BAILA: Being Active, Increasing Latinos healthy Aging

描述(申请人提供)：预计到2050年，拉美裔老年人口将占老年人口的20%。体力活动(PA)可以影响身体和认知功能健康结果的潜在下降，从而导致自我报告的功能限制和残疾。不幸的是，与年龄较大的非拉丁裔白人相比，65-74岁的拉丁裔人参与休闲活动的可能性低46%，而且对少数民族中PA的维持情况知之甚少。部分原因是由于PA水平较低，年长的拉丁裔报告行走困难的可能性是非拉丁裔白人的两倍，而且拉丁裔阿尔茨海默病症状开始出现的时间比非拉丁裔白人早7年。参与PA具有很大的潜力，可以帮助年长的拉丁裔人随着年龄的增长保持身体和认知功能。舞蹈有望成为一种适合弱势群体的文化上合适的PA形式，是一种挑战个人身体和认知的PA形式。到目前为止，还缺乏为年长的拉丁裔设计的PA课程。Bailamos(C)是一个舞蹈项目，它是根据社区中年长的拉丁裔人的意见并与一位经验丰富的拉丁舞教练合作开发的。单独一组，在BAILAMOS(C)试验前3个月证明了计划的实质性可行性，效果大小表明更多的自我报告参与生活方式PA，以及身体和认知功能的改善。原为期3个月的BAILAMOS(C)舞蹈项目根据参与者和舞蹈教练的反馈进行了修改。一项随机对照试验(RCT)被提议在久坐不动、有残疾风险的拉丁裔老年人中进行。参与者将被随机分为BAILAMOS(C)条件组或健康教育注意控制组。Bailamos(C)包含四种舞蹈风格，首先介绍最简单的风格(即Merengue)，最后介绍最难的风格(即Salsa)，以提高自我效能。每种风格的授课时间为四周，每周两次，每节课一小时(共32节)。还包括关于如何增加生活方式PA的小组讨论。为了在正式项目结束后加强PA的维护，每个站点的2-3名“土著领袖”将接受培训，教授为期4个月的BAILAMOS(C)舞蹈。控制条件活动包括伊利诺伊大学分校双语/双文化健康教育者用西班牙语教授的健康教育课。在三年的时间里，总共将在九个地点招募332名年长的拉丁裔。地点包括老年中心、社区中心和公园。每个站点将招募大约40人(治疗组20人，对照组20人)。这项临床试验将测试BAILAMOS(C)计划在4个月后对Lifestyle PA的影响，以及BAILAMOS(C)维持活动在8个月后对Lifestyle PA维持的影响。将测试4个月的BAILAMOS(C)计划和8个月的BAILAMOS(C)维持活动对自我效能(中介)以及对身体功能、认知功能以及自我报告的功能限制和残疾的健康结果的影响。长期目标包括在这一弱势群体中预防残疾。 与公共健康相关：拉美裔成年人是美国增长最快的群体之一，他们面临着严重的残疾风险，这在一定程度上可以用令人震惊的缺乏运动的比率来解释。拉丁舞在这一人群中作为一种适合文化的身体活动干预措施前景看好，但人们对拉丁舞的健康益处知之甚少。目前的研究将继续进行一系列研究，旨在为健康后果不良风险较高的拉美裔老年成年人开发基于证据的、文化上适当的体力活动干预措施。

DESCRIPTION (provided by applicant): Older Latinos are expected to constitute 20% of the older adult population by 2050. Physical activity (PA) can influence potential declines in the health outcomes of physical and cognitive function that lead to self- reported functional limitations and disability. Unfortunately, Latinos aged 65-74 are 46% less likely to engage in leisure time PA than older non-Latino whites, and little is known about PA maintenance among ethnic minorities. In part due to low levels of PA, older Latinos are twice as likely to report difficulty walking than non- Latino whites and Alzheimer's disease symptoms begin 7 years earlier in Latinos than in non-Latino whites. Participation in PA has substantial potential to help older Latinos maintain both physical and cognitive function as they age. Dance holds promise as a culturally appropriate form of PA for this disadvantaged population, and is a form of PA that challenges individuals both physically and cognitively. To date, PA programs designed for older Latinos are lacking. BAILAMOS(c) is a dance program that has been developed based on input from older community-dwelling Latinos and in collaboration with an accomplished Latin dance instructor. A single group, pre-post 3-month pilot of BAILAMOS(c) demonstrated substantial program feasibility, and effect sizes indicated greater self-reported participation in lifestyle PA, along with improvements in physical and cognitive function. The original 3-month BAILAMOS(c) dance program has been revised according to participant and dance instructor feedback. A randomized controlled trial (RCT) is proposed in sedentary, older Latinos at risk for disability. Participants will be randomized to the BAILAMOS(c) condition or a health education attention control group. BAILAMOS(c) encompasses four dance styles with the simplest style introduced first (i.e., Merengue) and the most difficult style last (i.e., Salsa) to enhance self-efficacy. Each style is taught for four weeks, twice weekly for one hour per class (32 sessions total). Group discussions on how to increase lifestyle PA are included. To enhance maintenance of PA after the formal program, 2-3 "indigenous leaders" from each site will be trained to teach the 4-months of dancing of BAILAMOS(c). Control condition activities consist of health education classes conducted in Spanish by bilingual/bicultural health educators of University of Illinois Extension. A total of 332 older Latinos will be recruited across nine sites over three years. Sites include senior centers, community centers, and parks. Each site will enroll approximately 40 individuals (20 treatment, 20 control). This clinical trial will test the impact of the BAILAMOS(c) program on lifestyle PA at 4 months and BAILAMOS(c) maintenance activities on lifestyle PA maintenance at 8 months. The impact of the BAILAMOS(c) program at 4 months and BAILAMOS(c) maintenance activities at 8 months on self-efficacy (mediators) and on health outcomes of physical function, cognitive function, and self-reported functional limitations and disability will be tested. Long term goals include the prevention of disability among this disadvantaged group. PUBLIC HEALTH RELEVANCE: Latino adults are one of the fastest growing groups in the US and are at serious risk for disability, which can be explained in part by alarming rates of physical inactivity. Latin dance holds great promise as a culturally-appropriate physical activity intervention in this population, yet little is known about the health benefits of Latin dance. The current study will continue a line of research aimed at developing evidence-based culturally-appropriate physical activity interventions for older Latino adults at high risk for adverse health outcomes.