About

Janet L. Larson, PhD, RN, FAAN, is a Professor and Shake Ketefian Collegiate Professor of Nursing at the University of Michigan School of Nursing. She is an expert in the pulmonary rehabilitation of people with chronic obstructive pulmonary disease (COPD) and maintains an active research program studying factors that influence symptoms, physical activity, and quality of life for individuals with COPD. Her research primarily focuses on exercise interventions for COPD, including studies on inspiratory muscle training and cycle ergometry training, as well as examining the effects of upper body strength training and self-efficacy interventions to promote exercise adherence. Dr. Larson has conducted longitudinal studies on respiratory muscle strength deterioration and functional status in COPD patients and is currently engaged in research to increase physical activity levels among this population. She mentors students in her research laboratory, teaches graduate research seminars, and lectures on respiratory physiology and exercise research related to COPD. Dr. Larson has also collaborated on global health nursing workshops and holds leadership roles in several professional organizations, including the American Thoracic Society and the Respiratory Nursing Society. Her contributions have been recognized through numerous awards, including the University of Michigan Shaké Ketefian Collegiate Professorship and fellowships in the American Academy of Nursing.

Research topics

• Medicine
• Physical therapy
• Psychology
• Internal medicine
• Gerontology

Selected publications

• Active for life intervention produces a sustained increase in physical activity in people with chronic obstructive pulmonary disease

  Respiratory Medicine · 2026-04-07

  article1st authorCorresponding
  PublisherDOI

• Barriers to Physical Activity in Low-Income Older Adults Living in Senior Housing

  Healthcare · 2025-05-16 · 3 citations

  articleOpen access

  While a majority of older adults fail to engage in recommended levels of physical activity (PA), lower-income older adults face unique challenges. They are at greater risk for low levels of PA, but little is known about the barriers they face. Objectives: This study aimed to investigate self-reported PA and barriers to PA for older adult residents of subsidized low-income senior housing, comparing barriers for those with lower and higher levels of PA. Methods: Ninety-two older adults (mean age 76.57 (SD = 7.50)) were recruited from low-income senior housing facilities. They completed a demographic questionnaire, the International Physical Activity Questionnaire (IPAQ), which measures MET-minutes/week of engaging in vigorous, moderate, and light PA levels, and the 27-item Inventory of Physical Activity Barriers (IPAB), which measures multifaceted barriers to PA. Results: The most common barrier for all residents was the PA priority. Independent t-tests revealed that the low-active group faced greater barriers than the high-active group in physical health barriers (t = 2.329, p = 0.022), PA priority of (t = 2.836, p = 0.006), environmental barriers (t = 2.072, p = 0.042), and total PA barriers (t = 2.281, p = 0.025). No significant differences were found between the low-active and high-active groups for emotional health barriers, skill barriers, external factor barriers, and social barriers. Conclusions: The low-active older adults were less likely to overcome barriers, such as physical health issues, PA priority, and environmental factors. Further research is necessary to gain a deeper understanding of the characteristics and underlying mechanisms of these barriers and to develop effective strategies for addressing them. However, findings should be interpreted cautiously due to the small and convenient sample and potential bias from self-reported PA measures.

  PublisherOA PDFDOI

• Profiles of long COVID symptoms and self-efficacy for self-management: A cross-sectional survey

  Applied Nursing Research · 2025-05-22 · 3 citations

  article
  PublisherDOI

• Postpandemic Sedentary Behavior and Physical Activity Among IT Workers

  Journal of Occupational and Environmental Medicine · 2025-10-08

  articleSenior author

  OBJECTIVE: We assessed postpandemic work arrangements among information technology (IT) workers at high risk for sedentary behavior (SB) and insufficient physical activity (PA), and examined factors influencing both SB and PA. METHODS: A cross-sectional, mixed-methods study collected data from 80 IT workers between November 2023 and April 2024. Accelerometry and survey data for both SB and PA were analyzed using descriptive statistics and negative binomial regression; qualitative data were analyzed using content analysis. RESULTS: Participants averaged 10.76 hours of SB, including 3.72 hours in prolonged SB, 221 minutes of light PA, and 21 minutes of moderate-to-vigorous PA per day. Hybrid workers were more sedentary than other groups. Individual perceptions and workplace social support were influencing factors. CONCLUSIONS: Hybrid IT workers need targeted interventions employing multilevel strategies, including behavioral education and supportive work environments.

  PublisherDOI

• Treatable Traits and Self-management of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  reviewSenior author

  Abstract Rationale: Managing COPD is complex due to its heterogeneous and progressive nature, requiring strategies beyond one-size-fits-all approaches. The treatable traits (TT) model is a personalized approach recommended in major guidelines for COPD management, with traits classified into pulmonary, extra-pulmonary, and behavioral/risk-factor domains. It is unclear if self-management interventions effectively address TT in COPD. This systematic review aimed to describe and evaluate the TT targeted by COPD self-management programs and identify if personalized self-management programs address TT more effectively than non-personalized programs. Methods: We searched PubMed, PsycINFO, Cochrane Library, CINAHL, and Scopus in September 2023 and updated the search in October 2024. Inclusion criteria were English-language, peer-reviewed, randomized controlled trials (RCTs) of COPD self-management interventions as defined by the authors with individual-level patient outcomes. Bias was assessed using Version 2 of the Cochrane Risk of Bias tool. We pooled RCTs using a random-effects model and calculated mean difference (MD) with 95% confidence intervals (CIs). We assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: 26 studies were included, with 4,235 participants (sample size: 29-743) and 1-12 months intervention durations. A majority of studies showed a low risk of bias (46.2%) and some concerns (34.6%). Most COPD self-management interventions focused on extrapulmonary (including depression, anxiety, and deconditioning) and behavioral/risk-factor domains (including suboptimal adherence, exercise intolerance, side effects, and written action plans). The meta-analysis for the six-minute walk test revealed a significant improvement after self-management interventions (6 RCTs with 769 participants; MD = 12.29 meters, 95% CI: 8.08 to 16.50; P < 0.0001; low certainty), addressing the TT of exercise tolerance. However, substantial heterogeneity was observed (I² = 94.3%). Meta-analysis of the COPD assessment test (CAT) total score addressed the TT of symptoms impact and showed a reduction (6 RCTs with 341 participants, MD = -1.60; 95% CI: -3.07 to -0.12; P = 0.034, moderate certainty), with no heterogeneity (I² = 0.0%). 17/26 studies incorporated personalized elements in the interventions. We performed a narrative synthesis on 6/26 studies that included the CAT. Four employed personalized self-management interventions, and two did not. Personalized self-management demonstrated greater effectiveness in addressing TT of symptoms impact compared to non-personalized approaches. Conclusions: Studies of COPD self-management employed heterogeneous outcomes, making it difficult to compare effects across studies. Further research is needed to explore strategies for using self-management programs within the TT approach and addressing the heterogeneity of COPD self-management outcomes.

  PublisherDOI

• Dose-response relationship of physical activity and sedentary time with mortality in people with chronic obstructive pulmonary disease: an analysis of UK biobank accelerometer cohort

  BMC Pulmonary Medicine · 2025-10-31 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: The COPD guidelines recommend engaging in regular physical activity and reducing sedentary time (ST), but little is known about the optimal or minimal dose of physical activity and ST. This study aimed to quantify the prospective dose-response relationships between daily time spent in moderate to vigorous physical activity (MVPA), light physical activity (LPA), ST and mortality, and examine the theoretical consequences of replacing ST with equal time of MVPA or LPA. METHODS: A population-based cohort study of 1,551 individuals with COPD enrolled in the UK Biobank. MVPA, LPA, ST were measured with the wrist-worn Axivity AX3 accelerometer. All-cause mortality was obtained through the linkage to death registries. Restricted cubic splines were used to assess the dose response associations of MVPA, LPA, ST and all-cause mortality. Isotemporal substitution models were used to estimate the theoretical effect of replacing ST with MVPA or LPA. RESULTS: 54% were male, and the mean (SD) age was 66.31 (6.52) years. Over a mean (SD) follow-up of 7.44 (1.67) years, 244 (15.7%) died. We observed a significant L-shaped association between MVPA and all-cause mortality, with an optimal amount at 60 min/day (HR = 0.27, 95% CI: 0.18-0.41). For LPA, we observed a significant U-shaped association, with an optimal amount at 5.2 h/day (HR = 0.15, 95% CI: 0.10-0.25). The threshold for ST was 12.43 h/day, above which a significant increase in mortality was observed. Replacing 30 min/day of ST was associated with 34% decreased risk in mortality for MVPA (HR = 0.66, 95%CI: 0.55-0.81, P < .001) and 10% lower mortality for LPA (HR = 0.90, 95% CI: 0.86-0.94, P < .001). CONCLUSIONS: The findings of this study suggest non-linear associations of MVPA, LPA, ST and all-cause mortality. Replacing ST with either MVPA or LPA is associated with decreased risk of mortality.

  PublisherOA PDFDOI

• Comparative Analysis Between ActiGraph And ActivPAL Measured Moderate To Vigorous Physical Activity For People With COPD

  Medicine & Science in Sports & Exercise · 2025-09-16

  articleSenior author

  ActiGraph (AG) accelerometers are commonly used to measure sedentary behavior (SB) and moderate-to-vigorous physical activity (MVPA), but there are compliance issues with waist-worn devices that lead to problems with missing data. ActivPAL (AP) devices are worn 24 hours/day on the thigh, and there is minimal missing data, but PAL software does not estimate MVPA. PURPOSE: We estimated MVPA from AP data using 5 data processing methods and assessed their agreement with AG-measured MVPA among older adults with chronic obstructive pulmonary disease (COPD) to determine whether AP devices can be used to measure MVPA. METHODS: This is a secondary data analysis of data collected from 148 inactive adults (aged ≥50) with COPD. Participants wore ActivPAL3 on the thigh and ActiGraph GT9X on the waist concurrently for 7 days. ActivPAL data was processed using the following methods: 1) metabolic equivalents (METs), 2) ≥75 steps/min, 3) ≥100 steps/min, 4) vector magnitude (VM) acceleration counts, and 5) vertical axis counts. ActiGraph data was processed using Freedson (2011) and Evenson (2023) VM cut points, 60s epochs, and normal filters. The Bland-Altman plots and concordance correlation coefficient (CCC) were used to assess the agreement between AP and AG MVPA using individual day-level data. RESULTS: Compared to AG MVPA using Freedson VM cut points, CCC ranged from 0.62 to 0.64 for all AP MVPA, except for 100 steps/min (CCC = 0.44). Compared to AG MVPA using Evenson VM cut points, CCC ranged from 0.08 to 0.18 for all AP MVPA. CONCLUSION: Most AP-derived estimates of MVPA showed moderate agreement and low bias and were reasonably accurate when compared to AG-derived MVPA with Freedson VM cut points. Further research is needed to further validate this approach. Table 1. - Comparing AG and AP Data Processing Methods for Measruing MVPA in Older Adults with COPD (n = 148) ActiGraph (60 second epochs, Normal Filter) Freedson VM cut points Evenson VM cut points ActivPAL Data Reduction Techniques Mean difference AG-AP (95%CI) Concordance Correlation(95%CI) Mean difference AG-AP (95%CI) Concordance Correlation(95%CI) METs (≥3 METs) 3.65 (-22.41, 29.72) 0.63 (0.58, 0.66) 33.50 (-32.27, 99.28) 0.18 (0.16, 0.21) Steps (≥75 steps/min) 3.93 (-22.16, 30.02) 0.62 (0.57, 0.66) 33.78 (-32.35, 99.90) 0.18 (0.15, 0.20) Steps (≥100 steps/min) 8.23 (-18.20, 34.66) 0.44 (0.40, 0.48) 38.08 (-32.14, 108.29) 0.08 (0.06, 0.09) VM acceleration counts (≥35492) 5.28 (-20.00, 30.56) 0.62 (0.57, 0.65) 35.13 (-31.54, 101.80) 0.16 (0.14, 0.19) Vertical axis counts (≥20492) 5.55 (-18.82, 29.91) 0.64 (0.60, 0.67) 35.39 (-31.43, 102.22) 0.16 (0.13, 0.18) Note. VM = Vector Magnitude; AG = ActiGraph; AP = ActivPAL; METs = Metabolic Equivalents Supported by: J.Y.S. is supported by NIH T32 NR016914.

  PublisherDOI

• Physical Activity and Sedentary Behavior in Assisted Living Residents: Feasibility and Acceptability of a Longitudinal Study

  Journal of Applied Gerontology · 2025-12-20

  articleOpen accessSenior author

  Older assisted living (AL) residents are at risk for decreasing physical activity (PA) and increasing sedentary behavior (SB), but the change is not well-documented. We aimed to (1) determine the feasibility and acceptability of a longitudinal study of PA/SB with accelerometers, tests of cognitive and physical function, and questionnaires, (2) establish a preliminary estimate of changes in PA/SB over 6 months, and (3) evaluate potential factors associated with PA/SB changes. Participants from nine AL facilities wore activPAL and ActiGraph accelerometers at baseline and 6 months, and completed other measures. Fifty residents completed baseline data collection, and 12% withdrew during the study. Over 6 months, there were small declines in PA and small increases in SB; PA change was more evident in individuals with cognitive impairment. Weak relationships were observed between PA/SB changes and 10 factors. This study supports the feasibility and acceptability of a longitudinal study of PA/SB in AL residents.

  PublisherOA PDFDOI

• PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOR IN RESIDENTS OF ASSISTED LIVING: A PILOT LONGITUDINAL STUDY

  Innovation in Aging · 2024-12-01

  articleOpen accessSenior author

  Abstract Low levels of physical activity (PA) and high sedentary behavior (SB) place older assisted living (AL) residents at risk for functional decline and premature transfer to a higher level of care. This study aimed to examine the feasibility and acceptability of conducting a longitudinal study using two objective measures of PA and SB. We recruited participants from four AL facilities in Michigan. Participants wore two devices (ActiGraph at the wrist and ActivPal on the anterior thigh) for seven consecutive days twice, once at baseline and again six months later, and completed questionnaires. We evaluated recruitment, retention, and compliance with and acceptability of wearing devices, and conducted a longitudinal multilevel model to estimate preliminary changes in PA and SB over 6 months. Forty-two people volunteered, 19% were excluded with a low Mini-Cog score, 62% completed baseline (77% female; mean age=80.1), and 60% completed 6 months data collection. Most participants were willing to perform two measures of PA and SB and generally found the procedures to be acceptable. Over 6 months, moderate to vigorous PA significantly declined by 8 min/day (p=0.02), light PA declined by 18 min/day (p=0.13), and SB increased by 15 min/day (p=0.48). In conclusion, the results support the feasibility and acceptability of this research protocol. Participants had a small decline in PA over a six-month period of time, which was not clinically meaningful but could become significant if the trend continued.

  PublisherDOI

• Factors associated with transfer from assisted living facilities to a nursing home: National Health Aging Trends Study 2011–2019

  Journal of the American Geriatrics Society · 2024-08-19 · 4 citations

  articleOpen accessSenior author

  BACKGROUND: Residents of assisted living facilities (ALF) transfer to a nursing home when they require a higher level of care, but limited research has examined risk factors for transfer to a nursing home. The aims of this study were to identify (1) baseline factors associated with transfer to a nursing home and (2) time-varying factors associated with transfer to a nursing home over 8 years, using a national dataset from the National Health Aging Trends Study (NHATS). METHODS: NHATS participants were included in this study if they: (1) resided in ALF from Round 1 (2011) through Round 8 (2018); (2) completed the sample person (SP) interview at baseline; (3) were admitted to ALF at age 65 years or older. We conducted Cox proportional hazards regression to examine candidate predictors (difficulty with basic activities of daily living (ADL), chronic conditions, hospitalization, sleep disturbances, mental health, physical performance, self-reported health, participation in social and physical activity, and sociodemographic) associated with transfer to a nursing home. Employing backward elimination, we built parsimonious final models for analysis. RESULTS: The analytic sample included 970 participants of whom 143 transferred to nursing homes over 8 years. Those who had a better physical performance at baseline (HR = 0.83, 95% CI = 0.79-0.88) and were college educated (HR = 0.58, 95% CI = 0.36-0.92) demonstrated a significantly lower risk for transfer to a nursing home over 8 years. Residents who maintained physical activity (HR = 0.56, 95% CI = 0.37-0.86), better physical performance (HR = 0.87, 95% CI = 0.80-0.94), and difficulty with fewer basic ADLs (HR = 1.13, 95% CI = 1.02-1.26) were at lower risk for transfer to a nursing home over 8 years. CONCLUSIONS: Our findings can be used to identify older adults in ALFs at risk of transfer to a nursing home. Strategies to promote physical function and physical activity could avoid/delay the need to transfer. Helping older residents to age in place will have important health and economic benefits.

  PublisherOA PDFDOI

Recent grants

• NIH Grant P30NR009014

  NIH · $3.7M · 2010

• NIH Grant R01NR004129

  NIH · $2.1M · 2004

• NIH Grant T32NR007075

  NIH · $2.2M · 2010

• NIH Grant R01NR008037

  NIH · $2.2M · 2009

• NIH Grant R01NR001428

  NIH · $2.5M · 1996

Frequent coauthors

• Margaret K. Covey

  University of Illinois Chicago

  76 shared

• Minu Patel

  University of Illinois Chicago

  68 shared

• Charles G. Alex

  66 shared

• Candice A. Vitalo

  University of Illinois Chicago

  51 shared

• Jean K. Berry

  40 shared

• Mi Ja Kim

  30 shared

• Scott Wirtz

  28 shared

• Mi Ja Kim

  Edward Hines, Jr. VA Hospital

  27 shared

Labs

• Janet L. Larson Research LaboratoryPI

Awards & honors

• University of Michigan Shaké Ketefian Collegiate Professor o…
• University Scholar, University of Illinois at Chicago (2003-…
• Distinguished Contribution to Research in the Midwest, Midwe…
• Founders Award, Respiratory Nursing Society (2000)
• Service Award, Respiratory Nursing Society (1995)