Scale up evaluation of a physical activity program for adults with physical disability

 描述(由申请人提供)：身体残疾(PWD)者缺乏体力活动的比率明显高于普通人群。残疾人参加室内和室外体育活动的机会较少；由于高失业率或就业不足，他们一天中获得的无结构体育活动较少；他们慢性健康状况的发生率大大高于普通人群。作为残疾相关的健康 护理支出继续上升，为残疾人提供机会以实现更高水平的定期体力活动的需求强烈且日益增长。互联网的可用性越来越高 与5年前相比，今天残障人士的参与提供了一个独特的、前所未有的机会，可以利用远程保健作为一种机制，接触到这一服务不足的人群。这项研究使用了一个理论驱动的电子健康平台和创新的PA计划，称为运动到音乐(M2M)，为身体残疾的成年人提供定制的、基于家庭的PA干预。参与者将通过大型物理医学和康复网络招募，这些诊所专门治疗肢体残疾患者。临床患者和他们的患者将被随机分成三组：a)M2M组；b)M2M+社交网络组(M2Mplus)；以及c)注意力控制组(AC)。参与者将被跟踪48周，以获得四个时间点的客观体力活动、健康状况和自我报告的健康指标。参与研究的医生将在48周的研究期间收到关于他们的患者进展(即，坚持和结果)的信息。这项研究将比较与AC组相比，M2M和M2Mplus在增加体力活动和依从性方面的有效性，估计与AC组相比，M2M和M2Mplus在健康方面的改善，并检查假设治疗效果的中介和调节因素，以了解干预对谁有效以及如何有效。这项多层次的可扩展性研究将 加强我们对电子健康的潜在好处的理解，以消除残疾人参与PA的障碍。

 DESCRIPTION (provided by applicant): Rates of physical inactivity among people with physical disability (PWD) are significantly higher than in the general population. PWD have less access to indoor and outdoor physical activity (PA); get less unstructured PA across the day due to high rates of unemployment or underemployment; and their incidence of chronic health conditions are substantially higher than in the general population. As disability-associated health care expenditures continue to rise, there is a strong and growing need to provide opportunities for PWD to achieve higher levels of regular physical activity. The growing availability of internet access among PWD today compared to 5 years ago provides a unique and unprecedented opportunity to use telehealth as a mechanism for reaching this underserved population. The study uses a theory-driven eHealth platform and innovative PA program referred to as movement-to-music (M2M) to deliver a customized, home-based PA intervention for adults with physical disability. Participants will be recruited through a large physical medicine and rehabilitation network of clinics specializing in treating patients with physical disability. Cliniians and their patients will be cluster randomized to one of three groups: a) M2M; b) M2M plus social networking (M2Mplus); and c) attention control (AC). Participants will be followed for 48 weeks to obtain objective measures on physical activity, fitness and self-reported measures on health at four time points. Participant physicians will receive information on their patients' progress (ie., adherence and outcomes) across the 48-week study period. The study will compare the effectiveness of M2M and M2Mplus in increasing physical activity and adherence compared to the AC group, estimate the improvements in health of M2M and M2Mplus compared to the AC group, and examine the mediators and moderators of the hypothesized treatment effect to understand for whom and how the intervention is effective. This multi-level, scalability study will strengthen our understanding of the potential benefits of eHealth to eliminate barriers to PA participation among PWD.