Randomized Trial to Reduce Sitting Time and Improve Cardiometabolic Health in Obese Older Adults

减少肥胖老年人久坐时间并改善心脏代谢健康的随机试验

• 批准号: 10162383
• 负责人: Dori E Rosenberg
• 金额: $ 54.61万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10162383
• 关键词: Address; Adherence; Adult; Age; American; Attention; Behavior Therapy; Behavioral; Blood Pressure; Body mass index; Cardiovascular system; Chronic Disease; Control Groups; Counseling; Data; Diabetes Mellitus; Effectiveness; Elderly; Evaluation; Evidence based intervention; Funding; Future; Goals; Gold; Guidelines; Habits; Health; Health Care Costs; Health Promotion; Health system; Healthcare Systems; Home environment; Hour; Hypertension; Individual; Intervention; Lead; Light Exercise; Lipids; Maintenance; Measures; Mediator of activation protein; Metabolic; Metabolic syndrome; Modification; Morbidity - disease rate; Obesity; Participant; Persons; Physical activity; Pilot Projects; Population; Posture; Psychosocial Factor; Public Health; Randomized; Randomized Controlled Trials; Reporting; Research; Research Design; Risk; Risk Factors; Risk Marker; Technology; Telephone; Testing; Thigh structure; Time; United States National Institutes of Health; Use Effectiveness; Washington; Weight; Work; Wrist; adult obesity; attentional control; base; cardiometabolic risk; cardiometabolism; cardiovascular health; cardiovascular risk factor; comorbidity; comparison intervention; disability; effectiveness evaluation; efficacious intervention; efficacy evaluation; fasting glucose; follow-up; group intervention; handheld mobile device; healthy aging; high risk; high risk population; implementation study; improved; innovation; mortality; motivational enhancement therapy; multimodality; new technology; novel; primary outcome; programs; randomized trial; recruit; satisfaction; secondary outcome; sedentary; sedentary lifestyle; sex; social cognitive theory; theories; treatment effect; waist circumference; wearable device

Abstract Nearly 40% of adults over age 60 are obese. On average, these individuals spend over 10 hours a day sitting. This is a concern since emerging research shows higher sitting time is associated with worse cardiovascular and metabolic health. In fact, most obese older adults have comorbid cardiometabolic conditions. Interventions which can reduce sitting time in this high-risk population could improve health and lower health care costs. As such, more research is needed to develop interventions to effectively reduce sitting time among older obese adults. The proposed study will address this important goal and build on the promising results of our I-STAND randomized pilot study. This study found that a theory-based, multi-modal behavioral intervention which combined phone counseling and technology-based behavioral prompts was feasible, acceptable, and significantly reduced sitting time (-75 minutes/day in the intervention compared to control group, p < .01). Among those with elevated blood pressure at baseline, blood pressure also improved in two of our pilot studies. In short, we found that I-STAND warrants evaluation in a large randomized controlled trial. The current study will compare I-STAND to an attention-matched control intervention among participants over age 60, with obesity, and who sit more than 8 hours per day (N = 284). Both interventions include one in- person session and 9 follow-up phone calls. Experimental participants will also receive prompts for standing via wrist-worn technology and a home environment audit to identify modifications to improve standing time. All participants will be followed for 12 months. After 6 months, experimental participants will be re-randomized to receive either 5 additional booster calls or no further intervention, allowing us to assess the effects of the initial intervention and booster sessions. The primary outcomes will be reduction in sitting time as measured by a thigh-worn activPAL inclinometer and blood pressure. The secondary outcomes include changes in cardiometabolic risk factors (e.g. weight, lipids, fasting glucose). Mediators of significant treatment effects will also be explored. If effective, I-STAND could easily be implemented by health care systems to improve the health of older obese adults nationwide.

抽象的 近 40% 60 岁以上的成年人患有肥胖症。这些人平均每天花费超过 10 个小时 坐着。这是一个令人担忧的问题，因为新兴研究表明久坐时间越长，身体状况越差。 心血管和代谢健康。事实上，大多数肥胖老年人都患有心脏代谢疾病 状况。减少这一高危人群久坐时间的干预措施可以改善健康状况， 降低医疗费用。因此，需要更多的研究来制定有效减少久坐的干预措施 老年肥胖者的时间。拟议的研究将解决这一重要目标并建立在有希望的基础上 我们的 I-STAND 随机试点研究的结果。本研究发现，基于理论的多模式行为 结合电话咨询和基于技术的行为提示的干预是可行的， 可接受的，并且与对照组相比，干预组的坐姿时间显着减少（-75 分钟/天） 组，p < .01）。在基线血压升高的患者中，有两名患者的血压也有所改善 我们的试点研究。简而言之，我们发现 I-STAND 值得在大型随机对照试验中进行评估。 目前的研究将 I-STAND 与参与者之间的注意力匹配控制干预进行比较 60 岁、肥胖且每天坐时间超过 8 小时的人 (N = 284)。两种干预措施都包括一项—— 个人会议和 9 个后续电话。实验参与者还将收到站立提示 通过腕戴式技术和家庭环境审核来确定改进措施以提高站立时间。全部 参与者将被跟踪12个月。 6个月后，实验参与者将被重新随机分配到 收到 5 次额外的加强电话或不再进行进一步干预，使我们能够评估最初的效果 干预和加强会议。主要成果将是减少坐着的时间（通过测量） 大腿佩戴的 activPAL 测斜仪和血压计。次要结果包括以下方面的变化： 心脏代谢危险因素（例如体重、血脂、空腹血糖）。显着治疗效果的中介因素将 也有待探讨。如果有效，I-STAND 可以很容易地由医疗保健系统实施，以改善 全国老年肥胖者的健康状况。