Reducing sedentary behaviour in older adults: Development of a brief habit-based intervention

晚年的体育活动可以改善健康和生活质量，但在英格兰65-74岁的成年人中，约有30%的人每月连续进行不到10分钟的休闲活动。以前针对老年人的活动推广计划未能产生现实世界的影响，也许是因为目标（例如每周150分钟的活动）是不现实的，或者因为观察到的活动变化依赖于外部支持，因此，当干预期结束时，参与活动也会结束。我们将设计和评估一种新的干预措施的可行性，以促进久坐者的活动。老年人这项工作在两个方面是新颖的：第一，我们专注于通过建议对现有常规进行小而易采用的改变来促进活动，第二，我们的目标是创造“活动习惯”，这些习惯将在干预结束后持续存在。我们的干预是基于心理学理论的最新进展，该理论表明，如果在同一情况下重复进行一项活动，它就会成为对该情况的相对轻松和自动的反应（即“习惯”）。我们的工作遵循最近的减肥干预，其中提供了关于如何形成饮食和活动“习惯”的简单书面建议，并导致用户形成“习惯”，并比对照组减轻更多体重。在研究1中，一个由20名久坐不动的老年人组成的小组，通过Age UK招募，将为他们可以可行且持续进行的活动（例如爬楼梯，步行，伸展和平衡运动）集思广益。然后，一个专家组将起草一系列建议活动，这些活动可能会成为“习惯”。当老年人小组和专家都同意建议的可行性时，第二个老年人小组将对建议的容易理解程度进行评分，他们是否有动机或可能执行这些建议，以及执行这些建议的难度。在研究2中，30名没有残疾身体障碍的久坐老年人将通过Age UK招募，并给出建议，以及一张记录单来监控遵守情况。他们将被要求在四周和八周后返回，以评估“习惯”的形成，活动和健康状况。我们将评估依从率和流失率，“习惯”和活动的变化，以及干预使用者是否认为额外的支持（例如电话咨询，社区支持）将有助于他们坚持建议。在研究3中，将进行一项小规模的对照试验，以评估在初级保健环境中的干预。120名没有残疾身体障碍的久坐老年人将被分配接受“活动习惯”建议（补充通过研究2确定的任何必要的额外支持）或对照治疗，促进老年人的活动，但不形成“习惯”。我们将评估招募率，坚持率和流失率，以及“习惯”，活动，健康和福祉的变化。本研究将为随后的完全随机对照试验产生效应量估计值。

Physical activity in later life can improve health and quality of life, yet around 30% of adults aged 65-74 in England do less than 10 consecutive minutes of leisure-time activity a month. Previous activity promotion initiatives for older adults have failed to have real-world impact, perhaps because targets (e.g. 150 minutes of activity per week) have been unrealistic, or because observed changes in activity have been dependent on external support, so that when the intervention period ends so too does engagement in activity.We will design and assess the feasibility of a novel intervention to promote activity among sedentary older adults. The work is novel in two aspects: first, we focus on promoting activity by recommending small and easily-adopted changes to existing routines, and second, we aim to create 'activity habits' which will persist after the intervention has ended. Our intervention is based on recent advances in psychological theory which show that, if an activity is performed repeatedly in the same situation, it becomes a relatively effortless and automatic response to that situation (i.e. a 'habit'). Our work follows a recent weight-loss intervention in which simple written advice on how to form eating and activity 'habits' was provided, and which led users to form 'habits' and lose more weight than a control group.We propose three studies. In Study 1, a panel of 20 sedentary older adults, recruited via Age UK, will brainstorm ideas for activities that they could feasibly and consistently undertake (e.g. climbing stairs, walking, stretching and balancing exercises). A group of experts will then draft a series of recommended activities that could feasibly become 'habitual'. When both the older adult panel and the experts agree on the feasibility of the recommendations, a second panel of older adults will rate the recommendations for ease of understanding, whether they are motivated or likely to perform them, and how difficult they would be to perform.In Study 2, 30 sedentary older adults with no disabling physical impairments will be recruited via Age UK and given the recommendations, together with a tick-sheet to monitor adherence. They will be asked to return at four and eight weeks later for assessment of 'habit' formation, activity and health. We will assess rates of adherence and attrition, changes in 'habit' and activity, and whether intervention users felt that additional support (e.g. telephone counselling, community support) would assist them in adhering to the recommendations.In Study 3, a small-scale controlled trial will be undertaken to evaluate the intervention in a primary care setting. 120 sedentary older adults with no disabling physical impairments will be allocated to receive either the 'activity habit' recommendations (supplemented with any necessary additional support identified via Study 2), or a control treatment which promotes activity in older adulthood but not 'habit' formation. We will assess rates of recruitment, adherence and attrition, and changes in 'habit', activity, health and wellbeing. This study would generate an estimate of effect size for a subsequent full randomised controlled trial.