Voice-Activated Technology to Improve Mobility & Reduce Health Disparities: EngAGEing African American Older Adult-Care Partner Dyads

项目总结 体力活动对所有年龄段、所有合并症和老年综合征都是必不可少的；它一直是 被描述为在衰老过程中保持功能独立性的理想干预措施。体力活动 干预措施一再被证明可以改善身体虚弱和体能表现，并防止行动不便 高危老年人的残疾和死亡。患有多发病、呆在家里的老年人面临着 长期维持体力活动的生理和功能挑战以及结构性障碍。 多发病在非洲裔美国人中更严重，在他们的一生中更普遍，他们 在美国，比其他任何种族都要经历更多加速老龄化的经历。生理紊乱，需要帮助 离开家，依赖于提供支持的培训或工具有限的护理伙伴，以及缺乏 家庭长期锻炼服务的覆盖范围最禁止这一弱势群体参与锻炼 可能会从干预中获得功能性收益。多发性疾病患者的体力活动增加， 待在家里的老年人需要改变干预措施，以针对老年人护理伴侣二人组并进行测试 远程干预交付的创新工具。我们开发了一种针对社交动机的锻炼工具 多病，非裔美国人，呆在家里的老年人和他们的护理伙伴，称为参与杠杆 声控技术。Engage是通过迭代参与式设计与目标用户共同设计的 方法论。在一项成功的可行性研究提供了初步的有效性证据后，我们现在 建议进行一项家庭内的随机有效性试验，分别是介入(干预)和纸质练习讲义(通常 护理)n=124个多病、非裔美国人、在家的老年人护理伴侣二人组。超过700万美元 老年人很难在家庭和3420万非正式照顾者之外获得医疗服务 在没有指导的情况下支持他们的护理。这项提议的结果将证明一部小说的有效性， 可扩展的计划，在这一难以接触到的老年人群体中促进锻炼，同时支持护理 与关键工具合作。

PROJECT SUMMARY Physical activity is essential for all age groups, across all comorbidities and geriatric syndromes; it has been described as the ‘ideal’ intervention for preserving functional independence during aging. Physical activity interventions have repeatedly been shown to improve frailty and physical performance, and to prevent mobility disability and death among high-risk older adults. Multimorbid, homebound, older adults face substantial physiologic and functional challenges and structural barriers to maintaining physical activity over time. Multimorbidity is more severe and more prevalent among African-Americans over their lifespan, and they experience more accelerated aging than any other race in the US. Disrupted physiology, the need for assistance to leave home, reliance on care partners who have limited training or tools to provide support, and lack of coverage for long-term exercise services in the home prohibit exercise participation in this vulnerable group most likely to experience functional gains from interventions. Increasing physical activity among multimorbid, homebound older adults requires a shift in interventions to target the older adult-care partner dyads and to test innovative vehicles for remote intervention delivery. We developed a socially-motivated exercise tool targeting multimorbid, African-American, homebound older adults and their care partners called EngAGE that leverages voice-activated technology. EngAGE was co-designed with targeted users through iterative participatory design methodology. Following a successful feasibility study providing preliminary evidence of effectiveness, we now propose a randomized, in-home, efficacy trial of EngAGE (intervention) versus paper exercise handouts (usual care) in n=124 multimorbid, African-American, homebound older adult-care partner dyads. Over 7 million U.S. older adults cannot easily reach health services outside of the home and >34.2 million informal U.S. caregivers support their care without guidance. Results from this proposal will demonstrate the effectiveness of a novel, scalable program promoting exercise among this difficult-to-reach group of older adults while supporting the care partners with critical tools.