Neighborhood Impact on Physical Activity in At-Risk Older Adults

描述(申请人提供)：尽管有规律的体力活动(PA)有公认的好处，但老年人是美国人口中最不活跃的部分，这使得他们患上一些慢性病和疾病的风险增加，包括心血管疾病、糖尿病和体重增加。了解影响这一重要高危群体体力活动的因素的努力主要局限于人口和心理社会领域。虽然为老年人制定了越来越多的个人适应干预措施，但很少有系统的调查研究在干预背景下客观和主观环境因素对体力活动增加的影响。拟议的项目利用了最近完成的一项NIH多点临床试验的抽样、招募和数据收集方法，该试验旨在评估社区居住的70-89岁成年人中体力活动干预对健康的影响(LIFE-P试验)。这项拟议研究的主要目的是调查LIFE-P参与者在根据研究地点(旧金山湾区，加利福尼亚州，达拉斯，德克萨斯州，匹兹堡，宾夕法尼亚州，温斯顿-塞勒姆，北卡罗来纳州)和其他感兴趣的变量进行调整后，其周围环境的步行能力是否促进或阻碍了他们变得更活跃的系统性尝试。其他感兴趣的问题涉及身体功能、社会经济地位、健康状况和感知的社区凝聚力对环境/体育活动干预关系的调节作用。丰富的LIFE-P数据集包括12个月期间关键健康变量的多个测量(例如，健康状况、客观确定和感知的身体功能、身体活动、生活质量)。它将与新获得的针对参与者邻里环境稳定元素的数据相结合(包括客观宏观尺度和观察到的微观尺度建筑环境特征，以及感知的邻里变量)。这项研究得益于一个多学科的国际团队的专业知识。它将提供重要的概念和公共卫生信息，为与改善社区环境特征相关的干预和政策决策提供信息，以促进身体脆弱的老年人的身体活动和其他健康和生活质量结果--这一群体代表着美国人口中普遍存在的、久坐不动和服务不足的部分。公共卫生相关性：这项研究将提供重要的概念和公共卫生信息，为改善社区环境特征的干预和政策决策提供参考，以促进身体脆弱的老年人的身体活动和其他健康和生活质量结果，老年人是美国人口中普遍存在的、久坐不动和服务不足的群体。

DESCRIPTION (provided by applicant): Despite the recognized benefits of regular physical activity (PA), older adults are the most inactive segment of the U.S. population, putting them at increased risk for a number of chronic diseases and conditions including cardiovascular disease, diabetes, and weight gain. Efforts to understand the factors influencing physical activity in this important at-risk group have been limited primarily to demographic and psychosocial domains. While an increasing number of individually-adapted interventions have been developed for older adults, few systematic investigations have studied the impacts of objective and subjective environmental factors on physical activity increases within an intervention context. The proposed project takes advantage of the sampling, recruitment, and data collection methods of a recently completed NIH multi-site clinical trial aimed at evaluating the health-related impacts of a physical activity intervention in community-dwelling adults ages 70-89 years (LIFE-P trial). The primary objective of the proposed study is to investigate whether LIFE-P participants' systematic attempts to become more physically active were facilitated or impeded by the walkability of their neighborhood environments after adjusting for study site (San Francisco Bay area, CA, Dallas, TX, Pittsburgh, PA, Winston-Salem, NC) and other variables of interest. Additional questions of interest concern the moderating effects of physical function, SES, health status, and perceived neighborhood cohesion on the environment/ physical activity intervention relationship. The rich LIFE-P dataset includes multiple measurements of key health variables over a 12-month period (e.g., health status, objectively determined and perceived physical functioning, physical activity, quality of life). It will be combined with newly acquired data targeting stable elements of participants' neighborhood environments (including objective macro-scale and observed micro-scale built environment features, and perceived neighborhood variables). This study benefits from the expertise of a multi-disciplinary international team. It will contribute important conceptual and public health information that can inform intervention and policy decisions related to modifying neighborhood environment characteristics to promote physical activity and other health and quality of life outcomes among physically vulnerable older adults-- a group representing a prevalent, sedentary, and under-served segment of the U.S. population. PUBLIC HEALTH RELEVANCE: This study will contribute important conceptual and public health information that can inform intervention and policy decisions related to modifying neighborhood environment characteristics to promote physical activity and other health and quality of life outcomes among physically vulnerable older adults a group representing a prevalent, sedentary, and under-served segment of the U.S. population.