PROGRAM HEAL--Activating the Lives of Older Adults

计划治愈——激活老年人的生活

• 批准号: 6533863
• 负责人: JOHN N. MORRIS
• 金额: $ 67.89万
• 依托单位: HEBREW REHABILITATION CENTER FOR AGED
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-01 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6533863
• 关键词: behavior modification; behavioral /social science research tag; clinical research; depression; exercise; extended care facility; functional ability; human subject; medical rehabilitation related tag; psychological aspect of aging; quality of life; rehabilitation

We intend to implement and test the effectiveness of a comprehensive intervention to prevent functional disability among nursing home residents. The intervention acts by promoting exercise adoption and adherence and reversing institutional factors that cause resident inactivity. Our program, HEAL ('Helping Elders Activate their Lives'), represents an integration of two interventions developed independently from different theoretical models within our institute. A selected exercise component, based on progressive resistance training, promotes behavioral change among nursing home residents, and has been shown to be safe and efficacious in building muscle mass, improving performance-based tests of physical functioning, improving and preventing decline in activities of daily living. The universal nursing-based rehabilitation component targets social and environmental factors contributing to the problem of resident inactivity. We have shown that residents can be helped to be more self-involved in performance of daily activities by targeting behavior of nursing staff and social forces within the facility through training and encouraging a redirection of care planning towards each resident's functional capacity. Each of these interventions has been shown to be efficacious in preventing functional disability when implemented independently. Combined as the HEAL intervention model, the program facilitates the continuity of functional capacity gains resulting from the exercise program into the daily activity of nursing home residents. Making use of existing staffing at three triplets of matched facilities, the intervention will be implemented within the confines of a quasi-experimental trial, involving an estimated 1,350 residents from both randomly assigned experimental exercise only, experimental exercise and nursing based rehabilitation, and usual care control homes. Performance on functional status, and physiologic, mood and self-efficacy measures will be collected at baseline and months 4, 8, 12 and 16 of the intervention. The aim of the proposed study is to establish the effectiveness of this intervention acting in a real world setting. Specifically, we hypothesize that the intervention will act proximally in 1) promoting resident exercise behavior, 2) improve performance on physiologic tests, and 3) act distally to prevent further functional decline and facilitate functional improvement. Further, we anticipate significant carry over effects on mood, well-being, self-efficacy and quality of life outcomes.

我们打算实施和测试全面干预措施的有效性，以防止疗养院居民的功能残疾。 干预措施通过促进锻炼的采用和依从性以及逆转导致居民无效的制度因素而采取行动。 我们的计划“ Heal”（“帮助长者激活他们的生活”），代表了两种干预措施的整合，独立于我们研究所内的不同理论模型。 基于渐进抗性训练的选定运动部分促进了疗养院居民的行为改变，并已被证明在建立肌肉质量方面是安全有效的，改善了基于绩效的身体功能测试，改善了日常生活活动的下降和预防。基于普遍护理的康复组件针对的是社会和环境因素，导致居民无活动问题。 我们已经表明，通过培训和鼓励将护理计划重定向到每个居民的职能能力，可以通过针对设施内护理人员和社会力量的行为来帮助居民在日常活动的表现中更加自我涉及。 这些干预措施中的每一个都被证明是在独立实施时预防功能残疾的有效性。该计划将其作为治疗干预模型的结合，促进了锻炼计划使疗养院居民日常活动所产生的功能能力增长的连续性。 利用现有的配备人员在三个匹配的设施的三胞胎中，该干预措施将在准实验试验的范围内实施，涉及估计只有随机分配的实验性运动，基于实验的康复和基于护理的康复和通常的护理对照组，估计有1,350名居民。 将在基线和干预措施的第4、8、12和16月收集功能状况以及生理，情绪和自我效能措施的表现。 拟议的研究的目的是确定在现实世界中作用的这种干预措施的有效性。 具体而言，我们假设干预措施将在1）促进居民运动行为，2）提高生理测试的绩效以及3）远端采取行动以防止进一步的功能下降并促进功能改善。 此外，我们预计对情绪，幸福感，自我效能和生活质量的影响重大影响。