Maintaining Exercise and Healthy Eating in Older Adults

描述(申请人提供)：这项研究项目的总体目标是开发有效的干预方法，以长期维持老年人的健康生活方式行为(运动和饮食)，以改善他们的健康状况和生活质量。本研究的具体目标是解决以下问题：(1)与对照条件相比，个体化的主动维护干预是否在四年内保持了老年人更高水平的健康饮食和锻炼行为？(2)在老年人中，与感知维护健康促进行为相关的心理社会因素是什么？(3)感知维护健康促进行为对报告的健康结果、心理社会测量、人体测量学和认知状态有何影响？以及(4)在一组老年人(包括与体力活动和饮食相关的环境因素)中，自我报告的锻炼和饮食水平与客观测量的水平之间有什么关系？这个项目与健康相关的意义重大，因为它的目标是在美国日益重要的人口群体--老年人--中促进两种与健康相关的基本行为(锻炼和饮食)。研究设计和方法纳入了社区居住的老年人口(从最初的1277个样本中预测N=680个，平均年龄=80岁)，作为先前资助的老年项目(老年罗德岛人锻炼和营养研究)的一部分，跟踪了两年多。参与者将被随机分为干预组和控制组，根据先前的高级项目组分配进行分层。这两组人都将每年接受采访，以评估锻炼水平和水果和蔬菜的摄入量，一般健康结果，以及心理社会变量。试验组将接受基于阶段的干预(手册、时事通讯和辅导电话)，重点是积极保持规定的运动水平和水果和蔬菜的摄入量。干预材料将包含重点关注关键技能、过程和方法的具体内容，这些技能、过程和方法是在疾病、住院、跌倒、社会经济变化和人际损失等复发威胁下保持行为水平的。这项拟议的研究代表了一个独特和前所未有的机会，可以在十年的纵向跟踪研究中，在大规模的老年人队列中了解健康生活方式维持的动态。这项研究与公共卫生的相关性是巨大的。老年人是美国人口增长最快的群体，对我们的社会构成了前所未有的健康促进挑战。最近的研究表明，与老年有关的一些慢性健康问题可以被预防或推迟和控制，从而减轻慢性病的负担，提高功能能力，并有可能节省大量的医疗保健费用。特别关注的是运动和饮食，因为它们最有可能实现这些目标。

DESCRIPTION (provided by applicant): The broad objectives of this research project are to develop effective intervention methods for long-term maintenance of healthy lifestyle behaviors (exercise and diet) in older adults to improve their health status and quality of life. The specific aims are to address the following questions: (1) Does an individualized active- maintenance intervention maintain greater levels of healthy dietary and exercise behaviors for four years, compared to a control condition, in older adults? (2) What are the psychosocial factors associated with perceived maintenance of health-promoting behaviors in the very old? (3) What are the effects of the perceived maintenance of health-promoting behaviors on reported health outcomes, psychosocial measures, anthropometries, and cognitive status? and (4) What is the relationship between self-reported and objectively measured levels of exercise and diet in a sub-sample of older adults (including environmental factors associated with physical activity and diet)? The health-relatedness of this project is significant, because it is targeted on promoting two essential health-related behaviors (exercise and diet) among an increasingly important population group in the US, older adults. The research design and methodology incorporates a community-dwelling older adult population (projected N = 680 from an original sample of 1277, mean age = 80 years) tracked for over 2 years as part of the previously funded SENIOR Project (Study of Exercise and Nutrition in Older Rhode Islanders). Participants will be randomized into intervention and control groups stratified by previous SENIOR Project group assignment. Both groups will be interviewed annually to assess exercise levels and fruit and vegetable consumption, general health outcomes, and psychosocial variables. The experimental group will receive stage-based interventions (manual, newsletters, and coaching calls) focusing on actively maintaining defined levels of exercise and fruit and vegetable consumption. Intervention materials will incorporate specific content focusing on key skills, processes, and methods of maintaining behavioral levels in spite of such threats to relapse as illness, hospitalization, falls, socioeconomic changes, and interpersonal losses. This proposed research represents a unique and unprecedented opportunity to understand the dynamics of healthy lifestyle maintenance in a large-scale older adult cohort over ten years of longitudinal follow-up study. The relevance of this research for public health is enormous. Older adults represent the fastest growing US population group and pose unprecedented health promotion challenges to our society. Recent research indicates that some of the chronic health problems associated with old age may be prevented or postponed and controlled, reducing the burden of chronic disease and improving functional ability and potentially saving substantial health care dollars. Particular attention has focused on exercise and diet as having the most potential for achieving these aims.