Testing Multi-Level Remote Physical Activity Interventions in a National Sample of Older Women: The WHISH EnCore Trial

在全国老年女性样本中测试多层次远程身体活动干预措施：WHISH EnCore 试验

• 批准号: 10363097
• 负责人: ABBY C KING
• 金额: $ 63.79万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10363097
• 关键词: Address; Adherence; Aerobic Exercise; Affect; Age; Age-Years; Aging; Automobile Driving; Behavior; Behavioral; Behavioral Medicine; Cellular Phone; Chronic Disease; Cognitive; Communication; Communities; Consent; Disease; Educational Activities; Educational Intervention; Educational process of instructing; Electronic Mail; Enrollment; Environment; Environmental Risk Factor; Ethnic Origin; Fostering; Gender; Generations; Geographic Locations; Geography; Health; Health Benefit; Health Care Costs; Health behavior; Health behavior change; Impaired cognition; Institutes; Internet; Intervention; Intervention Studies; Knowledge; Life Expectancy; Light; Link; Malignant Neoplasms; Measures; Mediator of activation protein; Mind; Modeling; Motivation; Neighborhoods; Newsletter; Observational Study; Online Systems; Participant; Patient Self-Report; Persons; Physical Function; Physical activity; Population; Precision Medicine Initiative; Process; Public Health; Race; Randomized; Regimen; Research; Resources; Risk Factors; Sampling; Surveys; System; Technology; Telephone; Testing; Touch sensation; United States National Institutes of Health; Voice; Walking; Woman; Women' s Health; academic standard; arm; base; behavioral health; caregiving; citizen science; cognitive benefits; cognitive function; contextual factors; dementia risk; exercise intervention; family support; functional decline; guidebooks; handheld mobile device; innovation; lifetime risk; light intensity; men; mobile application; novel; older men; older women; pedometer; population survey; pragmatic trial; programs; relative cost; remote delivery; response; sedentary lifestyle; social; social cohesion; social culture; socioeconomics; success; walkability; way finding; web site

Project Summary/Abstract Older women are disproportionately impacted by a range of chronic diseases and conditions, such as cognitive impairments, that can be alleviated by regular physical activity (PA), including walking; yet they are the most inactive segment of the US population. While the majority of older women use smartphones, few remotely delivered PA interventions have been developed specifically to address this age + gender PA disparity, and few such interventions leverage built and social environmental factors that can increase daily PA. Using a dynamically based socio-ecological model of health behavior change, this study’s primary aim is to enhance the efficacy of a “light-touch”, remotely delivered PA educational intervention for older women by testing the added impacts of an innovative, remotely delivered citizen science program to identify and address local environmental barriers to walking and other PA (called Our Voice TM [OV]). The “light-touch” PA educational program has been delivered since 2015 to >23,000 women >70 years that have been participating in the U.S.-wide Women’s Health Initiative Strong and Healthy (WHISH) pragmatic PA trial (U01HL122280-03). WHISH, which used a pragmatic, ‘opt-out’ consent enrollment process, includes the broadest range of PA, physical function levels, and geographic regions found in PA intervention studies to date. The original WHISH educational program has resulted in significant but generally modest PA increas- es in the overall WHISH population, and surveys indicate that many WHISH participants could benefit strongly from further intervention. An enriched version of the original remote program (called enCore) will serve as the enCore Alone arm in the proposed trial. To address local built and social environmental PA barriers that many WHISH women describe, the mobile app plus web based OV program will be added to enCore (enCore+OV arm). We will randomize a total of 300 WHISH intervention women (mean age=85 yrs.) with smartphones who are insufficiently active to the two arms. We hypothesize that women receiving enCore+ OV will show higher pedometer-measured 12-month PA levels than women receiving enCore Alone. Additional questions include changes in cognitive function and sedentary behavior; exploring a theo- retically derived multi-level set of putative mediators (e.g., social cohesion, rated neighborhood walkability, community wayfinding) and baseline moderators of program success (e.g., race/ethnicity, family support, geographic region); and exploring the relative costs of the two programs for PA change. The study will add important information on the benefits and trade-offs of combining these remotely delivered, practical, and potentially scalable behavioral health delivery approaches for this fast-expanding demographic group.

项目总结/摘要 老年妇女不成比例地受到一系列慢性疾病和病症的影响，例如 认知障碍，可以通过定期的身体活动（PA），包括步行来缓解;然而， 是美国人口中最不活跃的部分。虽然大多数老年妇女使用智能手机， 已经专门针对这一年龄+性别开发了一些远程提供的PA干预措施 差距，很少有这样的干预措施利用建筑和社会环境因素，可以每天增加 宾夕法尼亚州使用健康行为变化的动态社会生态模型，本研究的主要目的是 是为了提高老年妇女“轻触式”远程PA教育干预的有效性， 通过测试一个创新的、远程交付的公民科学计划的额外影响， 解决当地环境障碍步行和其他PA（称为我们的声音TM [OV]）。“轻触” 自2015年以来，PA教育计划已向超过23，000名超过70岁的妇女提供， 参加美国-广泛的妇女健康倡议坚强和健康（WHISH）务实的PA试验 （U01HL122280-03）。WHISH采用了务实的“选择退出”同意注册流程，包括 PA干预研究中发现的最广泛的PA、身体功能水平和地理区域， 约会最初的WHISH教育计划导致了显着但一般适度的PA增加- 在整个WHISH人群中，调查表明，许多WHISH参与者可以受益 强烈反对进一步干预。原始远程程序的丰富版本（称为enCore）将 作为拟定试验中的enCore Alone组。解决当地建筑和社会环境问题 许多WHISH女性描述的障碍，移动的应用程序加上基于网络的OV计划将被添加到 enCore（enCore+OV组）。我们将随机选择300名WHISH干预妇女（平均年龄=85岁 （年）智能手机对双臂不够活跃。我们假设女性接受 与接受enCore的女性相比，enCore+ OV将显示更高的计步器测量的12个月PA水平 一个人其他问题包括认知功能和久坐行为的变化;探索理论- 推定的介体的远程导出的多级集合（例如，社会凝聚力，邻里步行能力， 社区寻路）和计划成功的基线主持人（例如，种族/民族，家庭支持， 地理区域）;和探索PA变化的两个程序的相对成本。该研究将增加 关于将这些远程交付、实用和 为这个快速扩大的人口群体提供潜在的可扩展的行为健康交付方法。