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: 9901567
• 负责人: Dori E Rosenberg
• 金额: $ 67.01万
• 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/9901567
• 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; fasting glucose; follow-up; group intervention; handheld mobile device; healthy aging; high risk; high risk population; 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 60岁以上的成年人中，近40％是肥胖的。这些人平均每天花费10多个小时 坐着。这是一个问题，因为新兴的研究表明较高的坐姿与更糟 心血管和代谢健康。实际上，大多数肥胖的老年人都有合并症的心脏代谢 状况。可以减少这种高风险人群中坐时间的干预措施可以改善健康状况 降低医疗保健费用。因此，需要进行更多的研究来制定干预措施以有效减少坐姿 年龄较大的肥胖成年人的时间。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。这项研究发现，基于理论的多模式行为 将电话咨询和基于技术的行为提示结合在一起的干预是可行的， 可以接受的，并且大大减少了坐姿（干预措施与对照相比 组，p <.01）。在基线血压升高的患者中，血压也有所改善 我们的试点研究。简而言之，我们发现在大型随机对照试验中，i-Stand保证评估。 当前的研究将与参与者的注意力匹配的控制干预进行比较 60岁，肥胖，每天坐超过8个小时（n = 284）。两种干预措施都包括一个 人会议和9个后续电话。实验参与者还将收到站立的提示 通过腕上的技术和家庭环境审核，以确定改善站立时间的修改。全部 参与者将持续12个月。 6个月后，实验参与者将被重新融合到 接收5个额外的助推器电话，也没有进一步的干预，使我们能够评估初始的影响 干预和助推器会议。主要结果将减少坐着时间 大腿磨损的激活层和血压。次要结果包括更改 心脏代谢危险因素（例如重量，脂质，空腹葡萄糖）。具有重大治疗效果的介体将 也可以探索。如果有效，i-Stand可以很容易地由医疗保健系统来改善 全国老年肥胖成年人的健康。