Healthy Activity Improves Lives (HAIL)

项目摘要 老年人（年龄≥ 60岁）往往比年轻人少参加体育活动，参与率不到11%。 推荐的体力活动（PA）水平[1-3]。这些趋势在来自黑人的老年人中甚至更低 社区.老年人缺乏PA与全因死亡风险增加相关，特别是在 黑人[4]。大量基于人群的研究表明，中等水平的PA提供保护 老年人的慢性病[5]。因此，旨在改善老年黑人PA的干预措施 可以显著改善健康结果，并有助于减少这一人群的健康差距。到 在老年人中增加PA，黑人成年人，我们使用社会生态学的观点[7]来检查障碍， 每个影响力级别的促进者（即，自我、人际、组织/社区， 环境/政策）。为老年人开发的PA干预措施，针对黑人成年人的多个层面， 需要社会生态模式。以证据为基础的适应和强大！（F&S！）老年人计划，资助 由国家老龄化研究所，可以优化，以绕过这些障碍，并有效地参与老年人 黑人成年人在持续的PA。虽然F&S！该计划已在多个国家成功实施。 基于社区的、种族多样的设置，它是有限的，因为它只提供面对面（即，没有在线 部分），并在8周结束，很少有持续的支持。这些限制不仅增加了成本 并降低了程序的可访问性，但也未能优化或支持作为改进的收益， 在F&S期间PA！在后续阶段减少[8]。我们将绕过这些限制并开发一种辅助物， 在线平台到F&S！能够与可穿戴设备同步的程序（例如，Fitbit）。创建这个 平台，并研究其可行性和可接受性，我们将与黑人部长联盟合作， 大波士顿（BMA），一个主要由黑人教会组成的组织，并在这些地区管理该计划。 波士顿的教堂，MA与本FOA一致，“为以下项目提供长达两年的支持（R21阶段）： 研究规划活动和可行性研究”，我们将进行：1）重点小组在两个BMA附属 教会更好地了解在社会生态模式的每一个层面上必须绕过的关键障碍 然后建立这个附属的在线程序来创建F&S！在线课程和2）开放式试点研究 （N=30）在这两个教堂，以检查的可行性和可接受性的F&S！-在线程序。每 在FOA中，R21将是“随后可能过渡到扩大研究支持（R33阶段）， 优化干预措施并进行更大规模的可行性研究”。因此，对于R33阶段， 将进行一个更大规模的可行性研究，随机选择四个BMA附属教会到F&S！在线 或者标准的F&S！（N=120），以确定在线辅助平台的可行性和可接受性， 并对其有效性和可持续性进行试点。

PROJECT SUMMARY Older adults (age ≥ 60 years) tend to be less physically active than younger adults, engaging in less than 11% of recommended physical activity (PA) levels[1-3]. These trends are even lower in older individuals from Black communities. Lack of PA in older adults is associated with increased risk of all-cause mortality, especially in the Black population[4]. Large population-based studies suggest that moderate levels of PA provide protection from chronic diseases in older adults[5]. Therefore, interventions aimed at improving PA in older Black adults could significantly improve health outcomes and help to reduce health disparities among this population. To increase PA in older, Black adults, we use the socioecological perspective[7] to examine the barriers and facilitators at each level of influence (i.e., intrapersonal, interpersonal, organizational/community, environmental/policy). A PA intervention developed for older, Black adults that targets multiple levels of the socioecological model is needed. The evidence-based Fit and Strong! (F&S!) program for older adults, funded by the National Institute of Aging, can be optimized to bypass these barriers and effectively engaged older Black adults in sustained PA. Although the F&S! program has been successfully implemented in multiple community-based, ethnically diverse settings, it is limited because it is only offered in-person (i.e., no online component) and ends at 8 weeks with very little ongoing support. These limitations not only increase the cost and reduce the accessibility of the program but also fail to optimize or support gains made as improvements in PA during F&S! diminish over the follow-up phase[8]. We will bypass these limitations and develop an adjunct, online platform to the F&S! program that is capable of syncing with wearable devices (e.g., fitbit). To create this platform as well as examine its feasibility and acceptability, we will partner with the Black Ministerial Alliance of Greater Boston (BMA), an organization of predominantly Black churches, and administer the program in these churches in Boston, MA. Consistent with this FOA “to provide support for up to two years (R21 phase) for research planning activities and feasibility studies” we will conduct: 1) focus groups in two BMA-affiliated churches to better understand the key barriers necessary to bypass at every level of the socioecological model and then build this adjunct, online program to create the F&S!-Online program and 2) an open pilot study (N=30) across these two churches to examine the feasibility and acceptability of the F&S!-Online program. Per the FOA, the R21 will be, “followed by a possible transition to expanded research support (R33 phase) for optimizing the intervention and conducting larger-scale feasibility studies”. Consistently, for the R33 phase, we will conduct a larger scale feasibility study by randomizing four BMA-affiliated churches to either F&S!-Online or the standard F&S! (N=120) to determine the feasibility and acceptability of the online adjunct platform as well as pilot its efficacy and sustainability.