INSPIRE: Intervention to Support Participation in Regular Exercise in the Elderly

INSPIRE：支持老年人定期锻炼的干预措施

• 批准号: 8593645
• 负责人: Janey Christine Peterson
• 金额: $ 17.24万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8593645
• 关键词: Address; Adverse event; Affect; Aging; Angioplasty; Area; Award; Behavioral Medicine; Cardiovascular Diseases; Chronic Disease; Clinical; Clinical Investigator; Cognition; Communities; Comorbidity; Complex; Coronary Artery Bypass; Data; Effectiveness; Elderly; Equation; Event; Exercise; Feeling; Focus Groups; Future; Goals; Guidelines; Happiness; Health; Impaired cognition; Intervention; Ischemia; Lead; Maintenance; Mediating; Medical; Mentors; Methods; Modeling; Morbidity - disease rate; Myocardial Infarction; Operative Surgical Procedures; Outcome; Participant; Patients; Personal Satisfaction; Physical activity; Physiological; Population; Positioning Attribute; Principal Investigator; Provider; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recommendation; Research; Research Personnel; Rest; Risk; Stroke; Subgroup; Target Populations; Testing; Translating; Vulnerable Populations; Work; base; control trial; depressive symptoms; design; disability; effective intervention; high risk; improved; improved functioning; indexing; innovation; mortality; novel; novel strategies; psychosocial; success

DESCRIPTION (provided by applicant): Older adults with multiple chronic diseases are at high risk for both disability and adverse clinical events, outcomes that can be improved with physical activity, but there have been no trials to establish physical activity recommendations or clinical guidelines for this vulnerable population. Older adults with high comorbidity are a rapidl expanding subgroup, and thus there is a pressing need to develop effective approaches to motivate maintenance of physical activity to improve outcomes. A recent randomized controlled trial conducted by the applicant and mentors established the efficacy of inducing positive affect-a feeling of happiness and well-being-in motivating physical activity in older adults with cardiovascular disease, but the effect was not sustained beyond six months in older adults with multiple chronic diseases. Additional data shows that participants with a Charlson Index e 3 who maintained low levels of activity for 1 year had significantly lower rates of major clinical event t 2 years. The candidate's long-term goal is to become an independent clinical investigator in geriatric behavioral medicine focused on improving the health and quality of life of older adults with multiple chronic illnesses. The overall objective of this project, which is the next step towad that goal, is to leverage the initial successes achieved by the Positive Affect Induction for Regular Exercise (PAIRE) intervention for long-term maintenance of physical activity, targeted specifically to older adults with multiple high-risk chronic diseases. The central hypothesis is tht a tailored PAIRE intervention, customized to address the unique and complex needs of older adults with a Charlson Index e 3, will lead to sustained increases physical activity when compared to an educational control, even among those who have interval medical events or high depressive symptoms. Aim 1 is to adapt the PAIRE intervention to older adults with multiple high-risk chronic diseases. The approach will rest upon a novel and rigorous sequential mixed methods strategy to identify key psychosocial and clinical factors that mediate and moderate maintenance of physical activity in older adults with multiple high-risk chronic diseases, followed by focus groups with patients and community-based providers to assess the acceptability of potential intervention components. Aim 2 is to pilot test the new PAIRE intervention that is specific to older adults with multiple high-risk chronic illnesses. This work s innovative because it will translate the benefits of a proven intervention focused on positive affect to increase physical activity in older adults with multiple high-risk chronic illnesses, one that is tailored to the clinical and psychosocial challenges of this particularly vulnerable population. This work is significant because an effective intervention promoting physical activity will improve outcomes for older adults with multiple high-risk chronic diseases, and currently one does not exist. This project is expected to have an important positive impact because it will result in a new validated PAIRE intervention, while both positioning the candidate to submit a competitive R01 application as Principal Investigator, and enabling a novel and clinically important trajectory of work in geriatric behavioral medicine.

描述（由申请人提供）：患有多种慢性疾病的老年人面临着残疾和不良临床事件的高风险，这些结果可以通过体力活动得到改善，但尚未有试验为这一弱势群体建立体力活动建议或临床指南。患有高合并症的老年人是一个迅速扩大的亚群，因此迫切需要开发有效的方法来激励维持身体活动以改善结果。申请人和导师最近进行的一项随机对照试验证实了在患有心血管疾病的老年人中诱导积极情绪（幸福感和幸福感）来激励体育活动的功效，但对于患有多种慢性病的老年人来说，这种效果不会持续超过六个月。其他数据显示，查尔森指数 e 3 的参与者在 1 年内保持低水平活动，在 2 年内主要临床事件的发生率显着降低。候选人的长期目标是成为老年行为医学的独立临床研究者，专注于改善患有多种慢性疾病的老年人的健康和生活质量。该项目的总体目标是实现这一目标的下一步，是利用定期运动积极情绪诱导 (PAIRE) 干预措施取得的初步成功来长期维持身体活动，特别针对患有多种高危慢性病的老年人。中心假设是，与教育控制相比，为满足查尔森指数 e 3 的老年人独特而复杂的需求而定制的 PIRE 干预措施将导致身体活动持续增加，即使是那些有间歇性医疗事件或高度抑郁症状的人也是如此。目标 1 是将 PIRE 干预措施应用于患有多种高危慢性病的老年人。该方法将基于一种新颖且严格的顺序混合方法策略，以确定介导和适度维持患有多种高风险慢性病的老年人的体力活动的关键社会心理和临床因素，然后由患者和社区提供者组成焦点小组，以评估潜在干预措施的可接受性。目标 2 是试点测试新的 PIRE 干预措施，该干预措施专门针对患有多种高危慢性病的老年人。这项工作具有创新性，因为它将把经过验证的干预措施的好处转化为积极影响，以增加患有多种高危慢性疾病的老年人的身体活动，其中一种 这是针对这一特别弱势群体的临床和社会心理挑战而量身定制的。这项工作意义重大，因为促进身体活动的有效干预措施将改善患有多种高危慢性病的老年人的预后，但目前尚不存在这种干预措施。该项目预计将产生重要的积极影响，因为它将产生新的经过验证的 PIRE 干预措施，同时使候选人能够作为首席研究员提交有竞争力的 R01 申请，并在老年行为医学领域实现新颖且具有临床意义的工作轨迹。