A Multilevel Walking Intervention for Sedentary Assisted-Living Seniors

描述(由申请人提供)：在美国老年人中，有规律的体力活动(PA)可以降低罹患慢性病的风险，并改善现有慢性病的预后。然而，随着年龄的增长，PA的水平大幅下降，使老年人基本上不活跃。在老年人中推广PA的干预措施往往侧重于有组织的集体锻炼计划，尽管此类计划有时难以维持，而且老年人可能更喜欢独立开展活动。散步是一项经常为老年人推广的活动，因为它容易、便宜，而且几乎可以在任何地方独自进行。以个人和/或社会观点为基础的理论指导了最近促进老年人步行的方法，缺乏环境方面的因素。解决老年人面临的实际环境的局限性越来越重要，包括不平坦的人行道、不安全的街道和无法到达有用的目的地。辅助生活设施(ALF)中的个人很少成为体力活动研究的焦点，然而ALF是越来越多的老年人的家园，他们可能特别容易受到环境的限制。提高ALF患者步行水平的专门方法有望改善身体功能和健康。这项拟议研究的目标是测试一种多水平步行干预，重点关注辅助生活老年人的个人、人际和环境水平。这项研究将是一项随机对照的现场试验，居住在2-4个ALF的居民将参与干预或比较条件。干预部分将包括：用于自我监测、反馈和动机的计步器；专注于步骤目标设置的个性化健康咨询；鼓励社会支持和解决行走障碍的小组会议；以及量身定制的步行路线图，旨在改变参与者对其场地和邻里环境的看法。对照组参与者将每周接受健康老龄化研讨会，主题不是体力活动。据假设，与那些随机进入比较条件的参与者相比，干预组的参与者每周的步数、身体功能、抑郁和生活质量的报告都会有所改善。相关性：65岁以上的成年人构成了人口中越来越多的部分，越来越多的人正在转向ALF。在这一人群中促进步行可以促进健康和生活质量，但人们对如何做到这一点知之甚少。该项目将评估一种创新和可持续的干预措施，旨在使老年人克服自己所在社区的PA障碍；如果成功，它可能会推广到其他ALF。

DESCRIPTION (provided by applicant): Among older Americans regular physical activity (PA) can decrease the risk of developing, and improve outcomes of existing, chronic disease. Yet, levels of PA decline substantially with advancing years making older adults largely inactive. Interventions to promote PA among older adults often focus on structured group exercise programs even though such programs are sometimes difficult to sustain and older adults may prefer doing activity independently. Walking is an activity often promoted for older individuals as it is easy, inexpensive, and can be performed almost anywhere on one's own. Theory grounded in individual and/or social perspectives has guided recent approaches to promoting walking in older adults and lacked environmental dimensions. It is increasingly important to address limitations of the physical environment faced by older adults including uneven sidewalks, unsafe streets, and lack of access to useful destinations. Individuals in assisted living facilities (ALFs) have rarely been the focus of physical activity research yet ALFs are home to increasing numbers of older adults who may be particularly prone to the constraints of their environments. Specialized approaches to increasing walking levels in residents of ALFs hold promise for improving physical functioning and health. The goal of the proposed study is to test a multilevel walking intervention focusing on individual, interpersonal, and environmental levels in assisted-living older adults. The study will be a randomized controlled field trial where residents living in 2-4 ALFs will partake in an intervention or comparison condition. Intervention components will include: pedometers for self-monitoring, feedback and motivation; individualized health counseling focusing on step goal setting; group meetings to encourage social support and problem solve barriers to walking; and tailored walking route maps designed to change participant perceptions of their site and neighborhood environments. Comparison group participants will receive weekly healthy aging seminars on topics other than physical activity. It is hypothesized that, compared to those randomized to the comparison condition, participants in the intervention group will have improved weekly step counts, physical functioning, and reports of depression and quality of life. Relevance: Adults over age 65 constitute a growing segment of the population and increasing numbers are moving to ALFs. Promoting walking in this population can contribute to health and quality of life outcomes yet little is known about how to accomplish this. This project will evaluate an innovative and sustainable intervention that is designed to enable seniors to overcome barriers to PA in their own neighborhood; if successful it may be generalizable to other ALFs.