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好处已得到充分证实，但尽管近年来临床广泛建议增加身体活动，但美国只有不到三分之一的老年人达到了建议的身体活动水平。基于临床的增加体力活动的方法价格昂贵，难以在繁忙的实践环境中实施，并且影响范围有限。此外，这些方法的有效性的证据是模棱两可的。基于人群的方法可能是提高老年人身体活动水平的更有效且成本更低的策略。对身体活动的人口研究表明，每年，许多久坐的老年人开始进行身体活动，但几乎相同数量的活跃​​者变得久坐。在开始进行体力活动的老年人中，只有一半的人在 3 个月后继续保持活动状态。我们假设，强调身体活动维持的基于人群的方法可以显着提高特定老年人群的身体活动水平。这一假设在一项为期 24 个月的随机试验中得到了检验，该试验评估了一种创新的、基于理论的行为干预措施，以维持体力活动，随机抽取了 50-70 岁的成年人样本，这些人最近至少变得中等程度地活跃。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，2）基于电话和邮件的交互式干预计划，旨在维持老年人的身体活动。主要结果指标为： 1) 体力活动，以千卡/周支出评估； 2) 身体活动维持，根据相对于基线的后续千卡/周支出进行评估。将仔细衡量干预措施对特征明确的老年人口的渗透率以及干预措施的成本。还将检查身体活动维持的心理社会和行为调节因素。研究结果将与政策制定者、健康促进从业者和健康计划相关，并将提供有关干预措施的有效性、人口渗透率和成本的实用信息，该干预措施旨在最大限度地提高 9 名老年人的身体活动水平。

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.