Maintenance in Multiple Behaviors with Emphasis on Aging

描述(由申请人提供)：主要目标是通过系统分析以下方面的维持因素来增进对长期维持的了解，特别是在老年人中：1)治疗类型；2)人群类型。这项研究分析了10种行为内部和之间的14个变化过程，这些行为对老龄人口的健康越来越重要。这10种行为分别是：1.吸烟；2.饮酒；3.坚持服用降压药；4.坚持服用他汀类药物；5.自我监测血糖；6.压力管理；7.抑郁管理；8.运动；9.饮食；10.日晒。主要目标是：1)比较治疗类型内部和之间的维持率和维持途径(例如，治疗与不治疗；多水平治疗与单一水平治疗)；以及2)年龄、性别、教育或种族不同的人群类型。该项目将根据与动机、自我效能感和对变化的抵抗力相关的因素，评估老年人在保持变化方面与其他成年人相比哪些行为更好、哪些更差或相同。该项目将评估特定于每个行为的维护模型和跨行为的通用模型。这些分析将：1.计算和比较每种类型的治疗和人群的行为的维持率；2.用图形表示三种不良类型(维持者、复发者和不采用者)对14种维持因素的纵向使用；3.评估三种不良类型之间的统计差异，代表治疗或人群的群体和时间；4.评估14种维持因素的因果影响和中介作用；5.通过元分析确定维持因素和中介模型在行为中的常见和独特使用。该提案将是最大的维修比较研究，将分析22项研究，参与者超过4万人，得到来自多个学科的联合调查人员超过4000万美元的资助。产生的知识将产生60本对行为改变理论和长期维持干预措施具有重要意义的出版物。与老年人特别相关的包括识别与他们在维持特定健康行为的变化方面做得更好、更差或相同的维持因素。鉴于发生与这些行为相关的疾病的风险越来越高，这项研究对老年人慢性病的预防和管理具有特别的相关性。

DESCRIPTION (provided by applicant): The overarching goal is to advance knowledge about long-term maintenance, particularly in older adults, by systematically analyzing maintenance factors in: 1) types of treatment; and 2) types of populations. The research analyzes 14 change processes within and across 10 behaviors that are of increasing significance to the health of aging populations. The 10 behaviors are 1. smoking; 2. alcohol; 3. adherence to anti- hypertensives; 4. adherence to statins; 5. self-monitoring of blood glucose; 6. stress management; 7. depression management; 8. exercise; 9. diet; and 10. sun exposure. The primary goals are: 1) to compare maintenance rates and pathways to maintenance within and between types of treatment (e.g., treatment vs. no-treatment; multiple level treatments vs. single level); and 2) types of populations differing by age, gender, education or ethnicity. The project would assess on which behaviors older adults are better, worse or the same as other adults in maintaining change depending on factors related to motivation, self-efficacy and resistance to change. The project would assess maintenance models specific to each behavior and models that are general across behaviors. The analyses would: 1. Calculate and compare maintenance rates across behaviors for each type of treatment and population; 2. Graphically represent longitudinal use of 14 maintenance factors by three dynatypes (maintainers, relapsers, and non-adopters); 3. Assess statistical differences between the three dynatypes, groups representing treatments or populations, and time; 4. Assess causal influences and mediating effects of the 14 maintenance factors and 5. Identify common and unique use of maintenance factors and mediation models across behaviors by use of meta-analyses. The proposal would be the largest comparative study of maintenance and would analyze 22 studies with over 40,000 participants supported by more than 40 million dollars in grants with co-investigators from multiple disciplines. The knowledge generated would produce 60 publications of importance for theories of behavior change and for interventions for long-term maintenance. Special relevance for older adults includes the identification of maintenance factors related to their doing better, worse or the same in maintaining changes in particular health behaviors. Given increasing risks of developing diseases related to these behaviors, this research has special relevance for prevention and management of chronic diseases in older adults.