Mindful movement for physical activity and wellbeing in older adults

摘要 在美国，缺乏身体活动已成为所有年龄组的关键公共卫生问题。与 随着大部分人口迅速老龄化，人们越来越关注确保中老年人的健康， (50+）保持活跃，减少久坐，以降低发病率和死亡率风险。而老年人 建议每周至少进行150分钟的中度到剧烈的体力活动（PA），但大多数人没有。 基于特定理论的行为策略已被证明对健康和活动行为有积极影响。 也有新的证据表明，基于正念的干预（MBI）可以通过以下方式促进PA 增强身心意识和自我调节。然而，目前对MBIs和PA的研究有限， 在数量和方法上都很严格。 广泛的长期目标是优化中老年人的身体和久坐活动水平 通过一个综合的正念和行为方法，可扩展的广泛传播。大学 明尼苏达州（UMN）将与基督教青年会大双城，一个社区为基础的组织，致力于 提供可获得的资源，“为所有人建立健康的精神，思想和身体”，并使健康老龄化成为一个 要务为了缩短发现和转换之间的时间， 设计将被使用。第一阶段（R21）将解决以下问题：目标1将侧重于项目组织， 障碍/促进者评估、方案制定和培训。Aim 2将在多个平台测试项目协议 在一项随机试点研究（n=30）的正念运动与修改后的10个关键健康老龄化 使用过渡里程碑进行教育控制。第二阶段（R33）将解决：目标3，确定 在一项全面随机对照试验（RCT，n=182）中，正念运动与对照的有效性 在12周（主要结局）以及26周和52周（次要结局）时基于加速计的PA。其他 次要测量包括久坐活动、生活质量、锻炼自我效能和期望， 正念、健康、身体疼痛和不良事件。目标4将通过提供 来自参与者、员工和组织领导的上下文数据。其中包括：招生， 依从性、随访和忠诚率;以及对障碍/促进者、相关性、实用性 可承受性和可接受性。这一信息将用于创建一个工具包，供在其他 基督教青年会网站。这个项目是创新的，因为它将是第一个评估MBIs以提高老年人 在以社区为基础的环境中使用旨在促进和加速研究的设计 翻译.通过UMN和基督教青年会的伙伴关系，有很大的潜力，发展一个可持续的， 巴勒斯坦权力机构的干预措施具有重大影响和全国范围。

ABSTRACT Physical inactivity in the United States has become a critical public health concern for all age groups. With a large segment of the population rapidly aging, there is growing interest in ensuring mid to older age adults (50+) stay active and reduce sedentariness, to decrease their morbidity and mortality risk. While older adults are advised to engage in at least 150 minutes/week of moderate to vigorous physical activity (PA), most do not. Specific theory based behavioral strategies have been shown to positively affect health and activity behaviors. There is also emerging evidence that mindfulness based interventions (MBI) may facilitate PA through increased mind-body awareness and self-regulation. However, research for MBIs and PA is currently limited, both in quantity and methodological rigor. The broad long-term objective is to optimize physical and sedentary activity levels in middle-older age adults through an integrated mindfulness and behavioral approach scalable for broad dissemination. The University of Minnesota (UMN) will work with the YMCA Greater Twin Cities, a community based organization committed to providing accessible resources to “build healthy spirit, mind and body for all” and making healthy aging a priority. To decrease time between discovery and translation, a two-phase hybrid effectiveness-implementation design will be used. Phase I (R21) will address the following: Aim 1 will focus on project organization, barrier/facilitator assessment, protocol development, and training. Aim 2 will test project protocols at multiple levels in a randomized pilot study (n=30) of Mindful Movement versus a modified 10 Keys to Healthy Aging educational control using transition milestones. Phase II (R33) will address: Aim 3 to determine the relative effectiveness of Mindful Movement versus control in a full-scale randomized controlled trial (RCT, n=182) using accelerometer based PA at 12 weeks (primary outcome) and at 26 and 52 weeks (secondary outcomes). Other secondary measures include sedentary activity, quality of life, exercise self-efficacy and expectations, mindfulness, wellbeing, bodily pain, and adverse events. Aim 4 will facilitate RCT interpretation by providing contextual data from participants, staff, and organizational leadership. These will include: enrollment, adherence, follow up, and fidelity rates; and perceptions of barriers/facilitators, relevance, practicality, affordability and acceptability. This information will be used to create a toolkit for implementation at other YMCA sites. This project is innovative in that it will be among the first to assess MBIs for enhancing older adults' PA in community based settings using a design intended to facilitate and accelerate research translation. Through the UMN and YMCA partnership, there is great potential to develop a sustainable and replicable PA intervention with meaningful impact and nationwide reach.