Maintaining Physical Activity in Older Adult MCO Members

描述(申请人提供)：体育锻炼对成年人的好处是众所周知的，但在美国，尽管近年来临床上普遍建议增加体育锻炼，但只有不到三分之一的美国老年人达到了推荐的体育锻炼水平。以临床为基础的增加体力活动的方法昂贵，难以在繁忙的练习环境中实施，而且覆盖范围有限。此外，这些方法的有效性的证据也是模棱两可的。以人口为基础的方法可能是增加老年人体力活动水平的更有效和更低成本的策略。对体育活动的人口研究表明，每年都有许多久坐不动的老年人发起体育活动，但几乎相同数量的活动者开始久坐不动。在开始运动的老年人中，只有一半的人在3个月后继续运动。我们假设，强调保持体力活动的以人群为基础的方法可以显著提高一定数量的老年人的体力活动水平。这一假设在一项为期24个月的随机试验中得到了验证，该试验评估了一种创新的、基于理论的行为干预措施，以保持身体活动。随机样本为50-70岁的成年人，他们最近至少开始适度运动。一千(1000)名受试者将被随机分成两个试验组之一：1)“日常护理”对照组，和2)一项旨在维持老年人体力活动的基于电话和邮件的互动干预计划。主要结果衡量标准是：1)体力活动，评估为千卡/周支出；2)体力活动维持，评估为相对于基线的后续千卡/周支出。将仔细衡量干预措施对具有良好特征的老年人口的渗透率，并评估干预措施的成本。此外，还将研究身体活动维持的心理社会和行为中介因素。研究结果将与政策制定者、健康促进从业者和健康计划相关，并将提供有关干预措施的有效性、人口渗透率和成本的实用信息，该干预旨在最大限度地提高9名老年人的体力活动水平。

DESCRIPTION (provided by applicant): The benefits of physical activity for adults are well established, but less than one-third of older adults in the U.S. have achieved recommended levels of physical activity despite widespread clinical recommendations to increase physical activity in recent years. Clinic-based approaches to increasing physical activity are expensive, difficult to implement in busy practice settings, and have limited reach. Moreover, evidence of the efficacy of such approaches is equivocal. A population-based approach may be a more effective and less costly strategy to increase levels of physical activity in older adults. Population studies of physical activity have demonstrated that each year, many sedentary older adults initiate physical activity, but a nearly equal number of those who were active become sedentary. Among older adults initiating physical activity, only half continue to be active 3 months later. We hypothesize that a population-based approach that emphasizes physical activity maintenance can substantially increase physical activity levels in a defined populations of older adults. This hypothesis is tested in a 24-month randomized trial evaluating an innovative, theory-based behavioral intervention to maintain physical activity in a random sample of 50-70 year old adults who have recently become at least moderately active. One thousand (1000) subjects will be randomized to one of two experimental groups: 1) a "usual care" control group, and 2) an interactive phone- and mail-based intervention program tailored to maintaining physical activity in older adults. The primary outcome measures are: 1) physical activity, assessed as kcals/wk expenditure; and 2) physical activity maintenance, assessed as follow-up kcals/wk expenditure relative to baseline. Careful measurement of the penetration of the intervention into a well characterized older adult population, and the costs of the intervention, will be assessed. Psychosocial and behavioral mediators of physical activity maintenance will also be examined. Study results will be relevant to policy makers, health promotion practitioners and health plans, and will provide practical information on the effectiveness, population penetration, and costs of an intervention designed to maximize population levels of physical activity among 9 older adults.