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: 8708725
• 负责人: Janey Christine Peterson
• 金额: $ 16.35万
• 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/8708725
• 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)：患有多种慢性病的老年人有很高的残疾和不良临床事件的风险，这些结果可以通过体力活动来改善，但还没有针对这一弱势群体建立体力活动建议或临床指南的试验。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体力活动以改善结果。申请者和导师最近进行的一项随机对照试验证实，在患有心血管疾病的老年人中，诱导积极情绪-一种幸福感和幸福感-在激励体力活动方面具有有效性，但在患有多种慢性病的老年人中，这种效果无法持续超过六个月。另外的数据显示，Charlson指数为e 3的参与者在1年内保持较低的活动水平，两年内发生重大临床事件的几率明显较低。这位候选人的长期目标是成为老年行为医学领域的独立临床研究员，专注于改善患有多种慢性病的老年人的健康和生活质量。该项目的总体目标是利用积极情感诱导定期锻炼干预措施取得的初步成功，以长期维持身体活动，专门针对患有多种高危慢性病的老年人，这是实现这一目标的下一步。中心假设是，与教育对照组相比，定制的Paire干预措施将导致持续增加的体力活动，即使是在有间歇性医疗事件或高度抑郁症状的人中也是如此。目标1是使PAIRE干预措施适用于患有多种高危慢性病的老年人。该方法将依赖于一种新的和严格的顺序混合方法战略，以确定调解和适度维持患有多种高危慢性病的老年人的体力活动的关键心理社会和临床因素，然后由患者和社区提供者组成重点小组，评估潜在干预组成部分的可接受性。目标2是试点测试新的PAIRE干预措施，这种干预措施专门针对患有多种高危慢性病的老年人。S的这项工作具有创新性，因为它将转化为关注积极情绪的成熟干预措施的好处，以增加患有多种高危慢性病的老年人的体力活动， 这是为这一特别脆弱人群的临床和心理社会挑战量身定做的。这项工作意义重大，因为促进体力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，而目前还不存在这种疾病。该项目预计将产生重要的积极影响，因为它将导致一种新的有效的PAIRE干预措施，同时将候选人定位为首席调查员提交竞争性的R01申请，并使老年行为医学领域的工作轨迹新颖且具有临床重要性。