diabetes and metabolic syndrome (MS). However, the role of HRV in predicting CVD risk in asym...
• Taylor-Piliae, R. (2004). Commentary. Evidence-based Cardiovascular Medicine, 8(3), 253-254.
• Taylor-Piliae, R. E., & Froelicher, E. S. (2004). Effectiveness of Tai Chi exercise in improving aerobic capacity: a meta-analysis.. The Journal of cardiovascular nursing, 19(1), 48-57.
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  PMID: 14994782;Abstract: PURPOSE: Meta-analysis involves the integration of several studies with small sample sizes, enabling the investigator to summarize research results into useful clinical information. Tai Chi exercise has recently gained the attention of Western researchers as a potential form of aerobic exercise. A goal of this meta-analysis was to estimate the effect of Tai Chi exercise on aerobic capacity. METHODS: A computerized search of 7 databases was done using key words and all languages. Sixteen study elements were critically appraised to determine study quality. D-STAT software was used to calculate the standardized mean differences (ESsm) and the 95% confidence intervals (CI), using means and standard deviations (SD) reported on aerobic capacity expressed as peak oxygen uptake (VO2peak) (mL x kg(-1) x min(-1)). RESULTS: Of 441 citations obtained, only 7 focused on aerobic capacity in response to Tai Chi exercise (4 experimental and 3 cross-sectional). Older adults including those with heart disease participated (n = 344 subjects); on average men were aged 55.7 years (SD = 12.7) and women 60.7 years (SD = 6.2). Study quality scores ranged from 22 to 28 (mean = 25.1, SD = 2.0). Average effect size for the cross-sectional studies was large and statistically significant (ESsm = 1.01; CI = +0.37, +1.66), while in the experimental studies the average effect size was small and not significant (ESsm = 0.33; CI = -0.41, +1.07). Effect sizes of aerobic capacity in women (ESsm = 0.83; CI = -0.43, +2.09) were greater than those for men (ESsm = 0.65; CI = -0.04, +1.34), though not statistically significant. Aerobic capacity was higher in subjects performing classical Yang style (108 postures) Tai Chi (ESsm = 1.10; CI = +0.82, +1.38), a 52-week Tai Chi exercise intervention (ESsm = 0.94; C = +0.06, +1.81), compared with sedentary subjects (ESsm = 0.80; CI = +0.19, +1.41). CONCLUSIONS: This meta-analysis suggests that Tai Chi may be an additional form of aerobic exercise. The greatest benefit was seen from the classical Yang style of Tai Chi exercise when performed for 1-year by sedentary adults with an initial low level of physical activity habits. Recommendations for future research are provided and the effect sizes generated provide information needed for sample size calculations. Randomized clinical trials in diverse populations, including those with chronic diseases, would expand the current knowledge about the effect of Tai Chi on aerobic capacity.
• Taylor-Piliae, R. E., & Froelicher, E. S. (2004). Measurement properties of Tai Chi exercise self-efficacy among ethnic Chinese with coronary heart disease risk factors: A pilot study. European Journal of Cardiovascular Nursing, 3(4), 287-294.
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  PMID: 15572017;Abstract: Improvement in aerobic capacity and reduction in blood pressure after Tai Chi exercise programs in persons with coronary heart disease (CHD) or with CHD risk factors have been reported. Self-efficacy has been shown to be a consistent predictor of behavioral outcomes, now being applied to Tai Chi exercise. To assess the utility and appropriateness of existing tools measuring aspects of Tai Chi exercise self-efficacy (TCSE) in a new population, ethnic Chinese with CHD risk factors. Specific objectives were: (1) examine acceptability and feasibility; (2) determine score distributions; (3) assess the reliability and known-groups validity; (4) translate tool into an equivalent Chinese version and determine if there were any differences between ethnic Chinese and non-Chinese. Following a review of the literature, two existing tools used with Caucasians were found and modified; a 9-item exercise self-efficacy tool developed by Resnick and Jenkins [Resnick B, Jenkins LS, Testing the reliability and validity of the Self-Efficacy for Exercise scale. Nurs. Res. 49(3) (2000) 154-159], and a 3-item tool developed by Li et al. [Li F, McAuley E, Harmer P, Duncan TE, Chaumeton NR, Tai Chi enhances self-efficacy and exercise behavior in older adults. J. Aging Phys. Act. 9 (2001) 161-171] to assess gradations of the challenge to perform Tai Chi among elderly populations. The modified TCSE tool was translated into Chinese and back-translated. A pilot study was conducted to pre-test the modified 14-item TCSE tool in ethnic Chinese and non-Chinese. A total of 18 subjects (mean age=60 years, S.D.=18.4) participated. Seven subjects (39%) identified themselves as ethnic Chinese. Ten subjects (56%) had experience performing Tai Chi, ranging from 3 months to 17 years (mean=5.0 years, S.D.=5.0). Half of the subjects reported having a history of hypertension (n=9, 50%), while nearly one-third reported having high cholesterol (n=5, 28%). No significant difference in TCSE mean scores was found between ethnic Chinese and non-Chinese (p>0.05). Internal consistency estimates were very high (TCSE Barriers, r=0.95; TCSE Performance, r=0.97). A statistically significant difference was found in the TCSE mean scores between Tai Chi practitioners and non-practitioners (TCSE Barriers, t=-3.3, p=0.01; TCSE Performance, t=-2.7, p=0.03), with Tai Chi practitioners reporting higher self-efficacy; thus providing initial evidence of known-groups validity. Measurement of self-efficacy to overcome barriers to Tai Chi exercise (TCSE Barriers) and self-efficacy to perform Tai Chi (TCSE Performance) functioned well in this sample. The acceptability and feasibility of this tool was established and known-groups validity was confirmed. Further research using this tool among ethnic Chinese with CHD or CHD risk factors, including those with less than high school education or low literacy, is recommended as the next step in development of TCSE. © 2004 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
• Taylor-Piliae, R. E., & Wang, C. (2004). Response to the systematic review of Tai Chi [8] (multiple letters). Archives of Internal Medicine, 164(22), 2503-2504.
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  PMID: 15596651;
• Taylor-piliae, R. E., & Froelicher, E. S. (2004). The Effectiveness of Tai Chi Exercise in Improving Aerobic Capacity: A Meta‐Analysis. Holistic Nursing Practice, 18(5), 254-263. doi:10.1097/00004650-200409000-00008
• Chair, S. Y., Taylor-Piliae, R. E., Lam, G., & Chan, S. (2003). Effect of positioning on back pain after coronary angiography. Journal of Advanced Nursing, 42(5), 470-478.
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  PMID: 12752867;Abstract: Background. Coronary angiography is a routine cardiac diagnostic procedure in Hong Kong. Patients are restricted to bedrest after the procedure due to potential vascular complications from using a femoral approach. Many patients are required to remain on bedrest for up to 24 hours after the procedure. The effects of reducing this bedrest time is still under investigation. In the meantime, nursing interventions aimed at decreasing patient discomfort due to prolonged bedrest are feasible to implement. Aims. The aims of this study were to evaluate the severity of back pain related to bedrest duration after coronary angiography and to compare the effects of changing patients' position in bed on their perceptions of back pain and on vascular complications. Methods. An experimental design was used, with patients randomly assigned either to a control or experimental group. The control group received the usual care, remaining supine and flat for 8-24 hours, with the affected leg straight. The experimental group changed their body position hourly, varying between supine, right side-lying, and left side-lying during the first 7 hours after coronary angiography. Results. A total of 419 patients participated in the study (control, n = 213; experimental, n = 206). Regardless of group assignment, back pain intensity increased with longer time on bedrest. In addition, the control group reported higher levels of pain at all five assessment times. Vascular complications in terms of bleeding at the femoral site were not significantly different between the control and experimental groups. Conclusion. The study findings suggest that patients may be able safely to change their position in bed earlier in the postcoronary angiography period than currently recommended in practice protocols. Changing position in bed may also reduce back pain, promote physical comfort, and possibly reduce patients' negative feelings toward coronary angiography.
• Holroyd, E. A., Taylor-Piliae, R. E., & Twinn, S. F. (2003). Investigating Hong Kong's Filipino domestic workers' healthcare behavior, knowledge, beliefs and attitudes towards cervical cancer and cervical screening. Women & health, 38(1), 69-82.
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  The aim of this study was to investigate Hong Kong Filipino domestic workers health behaviors, knowledge, beliefs and attitudes about cervical screening and cancer. A concurrent cross sectional survey design used a snowball method of recruitment was used because of the acknowledged problematic access to a random sample of immigrant women. A total of 98 female domestic helpers were actively recruited through designated recreation centers. The women were between 24-45 years old (mean = 37.9, SD = 7.7). The majority of these women were employed as full-time domestic helpers (91%), were earning less than dollar 4000 Hong Kong dollars/month (92%), were married (82%), with children (91%), were non-smokers (88%), and had at least a secondary level of education (100%), with 66% of these women having completed post-secondary education. While the majority of women had previously heard about cervical smears (78%) more than half (53%) reported never having a cervical smear taken. Women who had a prior cervical smear had significantly more knowledge about cervical smears and cervical cancer (mean = 51.34, SD = 2.5) than those who never had a cervical smear (mean = 49.72, SD = 3.2). Recommendations are made for culturally tailored mass screening programmers out of office hours and health information to be provided in both written and oral Tagalong. Doctors and nurse ideally of Filipino origin should be used to deliver health messages that prioritize the importance of self protection for the family and future fertility issues, culturally prized within Filipino society.
• Taylor-Piliae, R. E. (2003). Tai chi as an adjunct to cardiac rehabilitation exercise training. Journal of Cardiopulmonary Rehabilitation, 23(2), 90-96.
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  PMID: 12668929;Abstract: Heart disease is a chronic condition needing lifetime secondary prevention measures to decrease morbidity and mortality, and to improve quality of life. Cardiac rehabilitation exercise training, one aspect of cardiac recovery, traditionally includes some form of aerobic fitness and, more recently, muscle strength training to improve exercise tolerance. Tai chi, widely practiced in China for centuries, is a popular form of exercise among older Chinese persons associated with enhanced well-being and health among traditional Chinese practitioners. Recent research has reported improvement in cardiorespiratory function, balance and postural stability, fall prevention, and stress reduction. A review of the literature suggests potential benefits from tai chi exercise performed as an adjunct to cardiac rehabilitation exercise training. Tai chi is cost-effective and facilitates a lifestyle of health-related behavior practices.
• Taylor-Piliae, R. (2002). Commentary: Review: Music as a single session intervention reduces anxiety and respiratory rate in patients admitted to hospital. Evidence-Based Nursing, 5(3), 86-.
• Taylor-Piliae, R. (2002). Commentary: Review: Several techniques optimise oxygenation during suctioning of patients. Evidence-Based Nursing, 5(2), 51-.
• Taylor-Piliae, R. E., & Chair, S. (2002). The effect of nursing interventions utilizing music therapy or sensory information on Chinese patients' anxiety prior to cardiac catheterization: A pilot study. European Journal of Cardiovascular Nursing, 1(3), 203-211.
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  PMID: 14622675;Abstract: Background: Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. Nursing interventions using music therapy or sensory information among patients with coronary artery disease has resulted in anxiety reduction, though results in Chinese subjects has not previously been published. Aims: To determine the effects of using nursing interventions of music therapy or sensory information, on reducing anxiety and uncertainty, and improving negative mood among Chinese subjects immediately prior to cardiac catheterization. Methods: An experimental three-group repeated measures design for this pilot study was used. Forty-five hospitalized adults (15/group) undergoing cardiac catheterization were randomly assigned to either (1) a music therapy intervention, (2) a sensory information intervention or (3) treatment as usual (control). Anxiety, uncertainty and mood state were measured using self-reported questionnaires and physiological measures were made at baseline, post-intervention to determine their effect and post-cardiac catheterization to determine whether these interventions had any long-lasting effect. Results: The control group was found to be significantly older (P=0.001) than the two experimental groups. Older age was associated with lower anxiety scores (r=-0.31, P=0.04 at baseline; r=-0.30, P=0.04 post-intervention; r=-0.22, P=0.15 post-cardiac catheterization). After controlling for age, the use of music therapy or sensory information did not significantly reduce anxiety, improve mood state, reduce uncertainty, decrease heart or respiratory rate among subjects undergoing cardiac catheterization. Conclusion: The non-significant result may have been affected by the small sample, and the social and cultural expectations regarding the public display of emotions among Chinese populations. © 2002 European Society of Cardiology. Published by Elsevier Science B.V. All rights reserved.
• Holroyd, E. A., Molassiotis, A., & Taylor-Pilliae, R. E. (2001). Filipino domestic workers in Hong Kong: health related behaviors, health locus of control and social support. Women & health, 33(1-2), 181-205.
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  A total of 290 female Filipino domestic helpers residing in Hong Kong completed a concurrent cross sectional survey designed to provide an initial report of basic data which measured mental health symptoms, health-related behaviors, health locus of control and social support. The four top ranking symptoms of mental distress reported included waking in the early hours, loneliness, worry and taking a long time to get to sleep. In general, the level of health related behaviors was high, with a satisfactory diet and low rates of alcohol, nicotine and coffee consumption. However, few women surveyed had previously had a Pap smear. There were also low scores for other preventive health practices. Reinforcement for health behaviors was seen as either a matter of chance or being influenced by powerful others for two thirds of the women. The conclusion highlights the intersection between gender, immigration and social class by drawing attention to issues of acceptance and accessibility of healthcare services for immigrant within host countries. In addition, cultural directions for immigrant health education are outlined.
• Taylor-Piliae, R. E., & Molassiotis, A. (2001). An exploration of the relationships between uncertainty, psychological distress and type of coping strategy among Chinese men after cardiac catheterization. Journal of Advanced Nursing, 33(1), 79-88.
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  PMID: 11155111;Abstract: The experience of cardiac catheterization (CC) has included feelings of uncertainty, stress, fear and anxiety in many patients. However, conflicting findings from previous research have been reported. Chinese patients who undergo CC may experience psychological distress in a different way to other cultures as a result of traditional beliefs. Moreover, little research examining the impact of CC among Hong Kong Chinese has been carried out. Therefore, the aim of the study was to explore relationships between uncertainty, psychological distress and coping strategy in Chinese men after CC, using Mishel's model of uncertainty in illness as a framework. A convenience sample of 27 men hospitalized for cardiac catheterization participated in this study using a descriptive, correlational research design. Ethical approval was obtained from the Ethics Committee of the Medical Faculty at the Chinese University of Hong Kong and from the Executive Committee of the hospital. Participation was on a voluntary basis with patient confidentiality assured. Self-report questionnaires included Chinese versions of Mishel's Uncertainty in Illness Scale (MUIS), the Profile of Mood States (POMS), the State-Trait Anxiety Inventory (STAI) and the Chinese Coping Scale (CCS) for data collection. Data were analysed using the Statistical Package for Social Sciences. High mean scores for uncertainty (mean = 1014, SD = 1149) and variables measuring psychological distress (mood disturbance mean = 36.6, SD = 33.6, state-anxiety mean = 39.1, SD = 8.95, trait-anxiety mean = 43.7, SD = 8.1) among these participants suggest that Hong Kong Chinese men experience uncertainty and psychological distress when undergoing cardiac catheterization. Strong relationships between uncertainty and mood disturbance (r = 0.57, P = 0.01), trait-anxiety and mood disturbance (r = 0.65, P = 0.01) and state-anxiety and external coping strategies (r = 0.50, P = 0.05) were found. These findings suggest that relationships between uncertainty, psychological distress and external coping strategies exist in Chinese men hospitalized for cardiac catheterization. Moreover, these findings may help nurses' design culturally specific interventions for their patients.
• Taylor-Piliae, R. E., & Molassiotis, A. A. (2000). Psychometric evaluation of the Chinese version of Mishel’s Uncertainty in Illness Scale. Hong Kong Nursing Journal, 36, 14-21.
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  Taylor-Piliae, R.E. & Molassiotis, A. Psychometric evaluation of the Chinese version of Mishel’s Uncertainty in Illness Scale. Hong Kong Nursing Journal, 36:14-21, 2000.
• Taylor-Piliae, R. (1999). Utilization of the Iowa Model in establishing evidence-based nursing practice.. Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses, 15(6), 357-362.
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  PMID: 11868583;Abstract: Clinical practice based on tradition or established rituals appears to be widespread amongst a variety of nurses and practice settings. However, tradition-based practice may not necessarily be based on sound scientific evidence and could potentially be harmful to patients or result in inappropriate utilization of resources. Conversely, evidence-based practice is the utilization of the best available empirical evidence in the practice setting, to facilitate sound clinical decision-making. Suctioning ventilated patients is a necessary and important aspect of patient care. However, normal saline instillation prior to suctioning, in order to loosen secretions, remains a common nursing procedure despite research suggesting that there is no clear benefit and in some instances may be harmful. Several models have been developed over the past few years to facilitate nursing practice that is based on research or the best available evidence. The Iowa Model, developed at the University of Iowa Hospitals and Clinics, serves as a framework to improve patient outcomes, enhance nursing practice and monitor health care costs. Moreover, it facilitates the application of empirical evidence to clinical practice. This paper will discuss the utilization of the Iowa Model to promote evidence-based nursing practice, with regard to normal saline instillation prior to suctioning, in the critical care unit of a 100-bed hospital in Hong Kong. Patient, staff and fiscal outcomes will also be reported.
• Taylor-Piliae, R. E., Molassiotis, A. A., & Holroyd, E. (1999). Psychometric evaluation of the Chinese translation of the Profile of Mood States.. Hong Kong Nursing Journal, 35, 7-13.
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  Molassiotis, A., Holroyd, E. & Taylor-Piliae RE. Psychometric evaluation of the Chinese translation of the Profile of Mood States. Hong Kong Nursing Journal, 35:7-13, 1999.
• Taylor-Piliae, R. E. (1998). Establishing evidence-based practice: Issues and implications in critical care nursing. Intensive and Critical Care Nursing, 14(1), 30-37.
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  PMID: 9652259;Abstract: Evidence-based practice is the application of the best available empirical evidence, including recent research findings to clinical practice in order to aid clinical decision-making. The implementation of these findings is vital for optimizing patient outcomes, improving clinical practice, providing cost-effective high quality care and enhancing the credibility of nurses. The use of research findings to improve practice has been discussed and promoted for the last 20 years. The author argues that Rogers' theoretical model of the Diffusion of Innovations may prove useful in understanding the problem of the slow diffusion of the application of research evidence in clinical nursing practice. Many authors have discussed potential barriers to using research in clinical practice in order to facilitate utilization of findings. However, recent studies all document that a gap between research findings and their implementation in clinical practice still exists. This appears to hold true across a variety of practice settings, including nurses working in critical care. The diffusion of innovations in current critical care nursing practice at each stage of Rogers' theory will be examined, with recommendations given to facilitate the establishment of evidence-based practice (EBP). © 1998 Harcourt Brace & Co. Ltd.

Presentations

• Taylor-Piliae, R. E. (2021, Fall). Mind-Body Intervention Approaches to Improve Physical, Mental, and Sleep Health. Duet’s Congregational Health Services: Faith Community Nurses. online presentation due to COVID-19.
• Taylor-Piliae, R. E. (2021, Spring). Mind-Body Intervention Approaches to Improve Physical, Mental, and Sleep Health.. UArizona College of Medicine, Behavioral Medicine Sleep Seminar. online presentation due to COVID-19.
• Taylor-Piliae, R. E. (2021, Spring). Tai Chi for Health and Well-Being Among Older Adults. UArizona Retirees Association. online presentation due to COVID-19.
• Taylor-Piliae, R. E. (2021, Spring). Transforming Stroke Rehabilitation and Recovery by Integrating Tai Chi Exercise, A Mind-Body Intervention, Alongside Conventional Care to Ameliorate Post-Stroke Depression. UArizona College of Nursing Cutting Edge Seminar. online presentation due to COVID-19.
• Taylor-Piliae, R. E. (2021, Summer). Tai Chi Exercise for Health and Well-Being Among Adults with a Chronic Illness. Chronic Illness Care Symposium, Seventh Pan-Pacific Nursing Conference. online presentation due to COVID-19: The Chinese University of Hong Kong.
• Taylor-Piliae, R. E. (2020, November 18). Tai Chi for Health and Well Being. Wellness Wednesdays: A Community ConnectionUAHS.
• Taylor-Piliae, R. E. (2020, Spring). Unintentional Falls and Injuries Among Older Adults. Healthy Pima 2020Pima County Department of Public Health.
• Taylor-Piliae, R. E. (2019, Fall). Tai Chi Exercise for Fall Prevention. Fall Prevention Community Event. Tucson, AZ: Banner-UMC Tucson and University of Arizona.
• Taylor-Piliae, R. E. (2019, Fall). The Effectiveness of Tai Chi Exercise for Chronic Heart Failure: A Systematic Review and Meta-analysis (Keynote Speaker). The 2019 International Taijiquan Health Science Conference. Beijing, China: International Society of Chinese Health Practices.
• Taylor-Piliae, R. E. (2019, Spring). Tai Chi Exercise for Health and Well-being.. Arizona Holistic Nursing Symposium. Tucson, AZ: American Holistic Nurses Association.
• Chan, A. W., Leung, D. Y., Chair, S. Y., Sit, J. W., & Taylor-Piliae, R. E. (2018, March). Tai Chi Exercise is More Effective than Brisk Walking in Reducing Cardiovascular Disease Risk Factors. American Heart Association's 2018 EPI/Lifestyle Scientific Sessions. New Orleans, LA: American Heart Association.
• Taylor-Piliae, R. E. (2018, May). Tai Chi Exercise for Heart Failure: What is the Scientific Evidence?. Heart Failure 2018 Congress, CV Nursing Session: Alternative ways to Increase Physical Activity. Vienna, Austria: European Society of Cardiology.
• Sit, J. W., Chair, S. Y., Choi, K. C., Chan, C. W., Chan, A. W., Qiu, X., & Taylor-Piliae, R. E. (2017, Feb 21). Strategies for Enhancing Stroke Self-management Among Older Stroke Survivors: A Mixed Methods Inquiry. International Stroke Conference. Houston, TX: American Heart Association/Amercan Stroke Association.
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  Podium Presentation
• Taylor-Piliae, R. E. (2017, April 6). Meta-Analysis: A Research Method for Nursing Science. PhD Seminar. Jackson, MS: University of Mississippi Medical Center, School of Nursing.
• Taylor-Piliae, R. E. (2017, April 7). The Effectiveness of Tai Chi Exercise in Improving Health and Well-Being. The Dr. Barbara Rogers Endowed Lectureship and Oglevee Papers Keynote, Nursing Alumni Day. Jackson, MS: University of Mississippi Medical Center, School of Nursing.
• Taylor-Piliae, R. E. (2017, May 18-19). Tai Chi Exercise for Fall Prevention: What is the Scientific Evidence?. Western Arizona Conference on Aging. Yuma, AZ: Western Arizona Council of Governments.
• Rosenfeld, A. G., Taylor-Piliae, R. E., Carrington, J. M., Gephart, S. M., Insel, K. C., Loescher, L. J., & Reed, P. G. (2016, January). Defying the skeptics! Strategies and successes of an online PhD program.. AACN Doctoral Education Conference. Florida: AACN.
• Sit, J. W., Chair, S. Y., Choi, K. C., Chan Yip, C. W., Ching, R., Taylor-Piliae, R. E., & Tang, S. W. (2016, February). The Effects of a Theory-based Health Empowerment Intervention on Self-Management and Functional Recovery Post-Stroke. American Heart Association/American Stroke Association, State of the Science Stroke Nursing Symposium. Los Angeles, CA.
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  AbstractStroke 2016: 47 ANS7
• Taylor-Piliae, R. E. (2016, November). Effects of Tai Chi on Physical, Cognitive, and Psychological Function: Review of the Best Evidence. Gerontological Society of America, 69th Annual Scientific Meeting. New Orelans, LA: East meets West Symposium Keynote Speaker.
• Taylor-Piliae, R. E. (2016, October). Tai Chi Exercise for Fall Prevention: A Meta-Analysis of the Scientific Evidence. Research Seminar. Hong Kong, SAR: Nethersole School of Nursing, The Chinese University of Hong Kong.
• Taylor-Piliae, R. E. (2016, September). Tai Chi Exercise for Fall Prevention: What is the Scientific Evidence?. Advances in Aging Lecture Series. Tucson, AZ: UA College of Medicine, Arizona Reynolds Program of Applied Geriatrics, Arizona Geriatric Workforce Enhancement Program and the Arizona Center on Aging.

Poster Presentations

• Dolan, H., Rishel, C. J., Rainbow, J., & Taylor-Piliae, R. E. (2021, Fall). Relying on Myself: The Lived Experience of Being at Risk for Falling in the Hospital Among Older Adults. The Gerontological Society of America, 2021 Annual Scientific Meeting. online presentation due to COVID-19.
• Hastings, D., & Taylor-Piliae, R. E. (2021, Spring). Utilization of Leininger’s Culture Care Theory to Counter Violence and Human Trafficking Against American Indian Women and Adolescents.. Western Institute of Nursing's 54th Annual Communicating Nursing Research Conference. online presentation due to COVID-19.
• Taylor-Piliae, R. E., Morrison, H. W., Hsu, C., & Grandner, M. (2021, Summer). Changes in Symptoms, Sleep, Oxidative Stress, and Inflammatory Markers Among Community-Dwelling Stroke Survivors After a Tai Chi Exercise Intervention.. European Society of Cardiology, EuroHeartCare 2021 Congress. online presentation due to COVID-19.
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  (Abstract selected for Press Release). Taylor-Piliae, R.E., Morrison, H., Hsu, C.H., Grandner, M. (2021). Changes in Symptoms, Sleep, Oxidative Stress, and Inflammatory Markers Among Community-Dwelling Stroke Survivors After a Tai Chi Exercise Intervention. European Journal of Cardiovascular Nursing, Volume 20, Issue Supplement_1, July 2021, zvab060.075, https://doi.org/10.1093/eurjcn/zvab060.075
• Taylor-Piliae, R. E., Taylor-Piliae, R. E., Dolan, H., Dolan, H., Yako, A., & Yako, A. (2021, Summer). Stroke Survivors Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study.. European Society of Cardiology, EuroHeartCare 2021 Congress. online presentation due to COVID-19.
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  Taylor-Piliae, R.E., Dolan, H. Yako, A. (2021). Stroke Survivors Personal Efficacy Beliefs and Outcome Expectations of Tai Chi Exercise: A Qualitative Descriptive Study. European Journal of Cardiovascular Nursing, Volume 20, Issue Supplement_1, July 2021, zvab060.083, https://doi.org/10.1093/eurjcn/zvab060.083
• Dolan, H. R., Crane, T. E., & Taylor-Piliae, R. E. (2020, Spring). How Wearable Sensors Can Improve Self-Care in Chronic Illness. Western Institute of Nursing's 53rd Annual Communicating Nursing Research Conference. Portland, OR.
• Taylor-Piliae, R. E., & Finley, B. A. (2020, Spring). Benefits of Tai Chi Exercise among Adults with Chronic Heart Failure: A Systematic Review and Meta-Analysis.. American Heart Association's 2020 EPI/Lifestyle Scientific Sessions. Phoenix, AZ: American Heart Association/American Stroke Association.
• Dolan, H. R., & Taylor-Piliae, R. E. (2019, April). Embarrassment: A Concept Analysis. Western Institute of Nursing's 2019 Annual Communicating Nursing Research Conference. San Diego, CA: Western Institute of Nursing.
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  accepted for presentation
• Gallegos Jr., J. L., Taylor-Piliae, R. E., Pace, T. W., Gallek, M., & Ritter, L. S. (2019, March). Hidden Risks: Relationship among visceral adipose tissue, interleukin - 18, and adiponectin in the development of type 2 diabetes in Filipino Americans. American Heart Association's 2019 EPI/Lifestyle Scientific Sessions. Houston, TX: American Heart Association.
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  accepted for presentation
• Jajoo, A., Taylor-Piliae, R. E., Killgore, W., Warlick, C., Alfonso-Miller, P., & Grandner, M. (2019, Spring). Types of Habitual Physical Activity Associated with Habitual Sleep Duration, Sleep Quality, and Daytime Sleepiness.. Sleep 2019: 33rd Annual Meeting of the Associated Professional Sleep Societies.. San Antonio, TX..
• Marupuru, S., Bell, M. L., Grandner, M., & Taylor-Piliae, R. E. (2019, Spring). The effect of physical activity on sleep quality among older stroke survivors: Secondary analysis from a randomized controlled trial.. International Society for Pharmacoeconomics and Outcomes Research. New Orleans, LA.
• Taylor-Piliae, R. E., Hsu, C., Toosizadeh, N., & Mohler, M. J. (2019, March). Novel Dual-Task Balance Challenge to Prevent Falls in Older Adults with Cardiovascular Disease Risk Factors. American Heart Association's 2019 EPI/Lifestyle Scientific Sessions. Houston, TX: American Heart Association.
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  accepted for presentation
• Taylor-Piliae, R. E., Zeimantz, M. A., & Rosenfeld, A. G. (2019, February). Stroke Survivors' Perceptions of Well-Being and Recovery after a Tai Chi Exercise Intervention. International Stroke Conference. Honolulu, HI: American Heart Association/Amercan Stroke Association.
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  accepted for presentation
• Taylor-Piliae, R. E., Zeimantz, M., Dolan, H. R., & Rosenfeld, A. G. (2019, Fall). Community-Dwelling Stroke Survivors’ Feelings and Perceptions of a Tai Chi Exercise Intervention.. The 2019 International Taijiquan Health Science Conference. Beijing, China: International Society of Chinese Health Practices.
• Taylor, E., & Taylor-Piliae, R. E. (2017, April). The Effects of Tai Chi on Physical and Psychosocial Function among Persons with Multiple Sclerosis: A Systematic Review. International Integrative Nursing Symposium. Tucson, AZ: University of Arizona, College of Nursing.
• Taylor, E., & Taylor-Piliae, R. E. (2017, May 4). The Effects of Tai Chi on Physical and Psychosocial Function among Persons with Multiple Sclerosis: A Systematic Review. 2017 Nurse Week Poster Showcase. Tucson, AZ: University of Arizona, College of Nursing.
• Miller, S. M., & Taylor-Piliae, R. E. (2016, May). Tai Chi Exercise and Safe Driving Performance in Older Adults: An Observational Study. International Congress on Integrative Medicine and Health. Henderson, NV: International Congress on Integrative Medicine and Health.
• Webber-Ritchey, K. J., Loescher, L. J., & Taylor-Piliae, R. E. (2016, March). Predictors of Physical Activity Among African-American Parents of Young Children: Personal and Environmental Factors. American Heart Association/ American Stroke Association Cardiovascular Disease Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions. Phoenix, AZ.
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  AbstractCirculation 2016: 33: AP135

Creative Productions

• Taylor-Piliae, R. E. (2017. Building Better Futures Video. Tucson, AZ: University of Arizona, College of Nursing. https://www.youtube.com/watch?v=Pkm1wPposfo

Others

• Mohler, M. J., & Taylor-Piliae, R. E. (2017, Sept). Assessing and Intervening in Fall Risk for Older Adults. Elder Care: A Resource for Interprofessional Providers. http://aging.arizona.edu/program/elder-care-resource-interprofessional-providers