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

项目摘要 身体活动对于所有年龄组、所有合并症和老年综合征都是必不可少的; 被描述为在衰老过程中保持功能独立性的“理想”干预。身体活动 干预措施一再被证明可以改善虚弱和身体表现，并防止流动性 高风险老年人的残疾和死亡。多病，居家，老年人面临大量的 生理和功能挑战以及随着时间的推移维持身体活动的结构性障碍。 在非裔美国人的一生中，多发病更为严重，也更为普遍， 比美国任何其他种族都经历着更快的衰老。生理机能紊乱需要帮助 离开家，依赖护理伙伴，他们提供支持的培训或工具有限， 长期在家锻炼服务的覆盖范围最大限度地阻止了这一弱势群体的锻炼参与 有可能从干预措施中获得功能性收益。增加多病患者的体力活动， 居家老年人需要改变干预措施，以针对老年人的护理伴侣， 远程干预交付的创新车辆。我们开发了一种社会激励的锻炼工具， 多病，非裔美国人，居家老年人和他们的护理合作伙伴称为EngAGE，利用 声控技术EngAGE通过迭代参与式设计与目标用户共同设计 方法论在成功的可行性研究提供了有效性的初步证据后，我们现在 我建议进行一项随机的、家庭内的、关于EngAGE（干预）与纸质练习讲义（通常）的疗效试验 护理）在n=124多病，非洲裔美国人，居家老年人的成人护理合作伙伴二人。超过700万美元 老年人无法轻易获得家庭以外的医疗服务，超过3420万美国非正式护理人员 不求指导，只求照顾。该提案的结果将证明一种新的， 一个可扩展的计划，在这个难以接触的老年人群体中促进锻炼，同时支持护理 关键工具的合作伙伴。

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.