Randomized Trial to Reduce Sitting Time and Improve Cardiometabolic Health in Obese Older Adults

摘要 近40%的60岁以上的成年人患有肥胖症。平均而言，这些人每天花费10个小时以上 坐着。这是一个令人担忧的问题，因为新的研究表明，坐着的时间越长，情况就越糟糕 心血管和代谢健康。事实上，大多数肥胖的老年人都患有心脏代谢性疾病 条件。可以减少高危人群坐着时间的干预措施可以改善健康和 降低医疗保健成本。因此，需要更多的研究来开发有效减少久坐的干预措施 在老年肥胖者中间的时间。拟议的研究将针对这一重要目标，并在有希望的基础上 我们的i-Stand随机试验研究的结果。这项研究发现，一种以理论为基础，多模式的行为 将电话咨询和基于技术的行为提示相结合的干预是可行的， 可以接受，并且显著减少了坐着的时间(与对照组相比，干预组为-75分钟/天 集团，P&lt；.01)。在那些血压在基线水平升高的人中，有两人的血压也有所改善 我们的初步研究。简而言之，我们在一项大型随机对照试验中发现了I-Stand权证评估。 目前的研究将在参与者中比较I-Stand和注意力匹配的对照干预 60岁，肥胖，每天坐8小时以上(N=284)。这两种干预措施都包括一项- 个人会议和9个后续电话。实验参与者还将收到站立提示 通过手腕佩戴技术和家庭环境审计来确定改进措施，以延长站立时间。全 参与者将被跟踪12个月。6个月后，实验参与者将被重新随机分配到 接收5个额外的助推器呼叫或不进行进一步干预，使我们能够评估初始 干预和助推器会议。主要结果将是减少坐着的时间，通过 大腿佩戴的活动PAL测斜仪和血压。次要结果包括 心脏代谢危险因素(如体重、血脂、空腹血糖)。治疗效果显著的调解人将 也是被探索的。如果有效，i-Stand可以很容易地被医疗保健系统实施，以改善 全国老年肥胖成年人的健康状况。

Abstract Nearly 40% of adults over age 60 are obese. On average, these individuals spend over 10 hours a day sitting. This is a concern since emerging research shows higher sitting time is associated with worse cardiovascular and metabolic health. In fact, most obese older adults have comorbid cardiometabolic conditions. Interventions which can reduce sitting time in this high-risk population could improve health and lower health care costs. As such, more research is needed to develop interventions to effectively reduce sitting time among older obese adults. The proposed study will address this important goal and build on the promising results of our I-STAND randomized pilot study. This study found that a theory-based, multi-modal behavioral intervention which combined phone counseling and technology-based behavioral prompts was feasible, acceptable, and significantly reduced sitting time (-75 minutes/day in the intervention compared to control group, p < .01). Among those with elevated blood pressure at baseline, blood pressure also improved in two of our pilot studies. In short, we found that I-STAND warrants evaluation in a large randomized controlled trial. The current study will compare I-STAND to an attention-matched control intervention among participants over age 60, with obesity, and who sit more than 8 hours per day (N = 284). Both interventions include one in- person session and 9 follow-up phone calls. Experimental participants will also receive prompts for standing via wrist-worn technology and a home environment audit to identify modifications to improve standing time. All participants will be followed for 12 months. After 6 months, experimental participants will be re-randomized to receive either 5 additional booster calls or no further intervention, allowing us to assess the effects of the initial intervention and booster sessions. The primary outcomes will be reduction in sitting time as measured by a thigh-worn activPAL inclinometer and blood pressure. The secondary outcomes include changes in cardiometabolic risk factors (e.g. weight, lipids, fasting glucose). Mediators of significant treatment effects will also be explored. If effective, I-STAND could easily be implemented by health care systems to improve the health of older obese adults nationwide.