Comparing a recommendation for self-paced versus moderate intensity physical activity for midlife adults: an RCT

比较中年成年人自定进度体育活动与中等强度体育活动的建议：随机对照试验

• 批准号: 10254448
• 负责人: David M Williams
• 金额: $ 48.02万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10254448
• 关键词: Accelerometer; Adherence; Adult; Affective; Age; Alzheimer' s Disease; Behavior; Body Weight Changes; Body Weight decreased; Cardiovascular Diseases; Cessation of life; Chronic Disease; Colon Carcinoma; Data; Dementia; Energy Metabolism; Exercise; Exertion; Feeling; Frequencies; Guidelines; Health Benefit; Heart Rate; Laboratory Study; Lead; Malignant Neoplasms; Maximum Heart Rate; Measurement; Measures; Mediation; Mediator of activation protein; Methods; Modeling; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Osteoporosis; Overweight; Participant; Patient Self-Report; Physical activity; Physical assessment; Pilot Projects; Play; Population; Procedures; Protocols documentation; Public Health; Randomized; Recommendation; Research; Risk; Role; Secondary to; Self Determination; Testing; Walking; Weight; Weight Gain; Weight maintenance regimen; World Health Organization; adult obesity; age related; base; displeasure; exercise adherence; exercise prescription; experience; fitness; follow-up; heart disease risk; hedonic; improved; malignant breast neoplasm; middle age; novel strategies; overweight adults; pleasure; premature; prevent; primary outcome; programs; protective effect; recruit; response; sarcopenia; secondary analysis; secondary outcome; theories; therapy design; treatment effect; trend; vigorous intensity; weight maintenance

The current USDHHS guidelines recommend that adults expend at least 1000 kcal per week in PA,12 which can be obtained through 150 minutes per week of moderate intensity PA, 75 minutes of vigorous intensity PA, or some combination. However, current estimates suggest that only 3.5% to 43.5% of US adults, and 28% of overweight or obese adults adhere to these recommendations.13-16 Moreover, people across all World Health Organization regions become less active as they age.17 A more progressive decline in PA is seen after age 45- 50.15,18 In essence, PA rates tend to decrease as people age and gain weight while the health benefits of PA become more pronounced. A growing body of research19-36 suggests that a shift in national guidelines to emphasize PA of a self-selected intensity (i.e., self-paced) instead of prescribed moderate intensity PA may result in better adherence to PA programs, particularly among overweight and obese midlife adults.37,38 In the proposed RCT we will conduct a field-based experimental test of the hypothesis that, among overweight and obese midlife (ages 50-64) adults, adherence to PA programs will be improved when PA is explicitly recommended to be self-paced rather than prescribed at moderate intensity. This approach represents an important shift in mindset for those beginning a new program of PA: That is, PA need not be of a certain intensity in order to “count”. If a self-paced recommendation is found to lead to better PA adherence among overweight and obese midlife adults, this could have implications for PA recommendations for that population. Aim 1: We will conduct an RCT comparing the effects of self-paced versus prescribed moderate intensity PA on PA behavior among low-active overweight and obese midlife (ages 50-64) adults (N=240). Based on procedures developed in our pilot, all participants will receive a 12-month intervention designed to help them overcome barriers to regular PA.53 The independent variable will be random assignment to either self-paced or prescribed moderate intensity PA. The primary outcome will be total volume of PA (frequency x duration x intensity) as measured by accelerometry at months 3, 6, 9, and 12. H1: A recommendation for self-paced PA will result in more PA (primary outcome) relative to prescribing moderate intensity PA based on current public health guidelines.12,54-56 Secondary outcomes include: (a) self-reported min/week of PA over the 12-month program, (b) fitness changes, and (c) weight changes at months 6 and 12. Aim 2: Using EMA, we will examine putative mediators of treatment effects based on our conceptual model (see Figure 1). H2: Self-paced PA will lead to a more positive affective response (primary mediator) and thus greater increases in PA behavior.37 Secondary mediators (analogous to secondary outcomes) will include: (a) perceived autonomy, and (b) perceived exertion (RPE).37 Other predictors of PA behavior will also be explored.

当前的USDHHS指南建议成年人每周至少在PA中支出1000 kcal，12 可以通过每周150分钟的现代强度PA，75分钟的剧烈强度PA来获得 或一些组合。但是，目前的估计表明，美国成年人中只有3.5％至43.5％ 超重或肥胖的成年人遵守这些建议。13-16此外，全世界健康的人们 随着年龄的增长，组织区域变得不那么活跃。17在45岁以后，PA的逐渐下降逐渐下降。 50.15,18本质上，随着人的年龄增长，PA的健康益处，PA的利率往往会降低 变得更加明显。越来越多的研究机构19-36表明，国家准则的转变为 强调自我选择的强度（即自节奏）而不是规定的中等强度PA可能 可以更好地遵守PA计划，尤其是在超重和肥胖的中年成年人中。37,38 拟议的RCT我们将对超重和超重和 肥胖的中年（50-64岁）成年人，当PA明确时，遵守PA计划将得到改善 建议以现代强度进行自节奏而不是规定。这种方法代表 对于那些开始新的PA计划的人来说，心态的重要转变：也就是说，PA不必确定 强度以“计数”。如果发现自定进度的建议会导致更好的PA依从性 超重和肥胖的中年成年人，这可能对PA对该人群的建议有影响。 AIM 1：我们将进行RCT，比较自定进度与规定中等强度PA的影响 关于低活动超重和肥胖中年（50-64岁）成年人（n = 240）的PA行为。基于 在我们的飞行员中开发的程序，所有参与者都将获得12个月的干预措施，以帮助他们 克服常规PA.53的障碍。53自变量将是随机分配到自定为定价的或 规定中等强度PA。主要结果将是PA的总体积（频率x持续时间x 强度）通过在第3、6、9和12个月的加速度测定法测量。 基于当前公众，相对于规定中等强度PA的规定，将导致更多的PA（主要结果） 健康指南。12,54-56次要结果包括：（a）在12个月内自我报告的PA/周/周 程序，（b）健身变化，以及（c）第6个月和第12个月的重量变化。 目标2：使用EMA，我们将根据我们的概念模型检查推定的治疗效果介质 （见图1）。 H2：自节奏的PA将导致更积极的情感反应（主要调解人），从而导致 PA行为的增加。37次级介体（类似于次级结果）将包括：（a） 感知的自主权和（b）感知的劳累（RPE）。37还将探讨PA行为的其他预测指标。