Maintenance in Multiple Behaviors with Emphasis on Aging

描述（由申请人提供）：总体目标是通过系统地分析以下方面的维持因素，提高对长期维持的认识，特别是在老年人中：1)治疗类型；2)人口类型。该研究分析了10种行为内部和之间的14个变化过程，这些行为对老年人的健康越来越重要。这10种行为是1。吸烟;2. 酒精;3. 坚持抗高血压药物；4. 坚持服用他汀类药物；5. 自我血糖监测；6. 压力管理;7. 抑郁症管理;8. 锻炼;9. 饮食;和10。阳光照射。主要目标是：1)比较治疗类型内和不同治疗类型之间的维持率和维持途径（例如，治疗与不治疗；多级治疗与单级治疗）；2)年龄、性别、教育或种族不同的人口类型。该项目将根据与动机、自我效能和抗拒改变相关的因素，评估老年人在保持改变方面的哪些行为比其他成年人更好、更差或相同。项目将评估特定于每个行为的维护模型和跨行为的通用模型。分析将：1。计算和比较每种治疗类型和人群的行为维持率；2. 图形化地表示了三种动态类型（维护者、复发者和非采用者）对14个维护因素的纵向使用；3. 评估三种动态、代表治疗或人群的组和时间之间的统计差异；4. 评估14个维持因素和5个维持因素的因果影响和中介作用。通过使用元分析确定跨行为的维护因素和中介模型的常见和独特使用。该提案将是最大的维修比较研究，并将分析22项研究，有4万多名参与者，由来自多个学科的共同研究人员提供4000多万美元的资助。所产生的知识将产生60份对行为改变理论和长期维持干预具有重要意义的出版物。与老年人的特殊相关性包括确定与他们在保持特定健康行为的变化方面做得更好、更差或相同有关的维持因素。鉴于与这些行为相关的疾病风险增加，本研究对老年人慢性疾病的预防和管理具有特殊意义。

DESCRIPTION (provided by applicant): The overarching goal is to advance knowledge about long-term maintenance, particularly in older adults, by systematically analyzing maintenance factors in: 1) types of treatment; and 2) types of populations. The research analyzes 14 change processes within and across 10 behaviors that are of increasing significance to the health of aging populations. The 10 behaviors are 1. smoking; 2. alcohol; 3. adherence to anti- hypertensives; 4. adherence to statins; 5. self-monitoring of blood glucose; 6. stress management; 7. depression management; 8. exercise; 9. diet; and 10. sun exposure. The primary goals are: 1) to compare maintenance rates and pathways to maintenance within and between types of treatment (e.g., treatment vs. no-treatment; multiple level treatments vs. single level); and 2) types of populations differing by age, gender, education or ethnicity. The project would assess on which behaviors older adults are better, worse or the same as other adults in maintaining change depending on factors related to motivation, self-efficacy and resistance to change. The project would assess maintenance models specific to each behavior and models that are general across behaviors. The analyses would: 1. Calculate and compare maintenance rates across behaviors for each type of treatment and population; 2. Graphically represent longitudinal use of 14 maintenance factors by three dynatypes (maintainers, relapsers, and non-adopters); 3. Assess statistical differences between the three dynatypes, groups representing treatments or populations, and time; 4. Assess causal influences and mediating effects of the 14 maintenance factors and 5. Identify common and unique use of maintenance factors and mediation models across behaviors by use of meta-analyses. The proposal would be the largest comparative study of maintenance and would analyze 22 studies with over 40,000 participants supported by more than 40 million dollars in grants with co-investigators from multiple disciplines. The knowledge generated would produce 60 publications of importance for theories of behavior change and for interventions for long-term maintenance. Special relevance for older adults includes the identification of maintenance factors related to their doing better, worse or the same in maintaining changes in particular health behaviors. Given increasing risks of developing diseases related to these behaviors, this research has special relevance for prevention and management of chronic diseases in older adults.