Maintaining Physical Activity in Older Adult MCO Members

描述（由申请人提供）：身体活动对成年人的益处已经得到了很好的证实，但尽管近年来广泛的临床建议增加身体活动，但美国只有不到三分之一的老年人达到了推荐的身体活动水平。基于诊所的增加身体活动的方法是昂贵的，难以在忙碌的实践环境中实施，并且具有有限的范围。此外，这些方法的有效性的证据是模棱两可的。以人口为基础的方法可能是一种更有效和成本更低的策略，以增加老年人的身体活动水平。对体力活动的人口研究表明，每年都有许多久坐不动的老年人开始体力活动，但几乎相同数量的活动者变得久坐不动。在开始体力活动的老年人中，只有一半在3个月后继续活跃。我们假设，一个以人群为基础的方法，强调体力活动的维护，可以大大增加体力活动水平在一个确定的老年人群体。这一假设在一项为期24个月的随机试验中得到了验证，该试验评估了一种创新的、基于理论的行为干预措施，以维持50-70岁成年人的身体活动，这些成年人最近至少适度活跃。一千（1000）名受试者将被随机分配到两个实验组之一：1）“常规护理”对照组，以及2）针对老年人维持体力活动量身定制的基于交互式电话和邮件的干预计划。主要结局指标为：1）体力活动，评估为kcals/wk支出;和2）体力活动维持，评估为相对于基线的随访kcals/wk支出。将对干预措施在特征明确的老年人群体中的渗透率以及干预措施的成本进行仔细测量。还将检查维持体力活动的心理社会和行为介体。研究结果将与政策制定者，健康促进从业人员和健康计划有关，并将提供有关有效性，人口渗透率和干预费用的实用信息，旨在最大限度地提高9名老年人的体力活动水平。

DESCRIPTION (provided by applicant): The benefits of physical activity for adults are well established, but less than one-third of older adults in the U.S. have achieved recommended levels of physical activity despite widespread clinical recommendations to increase physical activity in recent years. Clinic-based approaches to increasing physical activity are expensive, difficult to implement in busy practice settings, and have limited reach. Moreover, evidence of the efficacy of such approaches is equivocal. A population-based approach may be a more effective and less costly strategy to increase levels of physical activity in older adults. Population studies of physical activity have demonstrated that each year, many sedentary older adults initiate physical activity, but a nearly equal number of those who were active become sedentary. Among older adults initiating physical activity, only half continue to be active 3 months later. We hypothesize that a population-based approach that emphasizes physical activity maintenance can substantially increase physical activity levels in a defined populations of older adults. This hypothesis is tested in a 24-month randomized trial evaluating an innovative, theory-based behavioral intervention to maintain physical activity in a random sample of 50-70 year old adults who have recently become at least moderately active. One thousand (1000) subjects will be randomized to one of two experimental groups: 1) a "usual care" control group, and 2) an interactive phone- and mail-based intervention program tailored to maintaining physical activity in older adults. The primary outcome measures are: 1) physical activity, assessed as kcals/wk expenditure; and 2) physical activity maintenance, assessed as follow-up kcals/wk expenditure relative to baseline. Careful measurement of the penetration of the intervention into a well characterized older adult population, and the costs of the intervention, will be assessed. Psychosocial and behavioral mediators of physical activity maintenance will also be examined. Study results will be relevant to policy makers, health promotion practitioners and health plans, and will provide practical information on the effectiveness, population penetration, and costs of an intervention designed to maximize population levels of physical activity among 9 older adults.