Community-based Intervention Effects on Older Adults' Physical Activity and Falls

基于社区的干预对老年人体力活动和跌倒的影响

• 批准号: 9330461
• 负责人: Siobhan Kathleen McMahon
• 金额: $ 63.83万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-15 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9330461
• 关键词: Accelerometer; Address; Adult; Behavioral; Biomechanics; Cessation of life; Clinical; Communities; Control Groups; Development; Elderly; Equilibrium; Experimental Designs; Fall prevention; Family; Goals; Habits; Health; Healthy People 2020; Individual; Informal Social Control; Injury; Intervention; Intervention Studies; Knowledge; Lead; Leg; Longevity; Mediating; Mission; Monitor; Motivation; National Institute of Nursing Research; Observational Study; Outcome; Participant; Physical activity; Protocols documentation; Public Health; Quality of life; Randomized; Readiness; Recruitment Activity; Research; Research Personnel; Research Proposals; Resources; Science; Social support; Testing; Time; Treatment Efficacy; Work; aged; base; behavior change; behavior influence; community center; evidence base; experimental study; fall risk; falls; follow-up; improved; innovation; intervention effect; post intervention; theories

Project Summary/ Abstract Despite evidence that physical activities (PA) targeting leg strength and balance reduce falls, less than 12% of older adults engage in these activities on a regular basis and fall rates continue to increase. Research examining intervention strategies that motivate older adults to engage in PA is scarce and inconclusive. The proposed research aims to address this gap in fall prevention science. The objective of this proposal is to identify behavioral change strategies that elicit increased PA, sustained for 12 months and, in turn, lead to a reduction in falls and improved quality of life (QOL). Building on prior research, the proposed study will use a factorial experimental design to test the relative influence of behavioral change strategies separated into two components. These components are comprised of distinct sets of behavior change strategies that represent two different ways of motivating people to take action: inter-personal and intra-personal, consistent with theories of behavioral change and life-span development, as well as empirical evidence. These components will be combined with core intervention content that includes Otago, an evidence-based, fall-reducing PA protocol, and a PA-monitor for self-tracking. We will recruit 308 community-dwelling adults > 70 years old and randomly assign them to one of four conditions: (a) Otago + PA-monitor; (b) Otago + PA-monitor + inter- personal component; (c) Otago + PA-monitor + intra-personal component; and (d) Otago + PA-monitor + inter-personal + intra-personal components. Content within all conditions will be delivered over 8 weeks to small groups in community centers. We will re-assess all participants post-intervention: immediately, 6 months and 12 months to evaluate the short and long-term efficacy of the intervention components. We hypothesize that participants receiving the inter-personal component, relative to participants not receiving this component, will have a) clinically meaningful increases in PA at all 3 follow-up time points; and b) reductions in falls and improved quality of life 12 months post-intervention. We will also explore the effects of intervention components on targeted mechanisms, motivational constructs (social support; readiness; self- regulation) and physical markers of fall risk (functional balance and strength), and whether these mechanisms are associated with PA and fall outcomes. We hypothesize that receiving the inter-personal motivational component, relative to not receiving this component, will elicit increases in motivational constructs and physical markers of fall risk, which will mediate the intervention’s effects on PA and falls. The proposed research is innovative, because it represents a substantive expansion of biomechanically-oriented fall-reducing PA protocols to a) examine which behavioral change strategies elicit sustained effects (e.g., 12 months) on increased PA, as well as on falls, and QOL; and b) explore underlying mechanisms of PA and falls. The long-term intent of the proposed research is to optimize a PA intervention for older adults that can be used by community-based organizations to promote PA, reduce falls, and improve QOL.

项目概要/摘要 尽管有证据表明以腿部力量和平衡为目标的体力活动 (PA) 可减少跌倒，但只有不到 12% 的老年人定期参加这些活动，并且跌倒率持续上升。研究 对激励老年人参与 PA 的干预策略的研究很少且没有结论。这 拟议的研究旨在弥补跌倒预防科学方面的这一空白。该提案的目的是 确定可引起 PA 增加并持续 12 个月的行为改变策略，进而导致 减少跌倒并提高生活质量 (QOL)。基于先前的研究，拟议的研究将使用 析因实验设计，测试分为两种的行为改变策略的相对影响 成分。这些组件由不同的行为改变策略集组成，这些策略代表 激励人们采取行动的两种不同方式：人际间和个人内部， 行为改变和寿命发展的理论以及经验证据。这些组件 将与核心干预内容相结合，其中包括 Otago，一种基于证据的、减少跌倒的 PA 协议和用于自我跟踪的 PA 监视器。我们将招募308名70岁以上的社区居民 将他们随机分配给以下四种情况之一：(a) Otago + PA-m​​onitor； (b) Otago + PA 监视器 + 间 个人部分； (c) Otago + PA 监视器 + 个人内部组件； (d) 奥塔哥 + PA 监视器 + 人际+个人内部的组成部分。所有条件下的内容将在 8 周内交付至 社区中心的小团体。我们将在干预后重新评估所有参与者：立即，6 个月和 12 个月来评估干预措施的短期和长期疗效。我们 假设相对于未接收的参与者，接收人际成分的参与者 该组成部分将 a) 在所有 3 个随访时间点 PA 均出现有临床意义的增加；和 b) 干预后 12 个月，跌倒次数减少，生活质量提高。我们还将探讨以下效果 针对目标机制、动机结构（社会支持、准备状态、自我保护）的干预组成部分 监管）和跌倒风险的身体标记（功能平衡和力量），以及这些是否 机制与 PA 和跌倒结果相关。我们假设接受人际交往 动机成分，相对于不接受该成分，将引起动机的增加 跌倒风险的构建和物理标记，这将调节干预措施对 PA 和跌倒的影响。这 拟议的研究具有创新性，因为它代表了生物力学导向的实质性扩展 减少跌倒的 PA 方案 a) 检查哪些行为改变策略会产生持续的影响（例如，12 月）增加 PA、跌倒和 QOL； b) 探索 PA 的潜在机制 瀑布。拟议研究的长期目的是优化老年人的 PA 干预措施， 被社区组织用来促进 PA、减少跌倒并提高生活质量。