Community-based Intervention Effects on Older Adults' Physical Activity and Falls

基于社区的干预对老年人体力活动和跌倒的影响

• 批准号: 9330461
• 负责人: Siobhan Kathleen McMahon
• 金额: $ 63.83万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-15 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9330461
• 关键词: Accelerometer; Address; Adult; Behavioral; Biomechanics; Cessation of life; Clinical; Communities; Control Groups; Development; Elderly; Equilibrium; Experimental Designs; Fall prevention; Family; Goals; Habits; Health; Healthy People 2020; Individual; Informal Social Control; Injury; Intervention; Intervention Studies; Knowledge; Lead; Leg; Longevity; Mediating; Mission; Monitor; Motivation; National Institute of Nursing Research; Observational Study; Outcome; Participant; Physical activity; Protocols documentation; Public Health; Quality of life; Randomized; Readiness; Recruitment Activity; Research; Research Personnel; Research Proposals; Resources; Science; Social support; Testing; Time; Treatment Efficacy; Work; aged; base; behavior change; behavior influence; community center; evidence base; experimental study; fall risk; falls; follow-up; improved; innovation; intervention effect; post intervention; theories

Project Summary/ Abstract Despite evidence that physical activities (PA) targeting leg strength and balance reduce falls, less than 12% of older adults engage in these activities on a regular basis and fall rates continue to increase. Research examining intervention strategies that motivate older adults to engage in PA is scarce and inconclusive. The proposed research aims to address this gap in fall prevention science. The objective of this proposal is to identify behavioral change strategies that elicit increased PA, sustained for 12 months and, in turn, lead to a reduction in falls and improved quality of life (QOL). Building on prior research, the proposed study will use a factorial experimental design to test the relative influence of behavioral change strategies separated into two components. These components are comprised of distinct sets of behavior change strategies that represent two different ways of motivating people to take action: inter-personal and intra-personal, consistent with theories of behavioral change and life-span development, as well as empirical evidence. These components will be combined with core intervention content that includes Otago, an evidence-based, fall-reducing PA protocol, and a PA-monitor for self-tracking. We will recruit 308 community-dwelling adults > 70 years old and randomly assign them to one of four conditions: (a) Otago + PA-monitor; (b) Otago + PA-monitor + inter- personal component; (c) Otago + PA-monitor + intra-personal component; and (d) Otago + PA-monitor + inter-personal + intra-personal components. Content within all conditions will be delivered over 8 weeks to small groups in community centers. We will re-assess all participants post-intervention: immediately, 6 months and 12 months to evaluate the short and long-term efficacy of the intervention components. We hypothesize that participants receiving the inter-personal component, relative to participants not receiving this component, will have a) clinically meaningful increases in PA at all 3 follow-up time points; and b) reductions in falls and improved quality of life 12 months post-intervention. We will also explore the effects of intervention components on targeted mechanisms, motivational constructs (social support; readiness; self- regulation) and physical markers of fall risk (functional balance and strength), and whether these mechanisms are associated with PA and fall outcomes. We hypothesize that receiving the inter-personal motivational component, relative to not receiving this component, will elicit increases in motivational constructs and physical markers of fall risk, which will mediate the intervention’s effects on PA and falls. The proposed research is innovative, because it represents a substantive expansion of biomechanically-oriented fall-reducing PA protocols to a) examine which behavioral change strategies elicit sustained effects (e.g., 12 months) on increased PA, as well as on falls, and QOL; and b) explore underlying mechanisms of PA and falls. The long-term intent of the proposed research is to optimize a PA intervention for older adults that can be used by community-based organizations to promote PA, reduce falls, and improve QOL.

项目摘要/摘要 尽管有证据表明靶向腿部力量和平衡的体育活动（PA）减少了下降，但不到12％ 老年人定期从事这些活动，跌倒率继续增加。研究 检查激励老年人参与PA的干预策略是稀缺且尚无定论的。这 拟议的研究旨在解决秋季预防科学中的这一差距。该提议的目的是 确定引起PA增加的行为改变策略，持续了12个月，然后导致 减少跌倒和改善的生活质量（QOL）。在先前研究的基础上，拟议的研究将使用 阶乘实验设计，以测试分为两者的行为改变策略的相对影响 成分。这些组成部分由代表的不同行为变化策略组成 激励人们采取行动的两种不同的方式：人际关系和个人内部，与 行为变化和生命发展的理论以及经验证据。这些组件 将与包括Otago在内的核心干预内容结合使用，Otago是一种基于证据的，降落的PA 协议，以及用于自我跟踪的PA-Monitor。我们将招募308名社区居民> 70岁的成年人 将它们随机分配到四个条件之一：（a）奥塔哥 + PA-Monitor； （b）Otago + PA-Monitor + Inter- 个人组成部分； （C）Otago + PA-Monitor +个人内部成分； （d）Otago + PA-Monitor + 人际关系 +个人内部成分。在所有条件下的内容将在8周内交付 社区中心的小组。我们将在干预后重新评估所有参与者：立即，6 评估干预组件的短期和长期效率的月零12个月。我们 假设参与者接受了个人间成分，相对于未接受的参与者 该组件将在所有3个随访时间点上具有a）PA的临床意义增加；和b） 干预后12个月的跌倒和生活质量改善。我们还将探讨 干预措施的组成部分，动机构造（社会支持；准备就绪；自我 调节）和跌倒风险的物理标记（功能平衡和力量），以及这些是否是否 机制与PA和跌倒结果有关。我们假设接受人际关系 相对于不接受此组件的动机组成部分将引起动机的增加 秋季风险的结构和物理标记，这将调解干预对PA和跌倒的影响。这 拟议的研究具有创新性，因为它代表了面向生物力学的实质性扩展 减少降落的PA方案以a）检查哪些行为改变策略会引起持续影响（例如，12 几个月）在PA和跌倒以及生活质量上增加； b）探索PA和PA的潜在机制 瀑布。拟议的研究的长期意图是优化老年人的PA干预措施 由社区组织使用来促进PA，减少跌倒并改善QoL。