Attempts to Reach the Oldest and Frailest: Recruitment, Adherence, and Retention of Urban Elderly Persons to a Falls Reduction Exercise Program
Attempts to Reach the Oldest and Frailest: Recruitment, Adherence, and Retention of Urban Elderly Persons to a Falls Reduction Exercise Program
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DOI：
10.1093/geront/gnr012
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发表时间：
2011-06-01
期刊：
影响因子：
5.7
通讯作者：
Jayadevappa, Ravishankar
中科院分区：
文献类型：
--
作者：
Stineman, Margaret G.;Strumpf, Neville;Jayadevappa, Ravishankar
这项研究的目的：评估城市老年人，主要是非洲裔美国人，参加跌倒减少练习计划的招募、坚持和保留情况。设计和方法：随机对照试验被设计为干预发展的先导研究。其目标是为跌倒并去急诊室就诊的老年人开发一种对文化敏感的干预措施。参与者在4个现场小组课中接受锻炼，并鼓励他们在家中继续锻炼12周，并参加额外的现场每月课程。该方案包括一项专门设计的干预措施，通过从参与者所在社区抽取训练有素的社区干预者来增加保留率。结果：1,521份ED病历落选后，有204名65岁及以上的患者入选。一半的人被随机纳入预防跌倒计划。在干预组的102人中，92人完成了最后6个月的评估，68人参加了所有现场会议，但只有1人报告说在家中锻炼了12周。那些独居的人更有可能(p=.03)，而那些有抑郁症状的人更不可能(p=.05)参加所有的现场锻炼课程。最终招聘率估计为31.8%。干预组和对照组最终保留率分别为90.2%和87.3%。影响：招募虚弱的老年非裔美国患者是资源密集型的。坚持现场锻炼课程的情况比坚持在家锻炼的情况要好。这些发现对未来以社区为基础的锻炼计划和试验的设计具有指导意义。
Purpose of the study: To assess the recruitment, adherence, and retention of urban elderly, predominantly African Americans to a falls reduction exercise program. Design and methods: The randomized controlled trial was designed as an intervention development pilot study. The goal was to develop a culturally sensitive intervention for elderly persons who suffered a fall and visited an emergency department (ED). Participants were taught exercises during 4 on-site group classes and encouraged to continue exercising at home for 12 weeks and attend additional on-site monthly classes. The protocol included a specifically designed intervention for increasing retention through trained community interventionists drawn from the participants' neighborhoods. Results: The screening of 1,521 ED records after falling yielded the recruitment of 204 patients aged 65 years and older. Half were randomized into the falls prevention program. Of the 102 people in the intervention group, 92 completed the final 6-month assessment, 68 attended all on-site sessions, but only 1 reported exercising at home all 12 weeks. Those who lived alone were more likely (p = .03) and those with symptoms of depression were less likely (p = .05) to attend all on-site exercise classes. The final recruitment rate was estimated as 31.8%. The final retention rates were 90.2% and 87.3% for the intervention and control groups, respectively. Implications: Recruitment of frail elderly African American patients is resource intensive. Adherence to the on-site exercise classes was better than to the home-based component of the program. These findings have implications for the design of future community-based exercise programs and trials.