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

摘要 有规律的体育活动对老年人的身体和精神都有好处。然而，可用性和 有证据表明，身体活动计划是安全的，适合于有护理风险的居家老年人 家庭准入受到严重限制。该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，如 家庭护理机构和国家单位对老龄化，以保持独立之间的养老院合格的老年人 成年人住在家里。拟议的项目将审查安全体力活动的有效性 该计划由家庭护理助理领导，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 和日常个人护理服务。主要目的是测试是否安全的物理 具有内置激励增强组件的活动程序，在坐姿下执行， 保持家庭护理客户的功能和福祉。第二个目标是了解谁 该计划是有效的，该计划可以达到目标人群的程度， 参与者退出计划，计划参与者保持行为变化的程度 以及该计划的成本效益如何。在试点项目的基础上， 这项随机对照试验证明了该计划在大型医疗补助家庭护理计划中的可行性， 将告知未来将身体活动计划扩展到现实世界的家庭护理环境。本研究 将为一种新的家庭护理模式提供证据和指导方针，这将有利于老年家庭护理客户 和他们的家庭护理助手一起工作，以维持或改善养老院合格老年人的功能 以便他们能够留在社区中。

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.