Peer Empowerment Program for Physical Activity in Low Income & Minority Seniors

低收入群体体育活动同伴赋权计划

• 批准号: 8797221
• 负责人: Jacqueline Kerr
• 金额: $ 77.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2019-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8797221
• 关键词: Address; Adopted; Adult; Advocacy; Advocate; Aerobic Exercise; Affect; Age; Aging; American; Area; Behavioral; Blood Pressure; Caring; Caucasians; Chronic Disease; Cognitive; Communities; Counseling; County; Data; Deterioration; Diabetes Mellitus; Diagnosis; Disease; Education; Effectiveness; Elderly; Environmental Risk Factor; Evidence based program; Exercise; Funding; Funding Mechanisms; Guidelines; Health; Health Educators; Health Expenditures; Health Status; Healthcare; Hour; Hybrids; Hypertension; Income; Individual; Institution; International; Intervention; Life; Low income; Measures; Mental Depression; Minority; Modeling; Monitor; Motivation; National Health and Nutrition Examination Survey; National Heart, Lung, and Blood Institute; Neighborhoods; Obesity; Outcome; Participant; Performance; Physical Fitness; Physical Function; Physical activity; Population; Population Group; Positioning Attribute; Quality of life; Randomized; Recreation; Reporting; Research; Resources; Retirement; Route; Safety; Sleep; Testing; Time; Trainers Training; Variant; Walking; Work; base; behavior change; cardiovascular health; cost; cost effectiveness; depressive symptoms; design; empowered; empowerment; ethnic minority population; executive function; experience; functional loss; health disparity; hypertensive heart disease; improved; instructor; loss of function; meetings; member; peer; population health; prevent; programs; public health relevance; secondary outcome; sedentary; treatment as usual; volunteer

DESCRIPTION (provided by applicant): Peer Empowerment Program for Physical Activity in Low Income & Minority Seniors Older adults are the least active population group in the US. Yet, research has shown that an increase in physical activity (PA) can have immediate and profound effects on cardiovascular health. Older adults who are active use significantly fewer health care resources, and with the increasing number of older adults in the US it is imperative to curb health care expenditure in this group. Many PA interventions are flawed because they focus on individual motivations and ignore variations in community resources, neighborhood walkability, and safety. Low income and ethnically diverse communities have disproportionately fewer resources and less supportive neighborhoods. This contributes to lower PA levels and health disparities in obesity, diabetes, hypertension and heart disease. National and international health institutions have called for community based PA programs to improve population health. Senior centers are an ideal setting for PA interventions because they serve a large number of older adults and there are funding mechanisms for delivery of evidence based programs. While there are multiple benefits of different PA programs, national guidelines for PA still emphasize aerobic activity. Senior Centers currently offer group based PA programs but our preliminary studies show that 1) low income, ethnically diverse older adults attending such centers are not meeting PA guidelines, 2) evidence based programs in such centers do not generate moderate intensity PA, 3) they do not provide behavioral strategies to support more frequent and independent PA and 4) members are not involved in the delivery of such programs which may increase engagement and sustainability. We propose to build upon our NHLBI R01 funded PA program that increased aerobic activity in retirement community residents. The program was delivered by UCSD health educators for 6 months with the help of peer leaders who then sustained it over 12 months. To improve upon this work, we propose a train the trainer model with a greater focus on empowering the peer leaders, center staff and participants to self-monitor, self-organize and advocate for additional resources from the start. Since our aim is to test a PA program that can be adopted by local area aging agencies with Older Americans Act Title IIID funds, we will employ an effectiveness-implementation hybrid design; which allows for the concurrent testing of both intervention and implementation strategies and outcomes. We will also extend program monitoring to 24 months. Thus, in a 2-year cluster randomized controlled field trial of 408 ethnically diverse, older adults (50+ years old) in 12 low income Senior Centers in San Diego County we will investigate the efficacy of PEP4PA (Peer Empowerment Program 4 Physical Activity) to reduce disparities in PA by increasing the percentage of participants achieving 150 minutes of PA per week and to improve physical functioning & fitness, blood pressure, depressive symptoms and quality of life at 6, 12 & 24 months. We will assess the incremental cost effectiveness ratio of PEP4PA in terms of cost per MET hour and cost per QALY compared to usual programming in the control centers at 12 & 24 months.

描述（由申请人提供）：低收入和少数族裔老年人的体育活动的同伴授权计划是美国活跃的人口最少的人群。然而，研究表明，体育锻炼（PA）的增加可能对心血管健康产生直接而深远的影响。积极使用的老年人明显减少医疗保健资源，并且随着美国老年人数量的增加，必须遏制这一组的医疗保健支出。许多PA干预措施存在缺陷，因为它们专注于个人动机，而忽略了社区资源，邻里步行性和安全性的差异。低收入和种族多元化的社区的资源较少，支持社区较少。这有助于肥胖，糖尿病，高血压和心脏病的PA水平降低和健康差异。国家和国际卫生机构呼吁基于社区的PA计划来改善人口健康。高级中心是PA干预措施的理想场所，因为他们为大量老年人提供服务，并且有用于提供基于证据计划的资金机制。尽管不同的PA计划有多个好处，但国家PA的指南仍在强调有氧活动。当前高级中心目前提供基于小组的PA计划，但我们的初步研究表明，1）低收入，种族多样化的老年人参加此类中心不符合PA指南，2）基于证据的计划并未产生中等强度的PA，3）他们没有提供行为策略，以支持更多的频繁和独立PA和4）成员不参与此类计划，并可以增加这种计划并维持能力互动并参与互动。我们建议建立在NHLBI R01资助的PA计划的基础上，以增加退休社区居民的有氧活动。该计划是由UCSD健康教育者在同行领导人的帮助下进行了6个月的6个月。为了改善这项工作，我们建议一名训练培训师模型，更着重于将同伴领导者，中心工作人员和参与者赋予自我监控，自我组织并倡导从一开始就提供更多资源。由于我们的目的是测试一个PA计划，该计划可以由美国老年人法案IIID资金的本地老化机构采用，因此我们将采用有效的实施混合设计；这允许同时测试干预和实施策略和结果。我们还将将程序监控扩展到24个月。因此，在一项为期2年的集群中，在12个低收入高级中心的408个种族多样的老年人（50岁以上）的随机对照现场试验中 在圣地亚哥县，我们将通过增加每周达到150分钟PA的参与者的百分比，并提高6、12和24个月的生活质量，以提高PEP4PA（同伴授权计划4体育活动）的疗效，以减少PA的差异。我们将根据每小时的成本和每QALY的成本来评估PEP4PA的增量成本效益率，而在12和24个月的控制中心的通常编程相比。