Enhancing Motivation for Physical Activity to Reduce the Risk of Falls

增强身体活动的动力以降低跌倒的风险

• 批准号: 8003309
• 负责人: Siobhan Kathleen McMahon
• 金额: $ 3.47万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-19 至 2012-08-18
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8003309
• 关键词: Accident and Emergency department; Address; Admission activity; Adoption; Age; Behavior; Behavioral; Cessation of life; Communities; Confusion; Dependence; Elderly; Equilibrium; Fall prevention; Financial cost; Fracture; Gait; Health; Hospital Nursing; Immobilization; Incidence; Individual; Injury; Instruction; Intervention; Intervention Studies; Knowledge; Life; Maintenance; Measures; Mental Depression; Motivation; Muscle Weakness; Nursing Homes; Outcome; Pattern; Persons; Physical activity; Pilot Projects; Population; Preventive; Process; Public Health; Research; Research Personnel; Resources; Risk Factors; Risk Reduction; Rural Community; Target Populations; Testing; United States; efficacy testing; fall risk; falls; fear of falling; fitness; frailty; innovation; programs; public health relevance; sedentary; theories

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.

描述(由申请人提供)：社区老年人中的意外跌倒是一个常见的、严重的、有可能预防的公共卫生问题。在美国，2001年每10万人中与跌倒有关的伤害年发生率为4616人，2008年上升到5252人。2000年，每10万人中与跌倒有关的死亡年发生率为29.3人，2006年上升到41.86人。随着年龄的增长，老年人特别容易摔倒。跌倒的后果对个人和社区都很重要，对老年人的健康产生负面影响。潜在的后果包括骨折、对坠落的恐惧、急诊室、医院和疗养院的入院、依赖、精神错乱、动弹不得、抑郁和死亡。重大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力活动的积极影响，但大多数老年人仍然久坐不动，跌倒的比率继续上升。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。尽管在过去的几十年里，关于预防跌倒的原因、风险因素和有效的体力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。作为解决研究和实践之间差距的一种策略，拟议的研究将利用经过检验的理论-健康动机理论-来解决行为变化与体育活动指导相结合的问题。拟议的试点干预研究的目标人群包括农村社区居住的老年人，这是该领域研究不足的人群。跌倒风险(平衡)和体力活动模式的创新测量将包括一个具有远程灵敏度的加速度计。拟议的试点研究的主要目标包括：(A)检验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、行为变化过程变量、体力活动的行为结果以及降低跌倒风险的健康结果(增加平衡和强度)。这项拟议的研究是一项专注于预防老年人跌倒和虚弱的研究计划的第一步。 公共卫生相关性：社区老年人的意外跌倒是一个常见的、严重的、有可能预防的公共卫生问题。研究人员已经证明了体育锻炼对预防跌倒的积极影响，但大多数老年人并不从事日常体育活动行为。这项拟议的试点研究的目的是检验一种干预措施的有效性、可行性和可接受性，该干预措施利用行为改变理论(健康动机理论)来促进采用和保持体育活动，以减少农村社区老年人的跌倒。