The overall goal of this feasibility study is to test an individualized, nurse-led behavioral health program that leverages home telehealth technology to directly teach low and fixed income older adults residing in the community to reduce their pain and fatigue by improving mobility through strength and balance training in the context of a complementary mental health intervention to address motivation and social support. Specifically, the integrated intervention includes components to address (1) balance and fall prevention (Otago), (2) strengthening and mindfulness (Yoga), and importantly, (3) affective state and social support which are crucial to maintaining motivation (Behavioral Activation). Moreover, these 3 best practices interventions will be enhanced by integrating physical activity data tracking to complement self-report measures, the former of which will be available in real time for patient and provider review, with parameter violations (eg, non-activity during scheduled activity time; overall activity level lower for a set period of time) triggering brief telehealth sessions to address any problems. Finally, participant qualitative feedback will be captured through voice/video recorded diaries focusing on experienced pain, fatigue, sleep, personal reactions to the project and physical activity as well as technology issues they may encounter.
Individuals with venous leg and diabetic foot ulcers often find these ulcers take a long time to heal and when they do, sometimes they come back. These ulcers can be quite painful making it hard to work, sleep and go about one's day to day activities. You will be asked to do a self-care routine of taking the temperature of the skin where the leg or foot ulcer just healed with a special thermometer and applying a small cooling gel patch over this skin. We want to know if this routine will prevent the ulcer from coming back, help you to become more active, and improve the quality of your life.