INCREASING PHYSICAL ACTIVITY OF ELDERS IN THE COMMUNITY

科学证据表明，体力活动有助于 改善健康和功能的重要途径。和生活质量 老年人，这反过来又增强了独立性，并有助于减少 利用保健。关键的下一步是增加 大部分老年人的身体活动水平， 他们大多久坐不动。这需要以社区为基础的公共卫生 适合所有老年人的定向计划以及招聘 有效招募那些最能受益的人的战略， 通常不会自愿加入这样的计划。社区健康 老年人活动模式方案（CHAMPS）是其中的第一个 计划试图满足这些需求，鼓励注册者 参加社区提供的体育活动课程和计划。 CHAMPS成功地提高了身体活动水平， 在6个月期间登记的人数比例; 在心理健康方面也有相应的改善。基于 根据第一代项目的结果，我们建议扩大 改进招募方法和干预措施。具体 目的是：（1）使用随机对照设计，实施1- 年基于社区的干预，针对个人需求， 偏好，结合使用体育活动类提供的 以家庭为基础的方法，并针对活动不足的老年人 (65（2）在医疗保险HMO中登记;（2）评估 该计划在增加身体活动方面的有效性 增强身体机能和与健康有关的其他方面 生活质量;（3）确定有助于项目采用的因素， 拒绝;（4）描述创新招聘方法的有效性 （5）评估成本效益。 重点是增加中等强度的耐力活动， 散步、游泳和一般的条件反射运动， 热量和促进腿部力量，这对身体很重要， 这是一个相对容易的活动，老年人可以参与其中。 运用社会认知原理和变化阶段理论， 将鼓励一个人从他/她自己的水平开始开始， 增加活动的频率和持续时间，目标是3-4 时代周刊。大约1，100名HMO登记者将通过以下方式进行筛选： 电话和枚举。将积极招聘符合条件的人员 使用创新的方法参加介绍性会议， 被邀请加入。其中，240例患者将接受随机化并随访1- 等待名单控制组将收到该计划， 时间将使用协方差分析和其他方法评价结果。 多元方法这项研究的目的是促进长期的 通过制定一项计划， 满足尽可能多的老年人的需求， 整合到当地的老年中心或医疗保健组织，作为一个持续的 为社区中的老年人提供服务。

Scientific evidence indicates that physical activity contributes in important ways to the improved health, functioning. and quality of life of older adults, which in turn enhance independence and contribute to reduced utilization of health care. A critical next step is to increase the physical activity levels of large segments of the older adult population, who are largely sedentary. This requires community-based, public-health oriented programs appropriate for all older adults as well as recruitment strategies that effectively recruit those who can most benefit yet who typically do not volunteer to join such programs. The Community Healthy Activities Model Program for Seniors (CHAMPS) is among the first of such programs attempting to fill these needs, encouraging enrollees to participate in community-offered physical activity classes and programs. CHAMPS successfully increased physical activity levels in a sizeable proportion of enrollees over a 6-month period; those who did so experienced corresponding improvements in psychological well-being. Based on the results from this first-generation project, we propose to extend and improve the recruitment methods and the intervention. The specific aims are to: (1) implement, using a randomized, controlled design, a 1- year community-based intervention that is tailored to individual needs and preferences, combines use of physical activity classes offered by the community with home-based approaches, and targets underactive older adults (65+ years of age) enrolled in a Medicare HMO; (2) evaluate the effectiveness of the program in terms of increased physical activity levels, enhanced physical functioning and other aspects of health-related quality of life; (3) identify factors contributing to program adoption and refusal; (4) describe the effectiveness of innovative recruitment methods to reach those who can most benefit; and (5) evaluate cost-effectiveness. The emphasis is on increasing moderate-intensity endurance activities such as walking, swimming, and general conditioning exercises that expend calories and promote leg strength that are important to physical functioning, and that are relatively easy for seniors to participate in. Using principles of social cognitive and stages of change theories, each person will be encouraged to begin at his/her own level and gradually increase the frequency and duration of activity, aiming for a goal of 3-4 times weekly. Approximately 1,100 HMO enrollees will be screened by telephone and enumerated. Eligible persons will be proactively recruited using innovative methods to attend an introductory meeting where they will be invited to join. Of these, 240 will be randomized and followed for a 1- year period; the wait-list control group will receive the program at that time. Results will be evaluated using analysis of covariance and other multivariate methods. The goal of the study is to facilitate long-term lifestyle changes in physical activity patterns by developing a program that meets the needs of as many seniors as possible and can ultimately be integrated into a local senior center or a Medicare HMO as an ongoing service to older adults in the community.