Promoting Seniors' Health with Home Care Aides: A Randomized Controlled Trial

摘要 定期的体育锻炼对老年人的身体和精神都有好处。然而，可用性和 对于有护理风险的居家老人来说，身体活动计划是安全和合适的证据 家庭入场受到严格限制。这个项目的长期目标是发展一个可持续的健康 由家庭护理助理领导的推广计划，可供社区组织使用，例如 家庭护理机构和国家老龄单位，以保持养老院合格老年人的独立性 成年人住在自己的家里。拟议的项目将检查安全的体力活动的有效性。 由家庭护理助理领导的计划，他们定期帮助难以接触到的老年家庭护理客户进行家务管理 以及家中的日常个人护理服务。主要目标是测试是否安全的物理 具有内置激励增强组件的活动计划，以坐着的姿势执行， 保护家庭护理服务对象的功能和福祉。次要目标是了解为谁服务 方案是有效的，方案能够达到目标人群的程度，方案在多大程度上 参与者退出计划，即计划参与者保持行为改变的程度 所引入的干预措施，以及该计划的成本效益是什么。以一个试点项目为基础， 在一个大型的医疗补助家庭护理计划中证明了该计划的可行性，这项随机对照试验 将为将来将身体活动计划扩展到现实世界的家庭护理环境提供信息。这项研究 将为一种新的家庭护理模式提供证据和指导方针，这将为老年家庭护理客户提供便利 和他们的家庭护理助手共同努力，维持或改善符合养老院资格的老年人的功能 这样他们才能留在社区里。

Abstract Regular physical activity benefits older adults physically and mentally. However, the availability and the evidence for physical activity programs that are safe and appropriate for home-bound seniors at risk for nursing home admission are severely limited. The long-term goal of this project is to develop a sustainable health promotion program led by home care aides that can be used by community-based organizations, such as home care agencies and state units on aging, to maintain independence among nursing home-eligible older adults living in their homes. The proposed project will examine the effectiveness of a safe physical activity program, led by home care aides who regularly help hard-to-reach older home care clients with housekeeping and routine personal care services in the home. The primary objective is to test whether the safe physical activity program with a built-in motivational enhancement component, performed in a seated position, preserves the function and well-being of home care clients. The secondary objective is to understand for whom the program is efficacious, the extent to which the program can reach the target population, the extent to which participants drop out of the program, the extent to which program participants maintain the behavioral change introduced by the intervention, and what the program's cost-effectiveness is. Building on a pilot project that demonstrated the program's feasibility in a large Medicaid home care program, this randomized controlled trial will inform future expansion of the physical activity program into real-world home care settings. This research will provide evidence and guidelines for a new model of home care, which will facilitate older home care clients and their home care aides to work together to maintain or improve the function of nursing home-eligible seniors so that they can remain in the community.