Enhancing Motivation for Physical Activity to Reduce the Risk of Falls

描述（由申请人提供）：居住在社区的老年人意外福尔斯跌倒是一种常见、严重且可能预防的公共卫生问题。在美国，2001年每100，000人跌倒相关伤害的年发生率为4616，2008年上升至5252。2000年，每10万人中与跌倒有关的死亡人数为29.3人，2006年上升到41.86人。随着年龄的增长，老年人特别容易受到福尔斯的伤害。福尔斯跌倒的后果对个人和社区都很严重，对老年人的健康产生负面影响。潜在后果包括骨折、害怕跌倒、急诊室、住院和疗养院入院、依赖、意识模糊、固定、抑郁和死亡。重要的可改变的跌倒风险因素包括肌肉无力、步态问题和平衡问题。虽然研究人员已经证明了预防跌倒的体育活动的积极作用，但大多数老年人仍然久坐不动，福尔斯的比率继续增加。老年人参加定期体育活动和健身活动的频率低于年轻人;贫穷和生活在农村社区的老年人之间的差距更大。虽然在过去的几十年里，关于原因、风险因素和有效预防福尔斯的身体活动的知识呈指数级增长，但弥合研究和实践之间的差距仍然是一个挑战。作为解决研究与实践之间的差距的策略，拟议的研究将利用一个经过检验的理论，健康动机理论，以解决行为变化与指导体育活动相结合。拟议的试点干预研究的目标人群包括居住在农村社区的老年人，这是该领域研究不足的人群。跌倒风险（平衡）和身体活动模式的创新措施将包括具有远程灵敏度的加速计。拟议的试点研究的主要目的包括：（a）检查健康动机干预的可接受性和可行性，以及（B）试点测试健康动机干预的有效性，以增加背景资源，行为改变过程变量，身体活动的行为结果，以及跌倒风险降低的健康结果（增加平衡和力量）。这项拟议中的研究是一项研究计划的第一步，该计划的重点是预防老年人的福尔斯和虚弱。 公共卫生相关性：在社区居住的老年人中，意外福尔斯是一种常见的、严重的、潜在的可预防的公共卫生问题。研究人员已经证明了身体活动对预防福尔斯的积极作用，但大多数老年人并不参与日常的身体活动行为。拟议的试点研究的目的是检查的有效性，可行性和可接受性的干预措施，利用行为改变理论（健康动机理论），以促进通过和维护的身体活动，减少福尔斯农村社区居住的老年人。

DESCRIPTION (provided by applicant): Unintentional falls among community-dwelling older adults are a common, serious and potentially preventable public health problem. In the United States, the annual incidence of fall related injuries per 100,000 persons was 4616 in 2001, rising to 5252 in 2008. The annual incidence of fall related deaths per 100,000 persons was 29.3 in 2000, rising to 41.86 in 2006. Older adults are particularly vulnerable to falls as they age. The consequences of falls are significant to both individuals and communities exerting a negative impact on the health of older adult populations. Potential consequences include fractures, fear of falling, emergency room, hospital and nursing home admissions, dependence, confusion, immobilization, depression, and death. Significant modifiable fall risk factors include muscle weakness, gait problems, and balance problems. While researchers have demonstrated the positive effects of fall preventive physical activity, the majority of older adults remain sedentary and the rate of falls continues to increase. Older adults participate in regular physical activity and fitness activities less often than younger populations; disparities are greater among older adults who are poor and living in rural communities. While knowledge about causes, risk factors, and efficacious physical activity to prevent falls has grown exponentially in the last several decades, bridging the gap between research and practice continues to be a challenge. As a strategy to address the gap between research and practice, the proposed study will utilize a tested theory, the wellness motivation theory, to address behavioral change in combination with instruction for physical activity. The target population of the proposed pilot intervention study includes rural community dwelling older adults, an understudied population in this field. Innovative measures of fall risk (balance) and physical activity patterning will include an accelerometer with remote sensitivity. Primary aims of the proposed pilot study include (a) examining acceptability and feasibility of the wellness motivation intervention, and (b) pilot testing the efficacy of the wellness motivation intervention to increase contextual resources, behavioral change process variables, the behavioral outcome of physical activity, and health outcome of fall risk reduction (increased balance and strength). The proposed study is the first step in a program of research focusing on the prevention of falls and frailty among older adults. PUBLIC HEALTH RELEVANCE: Unintentional falls among community-dwelling older adults are a common, serious, and potentially preventable public health problem. Researchers have demonstrated the positive effects of physical activity to prevent falls, yet the majority of older adults do not engage in everyday physical activity behaviors. The purpose of the proposed pilot study is to examine the efficacy, feasibility, and acceptability of an intervention that utilizes a behavioral change theory (the wellness motivation theory) to promote the adoption and maintenance of physical activities that reduce falls among rural community-dwelling older adults.