Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial.
Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial.
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DOI：
10.2196/51899
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发表时间：
2023-10-03
影响因子：
1.7
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中科院分区：
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缺乏医疗保险、教育水平低、积极性低和不便仍然是参与预防跌倒项目的障碍，特别是在低收入老年人中。低收入地位也有助于消极的衰老自我认知，并与护理的高感知障碍有关。现有的预防跌倒干预技术不能使参与者和从业者进行互动和协作，即使这些技术能够带来保持独立性、预防残疾和增加获得高质量护理的可行策略。研究也局限于使用技术来提高动机和帮助个人将他们的感知与生理跌倒风险联系起来。我们开发了一种新颖的，为期8周的身体反馈运动计划（PEER），其中包括(1)基于技术的身体反馈，使用实时便携式创新技术- BTrackS平衡跟踪系统，这是可靠的和负担得起的，允许家庭测试，并提供反馈和跟踪平衡进展；(2)基于跌倒风险评估矩阵的认知重构；(3)以平衡、力量训练为重点的同伴引导运动，并将运动融入日常活动。本研究包括三个目的。目的1是研究基于技术的PEER干预对跌倒风险、动态平衡和基于加速度计的身体活动（PA）的影响。目的2是研究同伴干预对跌倒风险评估转移和衰老负面自我认知的影响。目的3是探索参与者在同伴干预方面的经验，以及获取和采用基于技术的同伴干预的潜在障碍，为未来的研究提供信息。这是一项意向治疗、单盲、平行、双组随机对照试验研究。我们将收集340名低收入老年人的基线（T1）数据，并测量项目完成（T2）后的结果，并在3个月（T3）和6个月（T4）时进行随访。符合以下所有纳入标准的参与者将被纳入：年龄≥60岁，认知完整，能够独立站立。排除标准如下：身体状况不允许运动或PA，目前正在康复机构接受治疗，计划在一年内搬家，过去12个月内住院3次，不会说英语或西班牙语。截至2023年8月，参与者的招募正在进行中。本研究通过优化定制的、技术驱动的方法来解决公共卫生问题，该方法可在资源匮乏的环境中使用，用户数量不限，以防止跌倒并减少低收入老年人的健康差距。PEER是一种新颖的干预方法，它结合了生理反馈、认知重构和同伴引导运动的概念，通过激发跌倒风险自我估计的转变，使之与生理跌倒风险保持一致，以改善平衡、PA和负面衰老自我感知。ClinicalTrials.gov NCT05778604;https://www.clinicaltrials.gov/ct2/show/study/NCT05778604 derr1 - 10.2196/51899
The lack of health care coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially among low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high perceived barrier to care. Existing fall prevention intervention technologies do not enable participants and practitioners to interact and collaborate, even with technologies that bring viable strategies to maintain independence, prevent disability, and increase access to quality care. Research is also limited on the use of technology to enhance motivation and help individuals align their perception with physiological fall risk. We developed a novel, 8-week Physio-Feedback Exercise Program (PEER), which includes (1) technology-based physio-feedback using a real-time portable innovative technology—the BTrackS Balance Tracking System, which is reliable and affordable, allows for home testing, and provides feedback and tracks balance progression; (2) cognitive reframing using the fall risk appraisal matrix; and (3) peer-led exercises focusing on balance, strength training, and incorporating exercises into daily activities. This study consists of 3 aims. Aim 1 is to examine the effects of the technology-based PEER intervention on fall risk, dynamic balance, and accelerometer-based physical activity (PA). Aim 2 is to examine the effects of the PEER intervention on fall risk appraisal shifting and negative self-perceptions of aging. Aim 3 is to explore participants’ experiences with the PEER intervention and potential barriers to accessing and adopting the technology-based PEER intervention to inform future research. This is an intention-to-treat, single-blinded, parallel, 2-arm clustered randomized controlled trial study. We will collect data from 340 low-income older adults at baseline (T1) and measure outcomes after program completion (T2) and follow-up at 3 months (T3) and 6 months (T4). Participants will be enrolled if they meet all the following inclusion criteria: aged ≥60 years, cognitively intact, and able to stand without assistance. Exclusion criteria were as follows: a medical condition precluding exercise or PA, currently receiving treatment from a rehabilitation facility, plan to move within 1 year, hospitalized >3 times in the past 12 months, and does not speak English or Spanish. As of August 2023, the enrollment of participants is ongoing. This study addresses the public health problem by optimizing a customized, technology-driven approach that can operate in low-resource environments with unlimited users to prevent falls and reduce health disparities in low-income older adults. The PEER is a novel intervention that combines concepts of physio-feedback, cognitive reframing, and peer-led exercise by motivating a shift in self-estimation of fall risk to align with physiological fall risk to improve balance, PA, and negative aging self-perception. ClinicalTrials.gov NCT05778604; https://www.clinicaltrials.gov/ct2/show/study/NCT05778604 DERR1-10.2196/51899
DOI：
10.3390/healthcare9030349
发表时间：
2021-03-18
期刊：
Healthcare (Basel, Switzerland)
影响因子：
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作者：
Huang SH;Hsing SC;Sun CA;Chung CH;Tsao CH;Chung RJ;Wang BL;Huang YC;Chien WC
通讯作者：
Chien WC