Trial to Increase Walking Among Sedentary Older Latinos

定期的身体活动有助于老年人的健康和生活质量，但不幸的是，只有20%的男性和25%的65岁及以上的女性符合最低国家身体活动指南。老年拉丁美洲人的疾病发病率较高，这些疾病最有可能从体育活动中受益，但久坐不动的生活方式的发病率不成比例地高。为了解决这一重大的公共卫生问题，拟议的研究旨在实施和评估一项多方面的干预措施，以提高和维持老年拉丁美洲人的步行水平。 此前，这个多学科的研究团队设计并试点测试了一种结构化的干预措施，通过提高老年人对衰老的期望来提高步行水平。他们现在建议在随机临床试验中评估这种干预措施的有效性和可持续性。该团队计划招募600名来自大洛杉矶地区社区老年中心的久坐不动的老年拉丁美洲人。拟议研究的具体目的是测试干预对以下方面的影响：1）主要结局：通过数字计步器测量的每周步数从基线到1个月、12个月和24个月随访的变化; 2）自我报告的身体活动水平和干预结构（包括对衰老的期望和对身体活动的自我效能期望）; 3）次要结果，包括心理社会健康结构、身体表现测量和临床健康结果。 干预的核心包括一系列每周4次的1小时小组讨论会，利用动机心理学领域的归因再训练技术，结合基于社会认知理论的行为策略。讨论会将在高级中心进行，并由双语健康教育工作者领导;每次会议之后将有一个1小时的锻炼班，旨在增加力量，灵活性和耐力。在讨论环节，健康教育者将管理一个结构化的文化定制课程，其中参与者被教导要提高他们对身体活动的期望随着年龄的增长，而不是归因于久坐不动的“老年”。“4周一次的疗程之后，将进行11个月的每月一次的疗程，12个月后每2个月一次的疗程（总干预持续时间= 24个月）。受试者将被随机分配到2组中的1组：1）干预组）接受讨论会和运动课; 2）（对照组）仅接受与干预组相同频率和持续时间的运动课。该项目的目标是证明一个可行的干预措施，提高和维持老年拉丁美洲人的步行水平的成功。

DESCRIPTION (provided by applicant): Regular physical activity contributes to the health and quality of life of older adults, but unfortunately only 20% of men and 25% of women aged 65 years and greater meet the minimal national guidelines for physical activity. Older Latinos have higher rates of diseases that are most likely to benefit from physical activity, but have disproportionately high rates of sedentary lifestyle. To address this major public health problem, the proposed study seeks to implement and evaluate a multifaceted intervention to raise and sustain walking levels among older Latinos. Previously, this multidisciplinary team of investigators designed and pilot-tested a structured intervention to raise walking levels by raising older adults' expectations for aging. They now propose to evaluate the efficacy and sustainability of this intervention in a randomized clinical trial. The team plans to enroll 600 sedentary older Latinos recruited from community-based senior centers in the greater Los Angeles region. The specific aims of the proposed study are to test the effect of the intervention on: 1) the primary outcome: change in steps per week measured by digital pedometer from baseline to 1, 12, and 24-month follow-up; 2) self-reported physical activity level and intervening constructs (including expectations regarding aging and self-efficacy expectations for physical activity); 3) secondary outcomes including psychosocial health constructs, physical performance measures and clinical health outcomes. The core of the intervention consists of a series of 4 weekly 1-hour group discussion sessions that utilize attribution retraining techniques from the field of motivational psychology in combination with behavioral strategies based in social cognitive theory. Discussion sessions will be conducted at senior centers and led by a bilingual health educator; each session will be followed by a 1-hour exercise class aimed at increasing strength, flexibility and endurance. During the discussion sessions, the health educator will administer a structured culturally-tailored curriculum in which participants are taught to raise their expectations for physical activity with aging, and not to attribute being sedentary to "old age." The 4 weekly sessions will be followed by monthly sessions for 11 months, and sessions every 2 months for he following 12 months (total intervention duration = 24 months). Participants will be randomized to 1 of 2 arms: 1) intervention arm) receiving the discussion session and the exercise class; 2) (control arm) receiving just the exercise class with the same frequency and duration as the intervention group. The goal of this project is to demonstrate success of a feasible intervention that raises and sustains walking levels among older Latinos.