The Development and Implementation of a Peer-Led Diet and Exercise Intervention in Older Urban Dwelling Veterans with Dysmobility

针对行动不便的老年城市住宅退伍军人制定和实施同伴主导的饮食和运动干预措施

• 批准号: 10364800
• 负责人: Odessa Addison
• 金额: --
• 依托单位: BALTIMORE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10364800
• 关键词: Address; Adherence; Adoption; Aerobic Exercise; Affect; Age; Aging; Agriculture; American; Baltimore; Behavior; Behavioral; Body Weight decreased; Boredom; Chronic; Chronic Disease; Communities; Consumption; Data; Development; Diet; Dietary Intervention; Dietary intake; Elderly; Energy Intake; Evidence based intervention; Exercise; Feedback; Focus Groups; Food Access; Goals; Guidelines; Habits; Health; Health Promotion; Health behavior; Health behavior change; Individual; Intervention; Interview; Knowledge; Language; Life Style; Longterm Follow-up; Medical; Methods; Morbidity - disease rate; Motivation; Outcome; Participant; Phase; Physical activity; Pilot Projects; Positioning Attribute; Publishing; Qualitative Methods; Questionnaires; Reach Effectiveness Adoption Implementation and Maintenance; Recommendation; Recreation; Rehabilitation therapy; Reporting; Research; Resources; Risk; Role; Self Efficacy; Site; Sports Medicine; Surveys; Telephone; Training; Underrepresented Minority; Unhealthy Diet; Veterans; Walking; Weight maintenance regimen; acceptability and feasibility; adherence rate; base; cardiovascular health; college; cost; design; dietary; dietary guidelines; disability risk; effective intervention; energy balance; evidence base; exercise intervention; experience; family support; flexibility; food security; good diet; implementation fidelity; improved; improved mobility; intervention delivery; intervention participants; lifestyle intervention; military veteran; multi-site trial; multiple chronic conditions; novel; peer; peer support; physical inactivity; preservation; programs; recruit; rehabilitation research; research and development; resistance exercise; satisfaction; sleep pattern; social; theories; urban area; urban dwelling; virtual

Over the next ten years the share of Veterans age 65+ years will increase to over 50% of the total Veteran population. The ability to safely maintain mobility with aging is critical. Older Veterans with multiple chronic health conditions are more likely to experience mobility decline and our preliminary data show they also have decreased diet quality when compared to older non-Veterans. They further report that their reduced physical activity and poor dietary quality are related to a lack of access to exercise facilities, poor habits, and lack of motivation or boredom. While a multitude of interventions have attempted to address poor diet and physical inactivity in older adult; most have utilized resource-intensive professionally led diet OR exercise interventions, and few have focused on the unique needs of older Veterans. Peer support offers a potentially low-cost, easily scalable approach to encourage long-term dietary and physical activity change. In this proposal we seek to develop and pilot a 12-week peer-led lifestyle intervention that targets older Veterans with multiple chronic health conditions and dysmobility, in two diverse urban areas with a high percentage of underrepresented minority Veteran populations (Baltimore, MD and San Antonio, TX). We will accomplish this through two specific aims. Aim 1: Develop a theory-driven, peer-led nutrition and exercise intervention tailored for older Veterans with dysmobility. Aim 2: Determine the feasibility and acceptability of the peer-led intervention, to asses reach (recruitment, retention), adoption (satisfaction, perceived utility, attendance, engagement) and implementation (fidelity of intervention); as well as the estimated magnitude and potential impact on selected outcomes (i.e diet quality and mobility) in older 20 older Veterans with dysmobility and multiple chronic health conditions (N=10/site). Our results from Aim 2 will be compared to Gerofit data to determine long term potential of the project. With the successful development and pilot of this intervention we will be positioned to submit a multisite Rehabilitation and Research and Development (RR&D) Merit application focused on the use of peer-led interventions to improve long-term compliance to lifestyle intervention in older Veterans with multiple chronic conditions.

未来十年，65岁以上退伍军人比例将增至退伍军人总数的50%以上 人口。随着年龄的增长，安全地保持活动能力至关重要。患有多种慢性病的老年退伍军人 健康状况更有可能出现流动性下降，我们的初步数据显示，他们也有 与老年非退伍军人相比，饮食质量下降。他们进一步报告说，他们的体力下降 活动和饮食质量差与缺乏锻炼设施、不良习惯和缺乏 动机或无聊。尽管许多干预措施试图解决不良饮食和身体状况 老年人缺乏活动；大多数人都利用了资源密集型的专业饮食或运动干预措施， 很少有人关注老年退伍军人的独特需求。同伴支持提供了一种潜在的低成本、轻松的方式 鼓励长期饮食和身体活动改变的可扩展方法。 在本提案中，我们寻求开发和试点一项为期 12 周、由同伴主导的生活方式干预措施，针对老年人 在两个不同的城市地区，患有多种慢性健康问题和行动不便的退伍军人 代表性不足的少数族裔退伍军人人口的百分比（马里兰州巴尔的摩和德克萨斯州圣安东尼奥）。我们将 通过两个具体目标来实现这一目标。目标 1：开发理论驱动、同行主导的营养和运动方法 为行动不便的老年退伍军人量身定制的干预措施。目标 2：确定可行性和可接受性 同行主导的干预措施，以评估影响力（招聘、保留）、采用率（满意度、感知效用、 出席率、参与度）和实施（干预的保真度）；以及估计的震级和 对行动不便的 20 名老年退伍军人的选定结果（即饮食质量和行动能力）的潜在影响 和多种慢性健康状况（N=10/地点）。我们的目标 2 结果将与 Gerofit 数据进行比较 确定项目的长期潜力。随着这项干预措施的成功开发和试点，我们 将负责提交多地点康复和研究与开发 (RR&D) 优异申请 重点是使用同伴主导的干预措施来提高老年人对生活方式干预的长期依从性 患有多种慢性病的退伍军人。