Community-based Intervention Effects on Older Adults' Physical Activity and Falls

项目总结/摘要 尽管有证据表明，针对腿部力量和平衡的身体活动（PA）可以减少福尔斯，但不到12%的人会跌倒。 的老年人定期参加这些活动，跌倒率继续增加。研究 研究干预策略，激励老年人从事PA是稀缺和不确定的。的 拟议的研究旨在解决跌倒预防科学中的这一差距。这项建议的目的是 确定引起PA增加的行为改变策略，持续12个月，反过来导致 减少福尔斯和改善生活质量（QOL）。在先前研究的基础上，拟议的研究将使用 析因实验设计，以测试分为两个行为改变策略的相对影响 件.这些组件由不同的行为改变策略组成， 激励人们采取行动的两种不同方式：人际和个人内部，符合 行为变化和寿命发展的理论，以及经验证据。这些组件 将与核心干预内容相结合，其中包括奥塔哥，一个以证据为基础的，减少跌倒的PA 协议和PA监视器进行自我跟踪。我们将招募308名70岁以上的社区居民， 随机分配他们到四个条件之一：（a）奥塔哥+PA-监测;（B）奥塔哥+PA-监测+间- 个人部分;（c）Otago + PA-监测器+个人内部部分;和（d）Otago + PA-监测器+ 人际关系+个人内部因素。所有条件下的内容将在8周内交付给 社区中心的小团体。我们将在干预后重新评估所有参与者：立即，6 个月和12个月，以评估干预成分的短期和长期疗效。我们 假设接受人际关系部分的参与者，相对于不接受人际关系部分的参与者， 该组分将a）在所有3个随访时间点均具有临床意义的PA增加;和B） 干预后12个月福尔斯减少和生活质量改善。我们还将探讨 针对性机制的干预成分，动机结构（社会支持;准备;自我， 调节）和跌倒风险的身体标志物（功能平衡和力量），以及这些指标是否 机制与PA和跌倒结果相关。我们假设接受人际关系 动机成分，相对于没有收到这个组件，将引起动机的增加， 跌倒风险的结构和物理标志物，这将介导干预对PA和福尔斯的影响。的 拟议的研究是创新的，因为它代表了生物力学为导向的实质性扩展 减少跌倒的PA协议a）检查哪些行为改变策略引起持续的效果（例如，12 月）对PA增加以及福尔斯和QOL的影响;和B）探索PA和 福尔斯。拟议研究的长期目的是优化老年人的PA干预， 由社区组织用于促进PA、减少福尔斯和改善QOL。

Project Summary/ Abstract Despite evidence that physical activities (PA) targeting leg strength and balance reduce falls, less than 12% of older adults engage in these activities on a regular basis and fall rates continue to increase. Research examining intervention strategies that motivate older adults to engage in PA is scarce and inconclusive. The proposed research aims to address this gap in fall prevention science. The objective of this proposal is to identify behavioral change strategies that elicit increased PA, sustained for 12 months and, in turn, lead to a reduction in falls and improved quality of life (QOL). Building on prior research, the proposed study will use a factorial experimental design to test the relative influence of behavioral change strategies separated into two components. These components are comprised of distinct sets of behavior change strategies that represent two different ways of motivating people to take action: inter-personal and intra-personal, consistent with theories of behavioral change and life-span development, as well as empirical evidence. These components will be combined with core intervention content that includes Otago, an evidence-based, fall-reducing PA protocol, and a PA-monitor for self-tracking. We will recruit 308 community-dwelling adults > 70 years old and randomly assign them to one of four conditions: (a) Otago + PA-monitor; (b) Otago + PA-monitor + inter- personal component; (c) Otago + PA-monitor + intra-personal component; and (d) Otago + PA-monitor + inter-personal + intra-personal components. Content within all conditions will be delivered over 8 weeks to small groups in community centers. We will re-assess all participants post-intervention: immediately, 6 months and 12 months to evaluate the short and long-term efficacy of the intervention components. We hypothesize that participants receiving the inter-personal component, relative to participants not receiving this component, will have a) clinically meaningful increases in PA at all 3 follow-up time points; and b) reductions in falls and improved quality of life 12 months post-intervention. We will also explore the effects of intervention components on targeted mechanisms, motivational constructs (social support; readiness; self- regulation) and physical markers of fall risk (functional balance and strength), and whether these mechanisms are associated with PA and fall outcomes. We hypothesize that receiving the inter-personal motivational component, relative to not receiving this component, will elicit increases in motivational constructs and physical markers of fall risk, which will mediate the intervention’s effects on PA and falls. The proposed research is innovative, because it represents a substantive expansion of biomechanically-oriented fall-reducing PA protocols to a) examine which behavioral change strategies elicit sustained effects (e.g., 12 months) on increased PA, as well as on falls, and QOL; and b) explore underlying mechanisms of PA and falls. The long-term intent of the proposed research is to optimize a PA intervention for older adults that can be used by community-based organizations to promote PA, reduce falls, and improve QOL.