Trial to Increase Walking Among Sedentary Older Latinos

说明(申请人提供)：定期的体育锻炼有助于老年人的健康和生活质量，但不幸的是，65岁及以上的男性和女性中只有20%和25%达到了国家最低体育锻炼指导方针。年长的拉丁裔人的疾病发病率更高，这些疾病最有可能受益于体育运动，但久坐不动的生活方式的比例高得不成比例。为了解决这一重大的公共卫生问题，拟议的研究试图实施和评估一项多方面的干预措施，以提高和维持拉美裔老年人的步行水平。 此前，这个由多学科研究人员组成的团队设计并试行了一种结构化干预措施，通过提高老年人对衰老的预期来提高步行水平。他们现在建议在一项随机临床试验中评估这种干预的有效性和可持续性。该团队计划招募600名久坐不动的拉美裔老年人，这些人是从大洛杉矶地区的社区老年中心招募的。这项拟议研究的具体目的是测试干预的效果：1)主要结果：由数字计步器测量的每周步数从基线到1、12和24个月随访的变化；2)自我报告的体力活动水平和干预结构(包括对年龄的期望和对体力活动的自我效能预期)；3)次要结果，包括心理社会健康结构、身体表现测量和临床健康结果。 干预的核心是一系列每周4次、每次1小时的小组讨论，利用动机心理学领域的归因再培训技术，结合基于社会认知理论的行为策略。讨论将在老年中心进行，并由一名双语健康教育者领导；每一次会议之后将有一小时的锻炼课程，旨在增加力量、灵活性和耐力。在讨论期间，健康教育者将管理一个有组织的、根据文化定制的课程，在课程中，参与者被教导随着年龄的增长提高他们对体育活动的期望，而不是将久坐归因于“年老”。每周4次，然后每月治疗11个月，12个月后每2个月治疗一次(总干预时间=24个月)。参与者将被随机分成两组中的一组：1)干预组)接受讨论和锻炼班；2)(对照组)只接受与干预组相同频率和持续时间的训练班。该项目的目标是证明一种可行的干预措施的成功，该干预措施可以提高和维持拉美裔老年人的步行水平。

DESCRIPTION (provided by applicant): Regular physical activity contributes to the health and quality of life of older adults, but unfortunately only 20% of men and 25% of women aged 65 years and greater meet the minimal national guidelines for physical activity. Older Latinos have higher rates of diseases that are most likely to benefit from physical activity, but have disproportionately high rates of sedentary lifestyle. To address this major public health problem, the proposed study seeks to implement and evaluate a multifaceted intervention to raise and sustain walking levels among older Latinos. Previously, this multidisciplinary team of investigators designed and pilot-tested a structured intervention to raise walking levels by raising older adults' expectations for aging. They now propose to evaluate the efficacy and sustainability of this intervention in a randomized clinical trial. The team plans to enroll 600 sedentary older Latinos recruited from community-based senior centers in the greater Los Angeles region. The specific aims of the proposed study are to test the effect of the intervention on: 1) the primary outcome: change in steps per week measured by digital pedometer from baseline to 1, 12, and 24-month follow-up; 2) self-reported physical activity level and intervening constructs (including expectations regarding aging and self-efficacy expectations for physical activity); 3) secondary outcomes including psychosocial health constructs, physical performance measures and clinical health outcomes. The core of the intervention consists of a series of 4 weekly 1-hour group discussion sessions that utilize attribution retraining techniques from the field of motivational psychology in combination with behavioral strategies based in social cognitive theory. Discussion sessions will be conducted at senior centers and led by a bilingual health educator; each session will be followed by a 1-hour exercise class aimed at increasing strength, flexibility and endurance. During the discussion sessions, the health educator will administer a structured culturally-tailored curriculum in which participants are taught to raise their expectations for physical activity with aging, and not to attribute being sedentary to "old age." The 4 weekly sessions will be followed by monthly sessions for 11 months, and sessions every 2 months for he following 12 months (total intervention duration = 24 months). Participants will be randomized to 1 of 2 arms: 1) intervention arm) receiving the discussion session and the exercise class; 2) (control arm) receiving just the exercise class with the same frequency and duration as the intervention group. The goal of this project is to demonstrate success of a feasible intervention that raises and sustains walking levels among older Latinos.