Home for the Holidays: 10 Tips, Tricks, and Helpful Products to Improve Safety at Home - and When You’re Away from Home

By Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist
Owner: Healthy Aging Physical Therapy

The holiday season brings joy, family, and togetherness — but also new challenges for older adults. Between traveling, hosting, and adapting to new environments, it’s easy to underestimate just how much energy it all takes. Whether you’re hopping on a plane or staying home in your coziest slippers, a little planning and the right tools can go a long way toward keeping the season safe and comfortable.

Here are ten of my favorite practical, therapist-approved strategies and helpful products to make your holidays easier — without sacrificing the fun.

1. Manage Energy Like It’s Money

One of the biggest challenges of the holidays is fatigue — not just physical, but mental. The social effort of being “on,” chatting with relatives, and maybe even trying to mask any impairments can be draining.

💡 Tip: Think of each day as a dollar — you have $1 to spend. How much will church cost? Dinner with family? A trip to the store for pie ingredients? Spend wisely.
If dinner with your daughter is the highlight, maybe let go of the baking marathon and supervise while the grandkids take over the kitchen.

🎁 Helpful Product: Super Ear Personal Sound Amplifier. Hearing clearly during conversation saves tremendous mental energy.

2. Prepare for Low Surfaces

That comfy couch at your daughter’s house? Not so comfy when you’re stuck in it. While you may confidently get on and off the chairs in your own home, visiting friends, family and restaurants may leave you feeling like Goldilocks trying out difference surfaces to find the ‘just right’ seat for you. Avoid getting stuck with the tips below:

💡 Tip: Start “training” now. Practice sit-to-stands from different surfaces, even try sitting on a pillow to simulate a lower seat.
🎁 Helpful Product: Carex Up Easy Seat Assist — portable, hydraulic seat lift that helps you rise with less strain.

3. Conquer Community Stairs

Even if your home has no stairs, public places or loved one’s homes might. Don’t let a ‘3 STE’ (three stair entry in PT short hand!) stop you from enjoying the festivities.
💡 Tip: Practice toe taps and step-ups at home to build balance and confidence.
🎁 Helpful Product: Try a Stair Cane, which is a lightweight and portable “travel railing” for those steps without rails anywhere or the Stair Assist which lets you create a '“half step” to bridge the gap between the floor and a high step up anywhere you need one.

4. Sleep Smart in New Spaces

Guest beds are often softer, lower, or lack support for getting up. Further, the trip to the bathroom is unfamiliar, and likely dark and dangerous. Solution? BYO-Nightlight and a couple of helpful hints for chair placement:
💡 Tip: Place a sturdy chair or walker next to the bed, and use portable nightlights to light your path to the bathroom.
🎁 Helpful Product: Battery-Powered Motion Nightlights — compact, battery-powered and great for travel.

5. Fly Easier

Air travel can be exhausting long before you board. Fortunately, TSA has excellent support services available not only to reduce strain, but to speed you through long lines and reduce energy cost of travel.
💡 Tip: Call ahead to schedule TSA Cares Assistance for any air travel you have coming up — they’ll escort you by wheelchair through security and to your gate, often bypassing long lines.
🎁 Helpful Product: Drive Medical Nitro Dual Function Rollator/Transport Chair — walk when you can, ride when you need to, this dual-function walker/transport chair is one of my favorites to recommend to my patients.

6. Drive Safely AND Comfortably

While driving cross country may have been doable in your youth, as we age, even short road trips can become more challenging and may require advanced planning.
💡 Tip: Plan for frequent stops, avoid driving tired or at night, and consider public transit or rideshares for longer trips.
🎁 Helpful Product: A portable Car Cane + Car Handle and a Lumbar Support pillow can make getting in and out a breeze, and long drives more comfortable.

7. Stay Connected from Home

If you’re celebrating quietly at home, you can still fill your space with connection and joy.
Smart speakers like the Echo Dot can:

• Play your favorite holiday music (“Alexa, play Christmas music!”)

• Set medication reminders

• Control lights or thermostats

• Call for help in an emergency

Get even fancier with an Alexa Show which has all the fun features of a Dot with the addition of a 15” screen so you can see your reminders, follow along with recipes, watch the local news and even see your calendar for the day.

8. Give the Gift of Comfort

Nothing says “I love you - and want you to be safe” like warm, slip-proof slippers and house shoes. Fan favorites in my house AND with my patients include the classic LL Bean Moccasin and the Hey Dude Shoes — both easy to slip on, stable, and cozy.

9. Give the Gift of Health

Aging well takes time, effort and often, support. The good news is that there are great devices and services available to help your loved one stay healthy and active at home. Consider purchasing a portable elliptical like the Cubii or setting them up with a ten pack of training sessions with us through our Wellness365 program. We can bring personal training right to your home, with specialists who understand the needs of older adults.

10. Give the Gift of Safety

Technology is amazing and wearable devices can bring convince, accessibility and peace of mind. Devices like the Apple Watch can now detect falls and call emergency services — a simple, life-saving feature for any older adult.

Final Thought

The holidays aren’t about doing everything — they’re about doing what matters most. Whether that means a little extra planning for your trip to the kids or asking for help at the airport, small choices can keep you safe, confident, and able to enjoy what really counts: time with the people you love.

From all of us at Healthy Aging Physical Therapy, we wish you a safe, warm, and joyful holiday season.

FIT + FEARLESS: July Foundations Session Recap

Today, we wrapped up our very first Fit & Fearless Foundations class series — and wow, what a four-week journey it was.

Together, we dipped our toes (and knees, and elbows!) into the world of adaptive martial arts with a Healthy Aging spin on fall landing and recovery skills. We learned beginner Muay Thai skills, jabbed and kicked the heavy bags, practiced grappling with Coach Dave, and most importantly, we tackled one of the most essential life skills: how to safely up and down from the floor. Each week, we focused on a new skill: falling backwards, forwards, and laterally, all while building strength, confidence, and body awareness.

At the end of our final class, we asked everyone to shout out one word that captured how they felt about the experience. We heard Proud! Confident. Intense. Empowered. Educated…and Ouch! (We never said this was going to be easy!)

But Coach Dave and I? We both quickly said IMPRESSED - and that doesn’t even begin to cover it.

Lessons Learned

As with all firsts, there were some humbling, and hilarious, first round lessons:

• Lesson 1: Turn OFF the fall alerts on your Apple Watch. Unless you want an EMT surprise visit mid-backward-roll.

• Lesson 2: Teaching ten people to fall is not the same as teaching one. We learned quickly how to break movements down into smaller, more accessible components, and we’re already refining our methods for September to make the next round even better.

But beyond logistics, what Dave and I left with was a deep sense of awe and appreciation for this group. Every single person walked into that first class with some level of fear or hesitation. But they showed up. They did hard things. They did scary things. They let themselves fall - and each time, they got back up! Every single participant walked out stronger and more confident in their ability to fall safely and recover effectively. In a word? They got FEARLESS!

Why Fit & Fearless?

Falls happen. In fact, 1 in 4 adults over 65 falls each year - and while many falls are preventable through a combination of exercise, behavioral choices and environmental modifications, many falls just simply aren’t. And for the falls we can’t stop? That’s where fall landing skills come in.

In this class, we focus on two key goals when it comes to falling:

Goal 1: Change the Position

Avoid landing on high-risk areas (head, spine, hip, outstretched arms).

Goal 2: Change the Force

Use techniques to spread the impact — rolling, redistributing, and softening the fall to reduce injury risk.

How the Program Works

• We progress week by week, starting with education and movement basics and working our way into our adaptive martial arts and fall landing practice.

• Each week, we focus on a different skill: floor recovery, backwards falling, forwards falling and lateral falling.

• We provide guidance and adaptations to meet all fitness levels and encourage you to honor your pace, ask questions, and modify as needed.

Most importantly, this class isn’t just about falling - it’s about changing the way we think about falling. Instead of viewing it as a scary event that “just happens,” we begin to see it as something we can prepare for, influence, and even control. It’s about building the kind of confidence where the ground no longer feels threatening - it becomes familiar, manageable, and within your ability to navigate. And when we fear the ground less, research shows our balance confidence improves - which, in turn, can actually reduce our risk of falling in the first place (#mindblown)!

Ready to Get Fit & Fearless?

Our next round of Fit & Fearless begins this September, and we can’t wait to take everything we learned in July to make this session even more influential.

If you're ready to:

• Build strength and confidence

• Learn practical skills to reduce your fall risk - and your risk of injury from falls

• Master how to fall safely - and get back up with control

• And do it all in a fun, supportive environment...

Then join us at Fit and Fearless!

Registration is now open for our September session. Click the link below to reserve your spot —space is limited, and this class fills up fast. Confidence doesn’t come from avoiding falls - it comes from knowing you can handle them.

Movement Matters: Helping Loved Ones with Dementia Stay Active

By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist

June is Alzheimer’s & Brain Awareness Month - making it an ideal time to spotlight how purposeful movement can slow physical decline, curb agitation, and brighten the day for people living with dementia.

The Hidden Cost of Inactivity in Dementia

• Faster loss of strength, endurance, and mobility.
  People with dementia experience significantly steeper declines in muscle power, balance, gait speed, and overall endurance than their cognitively healthy peers. A 2017 systematic review found that targeted exercise can reverse many of these losses, highlighting just how much ground inactivity can cost them.

• A 2-3 fold higher fall risk.
  Up to 60–80% of individuals with dementia fall each year, double (or more) the rate seen in age-matched adults without cognitive impairment.

• More than “just weak legs.”
  Neurologic changes in the brain affect depth perception, spatial awareness, and dual-tasking, making tripping over obstacles or misjudging doorways far more likely, even in familiar environments.

Why Activity Often Fades

Research into barriers paints a clear picture:

• Low motivation and apathy.
  Dementia frequently dampens initiative, so even engaging in even once-loved hobbies may need an extra nudge.

• Safety worries - both real and perceived.
  Fear of falls, wandering, or behavioral changes can make caregivers over-cautious, unintentionally encouraging more sitting and inactivity.

• Limited guidance or support.
  When caregivers lack time, know-how, or resources, structured movement sessions often become a low priority when so many other caregiving needs exist.

The Upside of Movement: Small Steps, Big Impact

Despite the challenges, the benefits of regular movement are powerful. Studies link even modest activity to:

• Reduced agitation and anxiety

• Improved mood and quality of life

• Better executive function and attention span

The World Health Organization and Alzheimer’s Disease International recommend that older adults, including those with dementia, aim for:

• At least 150 minutes of moderate-intensity aerobic activity per week (e.g., brisk walking, dancing, cycling)

• Muscle-strengthening activities 2 or more days per week

• Balance and mobility-focused exercises at least 3 days per week, especially for those with a history of falls or unsteadiness

But here’s the most important part:
These goals don’t need to be met all at once. Even 10-minute bouts of movement count. A short daily walk, chair yoga, or marching in place while brushing teeth can build into meaningful progress over time.

And remember—something is always better than nothing. Consistency and routine matter far more than intensity.

My Top 3 Tips to Get Your Loved One Moving

1. Make It Part of the Routine

• Same time, every time.
  Repetition breeds familiarity, and familiarity feels safe. A short walk after breakfast or gentle seated exercises during nightly news on TV can become as automatic as brushing teeth.

• Leave visual “clues.”
  Place sneakers by the dining chair or set out resistance bands where they’ll be noticed. Then cue your loved one with a calm, confident “Time for our walk!”

2. Make It Meaningful

Movement can be easier, and more enjoyable, when it feels like a meaningful activity, rather than a workout. The best way to help a loved one with dementia get active? Choose activities that connect with who they are and what they’ve always loved to do.

Tie movement to personal identity and past routines:

• Gardener?
  Keep a raised-bed planter or container garden ready to go. Practice squatting or sit-to-stand movements while pulling weeds, watering plants, or sorting seed packets.

• Make household chores a team effort.
  Turn household chores into movement moments. Fold towels together while standing, carry a light basket across the room, or reach to hang clothes on a low rack or line. Involve them in safe cleaning tasks like dusting, wiping counters, or organizing drawers. These repetitive tasks offer built-in structure and gentle physical activity.

• Dancer or music fan?
  Put on their favorite music from high school or early adulthood. March in place, sway side to side, or tap feet to the beat. Even seated, this can raise the heart rate and lift the mood.

• Involve the family pets.
  Take short walks with the family dog, brush the cat, or pretend to care for a stuffed animal if pets aren't available. Caring for something else often sparks a natural desire to move.

• Crafter or artist?
  Set up a workspace that encourages posture shifts—standing to cut fabric, reaching to gather supplies, or walking to display finished pieces.

Bonus Tip: Use exercise time to engage. Talking is a great form of ‘dual-tasking’ and dual-tasking is a powerful way to improve balance. Reminisce while you move. Play cognitive games like eye-spy or categories. Ask questions about the world around you - see if they can count the passing cars or recall facts about your neighbors as you walk by.

3. Try a Group Fitness Class

• Community programs, like local strength and balance classes, add social interaction and gentle accountability.

For locals, Healthy Aging PT’s Strong and STEADI sessions blend fall-prevention drills with upbeat music and expert guidance. Ask your senior center for recommendations or check our calendar.

When to Call in for Backup

Encouraging safe, consistent movement isn’t always easy, especially when dementia is involved. You might find that your loved one resists participation, struggles to follow instructions, or becomes overwhelmed by too many choices. That’s completely normal - and it's exactly where we come in.

At Healthy Aging Physical Therapy, our licensed Physical and Occupational Therapists and certified personal trainers are experienced in working with older adults living with cognitive impairment. We understand how to blend clinical expertise with patience, creativity, and compassion.

Here’s how our Therapy and Wellness365 teams can help:

• Comprehensive Assessment
  We evaluate strength, mobility, balance, and fall risk while considering cognitive status, emotional state, and home environment. This helps us determine what’s safe, what’s realistic, and what’s meaningful.

• Personalized Movement Prescription
  One-size-fits-all exercise plans don’t work, especially in dementia care. We’ll create a tailored program that matches your loved one’s current abilities and interests, focusing on what they can do and building from there.

• Cognitive-Aware Coaching
  We train family members and paid caregivers in practical strategies: how to cue movement clearly, how to redirect attention when needed, and how to create daily routines that support success without stress.

• Progress Monitoring & Support
  Our team can check in regularly to adjust the plan, troubleshoot challenges, and provide encouragement. Even small wins, like standing up more easily or walking an extra lap around the kitchen, can be incredibly meaningful.

If your loved one is struggling with inactivity, mood changes, falls, or increasing dependence, it may be time to bring in professional support.

We’re here when you’re ready.
Call us at (617) 398-4508 or visit our website to request:

• A Medicare-covered Physical or Occupational Therapy Evaluation, or

• A private Wellness365 Personal Training session for continued fitness and support after therapy ends.

Let’s work together to keep your loved one strong, steady, and engaged - every step of the way.

The Science of Socialization

By: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist

Owner: Healthy Aging Physical Therapy

Earlier this month, I returned from a very special trip: a full week away in Sedona with my best friends — my college roommates. Since meeting back at ‘the turn of the century’ (how ridiculous does that sound ?1?), our lives have taken us in many different directions: new careers, marriages, divorces, losses, love, babies, teenagers (😫) moves across states - even moves across oceans! And like many adult friendships, the day-to-day demands of life often mean that we go far too long without seeing each other face to face.

But no matter what else is happening in our lives, we've remained religious about one thing: scheduling our annual girls weekend. Even when it’s just a long weekend over the summer, we’ve kept the tradition alive. This year was the first time we carved out a full week — and let me tell you, it was pure magic.

More than the hikes, the incredible views, or the late nights laughing until we cried, what made it so meaningful was simply the connection. That feeling of being truly known, truly supported, and truly in the moment with people who have walked beside you through all of life’s changes. And it reminded me how critical — and how scientifically essential — social connection is for our health.

What Happens Inside Your Body When You Connect

When we connect meaningfully with others, it’s not just a "nice feeling" — our bodies actually respond biologically:

• Oxytocin, sometimes called the “bonding hormone,” is released, promoting feelings of trust, belonging, and relaxation.

• Levels of cortisol, our main stress hormone, decrease when we engage in positive social interaction, helping reduce inflammation and boost immune function.

• Dopamine and serotonin — the "feel good" neurotransmitters — increase, improving mood, energy, and even pain tolerance.

• Meaningful social interaction can even lower blood pressure and support cardiovascular health over time.

In short, connection is not just emotional — it’s chemical. Your brain and body are wired to thrive on human interaction.
(Source: Harvard Health Publishing, 2021; National Institutes of Health, 2022)

How Our Social Networks Change Over Time

It’s also normal that how and when we socialize evolves throughout life:

• As children, friendships are constant and casual, woven into daily school and playtime.

• In adolescence, friendships intensify, shaping identity and emotional development.

• As new parents, social circles often shrink, with focus centered on caregiving and family demands.

• In midlife and later adulthood, social opportunities can decline as retirement, relocation, health issues, or caregiving responsibilities arise.

Without mindful effort, social isolation can sneak up, making connection even more critical as we age.

Why Socialization Matters for Healthy Aging

We often think about diet and exercise as the pillars of healthy aging (and they are), but strong social connections are just as essential to long-term health and well-being. In fact, research shows:

• More than one-third of adults over age 45 report feeling lonely, and nearly one-fourth of adults over age 65 are considered socially isolated.

• Loneliness is often considered as harmful as smoking 15 cigarettes a day and raises the risk of heart disease by 29% and stroke by 32%.

• Social isolation significantly increases the risk of premature death from all causes, comparable to risks posed by smoking, obesity, and physical inactivity.

• Older adults with strong social ties have better cognitive health, lower depression and anxiety rates, and stronger physical health overall.

(Source: National Academies of Sciences, Engineering, and Medicine, 2020)

The simple truth is: connection heals. It protects, energizes, and helps us live not just longer — but better.

Small Steps to Build (or Rebuild) Your Social Connections

If you’re feeling the need for more connection in your life — you're not alone. And it’s never too late to take steps to strengthen your social well-being:

• Reach out to an old friend you haven't spoken to in a while.

• Join a local class or club that sparks your interest — fitness, art, volunteering, book clubs, or travel groups.

• Explore virtual communities if distance or transportation is a barrier.

• Schedule regular get-togethers, even if just for a coffee or walk.

• Be open to making new friends — every stage of life can bring new connections.

Just like exercising your body or eating nourishing food, tending to your social life is an important part of caring for your health.

As I was reminded during my week in Sedona, it’s not about where you go — it’s about the people you walk beside. Connection is a vital ingredient in the recipe for healthy aging — and one of the most joyful, too.

Unlocking Cognitive Fitness: 6 Steps to Optimize Brain Health

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist, Owner of Healthy Aging PT

As we age, it’s natural to notice changes in cognitive function—whether it’s misplacing your keys or taking longer to process information. While these changes can feel concerning, there’s plenty you can do to maintain and even improve your brain health. By focusing on building cognitive reserve, you can safeguard your mind and maintain your independence as you age. Think of cognitive reserve as a savings account for your brain. The more reserve you build, the more resilient you are to cognitive challenges.

The great news? Building cognitive fitness is possible at any stage of life, and it starts with these six proven steps.

1. Exercise for Brain Health

Exercise isn’t just for physical fitness—it’s for cognitive fitness, too! Regular physical activity stimulates neurotrophin release, enhances hippocampal neurogenesis, and improves blood flow to the brain, all of which help maintain cognitive function.

• The Science: A National Institute on Aging study found that individuals who exercise 1–4 times weekly reduce their risk of memory decline by 33%.

• Action Step: Engage in moderate-to-vigorous physical activity for at least 150 minutes weekly. Activities like brisk walking, resistance training, or swimming boost brain health and physical well-being. You can check out our list of curated exercise videos for some great (and free!) workouts you can do at home. 

2. Nutrition for Cognitive Health

Your diet plays a critical role in cognitive fitness. Whole-food diets like DASH, Mediterranean, and MIND reduce inflammation and support brain function.

• The Science: According to NIH research, diets rich in fruits, vegetables, and lean proteins are linked to better cognitive outcomes and reduced risk of Alzheimer’s disease.

• Action Step: Prioritize unprocessed, whole foods. Incorporate brain-boosting foods such as leafy greens, berries, nuts, and omega-3-rich fish. For more information about evidenced-based dietary patterns that support cognitive health, I suggest checking out the Harvard School of Public Health’s ‘Nutrition Source’ page. 

3. Sleep and Brain Function

Sleep is essential for brain health, supporting memory consolidation and overall cognitive function.

• The Science: Studies reveal that individuals sleeping 6–8 hours nightly maintain greater grey matter volume, which is crucial for cognitive fitness. Both insufficient and excessive sleep can harm brain health.

• Action Step: Create a sleep-friendly environment by keeping your bedroom cool, dark, and free from screens. Aim for a consistent 6–8 hours each night. For some more information, you can download this free E-Book from the NIH about Sleep for Older Adults. We keep these on hand and ready for any of our patients who need help getting their zzzz’s and it is our go-to resource.  

4. Stress Management for Healthy Aging

Chronic stress can damage the brain, but reframing how we view stress makes a big difference. A positive mindset can reduce the negative impact of stress on cognitive health.

• The Science: Research shows that reframing stress reduces its physiological effects, helping maintain cognitive resilience.

• Action Step: Practice stress management techniques such as mindfulness, journaling, or meditation. Reframing challenges as opportunities for growth supports both cognitive and emotional well-being. Looking for more? The Free Mindfulness Project has an awesome library of guided meditation and mindfulness exercises available for everyone.  

5. Social Connections and Brain Health

Meaningful social interactions aren’t just good for the soul—they’re essential for cognitive fitness.

• The Science: NIH studies show that loneliness increases the risk of dementia by up to 40%, while maintaining social connections helps preserve brain health.

• Action Step: Strengthen your social network by joining group activities, such as Wellness365, that combine fitness and fun with community-building. Want to hit two birds with one stone? Check out our in-person Group Fitness Classes to get your exercise in while engaging with like-minded peers for the added bonus social connection.

6. Lifelong Learning and Brain Health

Your brain thrives on novelty. Learning new skills, trying different hobbies, and exposing yourself to new experiences keep your mind sharp.

• The Science: NIH-supported studies highlight that engaging in novel activities throughout life helps maintain cognitive reserve and delay decline.

• Action Step: Get curious and commit to trying one new activity each month, whether it’s taking a class, visiting a new place, or trying a new hobby. We are lucky to live in a great area - with the city, the mountains, or the beach all with in an hours drive, there is always a new adventure you can try. Looking for something closer to home? Check out your local Senior Center and Library calendars to see if they have any lectures or workshops that might pique your interest. I’ve linked my hometown’s centers above, but check out the centers closest to you!

Building a Brain-Healthy Lifestyle

Cognitive fitness isn’t a one-time achievement; it’s a lifelong commitment. By incorporating exercise, nutrition, quality sleep, stress management, social engagement, and novelty into your routine, you can boost your cognitive reserve and maintain your independence. Through our Wellness365 program, Healthy Aging Physical Therapy provides tailored support to help you achieve these goals. Our program is always individualized to meet your needs, but can include things like supported fitness to build up your physical resilience and support your brain health, nutrition guidance to enhance your cognitive and physical wellness and education about stress management strategies to maximize your emotional balance.

Your journey to better cognitive fitness begins today. Want to take Let’s the first step together? If you live in one our service areas, we’d love to help! Check out out Wellness365 Page for more information and to get signed up today!

References

1. Augusto-Oliveira, M., et al. (2023). Exercise Reshapes the Brain: Molecular, Cellular, and Structural Changes Associated with Cognitive Improvements. Molecular Neurobiology, 60(12), 6950-6974.

2. Puri, S., et al. (2023). Nutrition and Cognitive Health: A Life Course Approach. Frontiers in Public Health, 11.

3. Tai, X.Y., et al. (2022). Impact of Sleep Duration on Executive Function and Brain Structure. Communications Biology, 5(201).

4. Seward, B.L. (2017). Managing Stress: Principles and Strategies for Health and Well-Being. Jones & Bartlett Learning.

5. Sutin, A.R., et al. (2020). Loneliness and Risk of Dementia. The Journals of Gerontology: Series B, 75(7), 1414–1422.

6. Karsazi, H., et al. (2024). Which Intellectual Activities Are Related to Cognitive Reserve? Psychological Research.

7. National Institute on Aging (NIA). Brain Health and Cognitive Reserve. (Available at: https://www.nia.nih.gov)

8. Harvard Health Publishing (n.d.). Cognitive Health and Aging: How Exercise and Nutrition Protect the Brain. (Available at: https://www.health.harvard.edu)