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）可以降低患慢性病的风险，并改善现有慢性病的预后。然而，PA水平随着年龄的增长而大幅下降，使老年人基本上不活动。在老年人中促进PA的干预措施通常集中在结构化的团体运动计划上，即使这些计划有时难以维持，老年人可能更喜欢独立进行活动。步行是一项经常为老年人推广的活动，因为它简单，便宜，几乎可以在任何地方独自进行。基于个人和/或社会观点的理论指导了最近促进老年人步行的方法，缺乏环境因素。解决老年人所面临的物理环境的限制，包括不平坦的人行道，不安全的街道，以及缺乏前往有用目的地的机会，这一点越来越重要。辅助生活设施（ALFs）中的个人很少成为身体活动研究的重点，但ALFs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居民步行水平的专门方法有望改善身体功能和健康。这项研究的目的是测试一个多层次的步行干预，重点是个人，人际关系和环境水平的辅助生活老年人。该研究将是一项随机对照现场试验，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、反馈和激励的计步器;侧重于步数目标设定的个性化健康咨询;鼓励社会支持和解决步行障碍的小组会议;以及旨在改变参与者对其所在地和社区环境的看法的定制步行路线图。对照组的参与者将每周接受一次健康老龄化研讨会，主题除了体育活动。据推测，与那些随机分配到比较条件的人相比，干预组的参与者将改善每周步数，身体功能以及抑郁和生活质量的报告。相关性：65岁以上的成年人在人口中所占的比例越来越大，越来越多的人正在转向积极生活方式。促进这一人群的步行可以促进健康和生活质量的结果，但很少有人知道如何实现这一点。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.