Keep it Movin': A Church-based Intervention to Improve Physical Function in African Americans

项目总结 患有多种慢性病(MCC)的人残疾风险增加，生活质量下降， 住院和死亡人数增加。MCC的负担尤其沉重地落在了非裔美国人(AA)身上 他们比非西班牙裔白人和西班牙裔有更高的多发病患病率，并且更早 身体机能下降，残疾患病率上升。在我们在芝加哥西区的工作中 在社区中，我们观察到MCC对身体功能的这些不利影响。十多年来，拉什 研究人员和AA教会通过活着的信仰网络(AFN)合作，为健康公平而工作 在芝加哥地区。最近对会众和社区进行的健康筛查显示出很高的比率 肢体生理功能受限，其中肢体功能受限最常见于有 慢性病。因为体力活动(PA)提供了减少发病率和死亡率的有效途径 在经历MCC相关损害的人中，教会伙伴呼吁对PA进行测试 可能应对这一健康挑战的干预措施。因此，调查人员将测试一个多级别的PA计划 名为Keep It Movin‘(Kim)的社区成员。金的干预建立在以证据为基础的 老年人的生活方式干预和独立性(LIFE)研究表明，一个结构化的PA计划 可以减少身体功能受限的老年人的行动障碍。生活中的发现 干预措施以前没有在以AA为主的社区进行过测试。KIM试点项目的参与者 一项研究报告说，参与推荐的PA存在重大障碍，包括疼痛和 呼吸困难、害怕受伤和功能受限。因此，我们对生活干预措施进行了调整 实施，增加职能教育，帮助克服启动和维护常规PA的障碍 在患有MCC的人中。我们假设，这种增强的干预，它增强了 教会成员通过知识渊博的康复专家提供额外的社会支持和教育， 将导致由于MCC而导致PF受限的AA成人的身体功能和PA增加。 这项研究将确定，相对于来自比较教会的匹配参与者，参与者是否收到 根据Mean SPPB的记录，在干预6个月后，保持运动将改善身体功能 得分至少高出0.50分。次要目标包括测试金相对于教育的干预 6个月和12个月时的比较条件对中度或重度PA的结果、对PA的社会支持、自我评价 PA的疗效、生活质量和自我报告的身体功能。我们将使用RE-AIM框架来评估 影响范围和推动成功采用、实施和维护Keep It Move的因素 各教堂之间的干预。

PROJECT SUMMARY Persons with Multiple Chronic Conditions (MCCs) experience increased risk of disability, reduced quality of life, increased hospitalizations, and death. The burden of MCCs falls particularly hard on African Americans (AAs) who have a higher prevalence of multimorbidity than non-Hispanic whites and Hispanics, and have earlier declines in physical functioning and higher prevalence of disability. In our work in Chicago’s west side AA community, we have observed these adverse impacts of MCCs on physical functioning. For over a decade, Rush researchers and AA churches have collaborated through the Alive Faith Network (AFN) to work for health equity in the Chicago region. Recent health screenings with congregants and the community demonstrated high rates of lower extremity physical function limitations, with physical function limitations most common among those with chronic illness. Since physical activity (PA) offers an effective approach to reducing morbidity and mortality among persons experiencing MCC-associated impairments, Church partners have called for the testing of PA interventions that might address this health challenge. Investigators will therefore test a multi-level PA program that community members named Keep It Movin’ (KIM). The KIM intervention builds on the evidence-based Lifestyle Interventions and Independence for Elders (LIFE) Study which showed that a structured PA program can reduce mobility disability among older adults with limitations of physical function. Findings from the LIFE intervention have not been previously tested in predominantly AA communities. Participants in the KIM pilot study reported significant barriers to engaging in recommended PA, including symptoms such as pain and dyspnea, fear of injury, and functional limitations. We have therefore adapted the LIFE intervention for implementation, adding functional education to help overcome barriers to starting and maintaining regular PA among persons with MCCs. We hypothesize that this augmented intervention, which enhances capability of church members through additional social support and education by knowledgeable rehabilitation specialists, will lead to both increased physical function and increased PA among AA adults with PF limitations due to MCCs. The study will determine if, relative to matched participants from comparator churches, participants receiving the Keep it Movin’ intervention will have improved physical function at 6 months, as documented by mean SPPB scores at least 0.50 points higher. Secondary aims include testing the KIM intervention relative to an education comparator condition at 6 and 12 months on outcomes of Moderate or Vigorous PA, social support for PA, self- efficacy for PA, quality of life and self-reported physical functioning. We will use the RE-AIM framework to assess reach and factors driving successful adoption, implementation, and maintenance of the Keep it Moving intervention across churches.