A Randomized Controlled Trial of an Automated Exercise Coach for Older Adults
A Randomized Controlled Trial of an Automated Exercise Coach for Older Adults
复制标题
DOI：
10.1111/jgs.12449
复制
发表时间：
2013-10-01
影响因子：
6.3
通讯作者：
Paasche-Orlow, Michael K.
中科院分区：
文献类型：
--
作者：
Bickmore, Timothy W.;Silliman, Rebecca A.;Paasche-Orlow, Michael K.
目的比较基于计算机的体力活动计划和计步器控制条件在久坐不动的老年人中的疗效。设计单盲区组随机对照试验，根据临床地点和健康素养状况分层。从2009年4月到2011年9月在波士顿医学中心设置了三个城市门诊护理实践。参与者老年人(N=263；平均年龄71.3；女性61%；非洲裔美国人63%；51%高中或以下学历)。干预向ECA参与者提供了可使用2个月的带有触摸屏的便携式平板电脑，并指示他们使用数据线将计步器连接到电脑上，并每天与电脑动画虚拟锻炼教练互动，讨论步行和设定步行目标。然后，干预参与者有机会在接下来的10个月里在诊所候诊室的一个售货亭与ECA互动。对照组参与者被给予控制计步器干预，在相同的时间段内只跟踪步数。干预参与者还被提供了计步器。测量主要结果是12个月访谈前30天的平均每日步数。次要结果是为期2个月的访谈前30天的日均步数。结果在2个月时，ECA参与者的步行步数明显多于对照组参与者(调整后的平均步数为4,041步/天比3,499步/天，P=.01)，但这种影响在12个月后减弱(3,861步比3,383步，P=.09)。对于健康素养充足的参与者，ECA组在2个月(P=0.03)和12个月(P=0.02)时的步行显著多于对照组，而健康素养不足的参与者在这两个时间点都没有表现出显著差异。干预参与者对该计划非常满意。结论从门诊诊所部署的自动运动促进系统在短期内增加了老年人的步行。需要有效的方法来长期维持行为改变。
ObjectivesTo compare the efficacy of a computer-based physical activity program (Embodied Conversational AgentECA) with that of a pedometer control condition in sedentary older adults.DesignSingle-blind block-randomized controlled trial stratified according to clinic site and health literacy status.SettingThree urban ambulatory care practices at Boston Medical Center between April 2009 and September 2011.ParticipantsOlder adults (N=263; mean age 71.3; 61% female; 63% African American; 51% high school diploma or less).InterventionECA participants were provided with portable tablet computers with touch screens to use for 2months and were directed to connect their pedometers to the computer using a data cable and interact with a computer-animated virtual exercise coach daily to discuss walking and to set walking goals. Intervention participants were then given the opportunity to interact with the ECA in a kiosk in their clinic waiting room for the following 10months. Control participants were given a control pedometer intervention that only tracked step counts for an equivalent period of time. Intervention participants were also provided with pedometers.MeasurementsThe primary outcome was average daily step count for the 30days before the 12-month interview. Secondary outcomes were average daily step count for the 30days before the 2-month interview. Outcomes were also stratified according to health literacy level.ResultsECA participants walked significantly more steps than control participants at 2months (adjusted mean 4,041 vs 3,499 steps/day, P=.01), but this effect waned by 12months (3,861 vs 3,383, P=.09). For participants with adequate health literacy, those in the ECA group walked significantly more than controls at both 2months (P=.03) and 12months (P=.02), while those with inadequate health literacy failed to show significant differences between treatment groups at either time point. Intervention participants were highly satisfied with the program.ConclusionAn automated exercise promotion system deployed from outpatient clinics increased walking among older adults over the short-term. Effective methods for long-term maintenance of behavior change are needed.