PDF(Pubmed)
Abstract：
UNASSIGNED: Despite guidelines that recommend physical activity (PA), little is known about which types of behavior change strategies (BCSs) effectively promote sustained increases in PA in older adults who are insufficiently active.
UNASSIGNED: To determine whether intrapersonal BCSs (eg, goal setting) or interpersonal BCSs (eg, peer-to-peer sharing or learning) combined with the Otago Exercise Program (17 strength and balance exercises and a walking program that are learned and individually tailored, with instruction to perform 3 times per week at home or location of choice) and a wearable PA monitor help older adults sustain increases in their PA.
UNASSIGNED: This 2 × 2 factorial randomized clinical trial (Community-Based Intervention Effects on Older Adults\' Physical Activity) of community-dwelling older adults 70 years or older with PA levels below minimum national PA guidelines was conducted in urban community centers. Dates of enrollment were from November 17, 2017, to June 15, 2021, with final follow-up assessments completed on September 2, 2022.
UNASSIGNED: Participants were randomized to intrapersonal (eg, goal setting) BCSs, interpersonal (eg, problem-solving with peer-to-peer sharing and learning) BCSs, intrapersonal and interpersonal BCSs, or an attention control group. All interventions included a PA monitor and 8 weekly small-group meetings with discussion, practice, and instructions to implement the exercise program and relevant BCSs independently between meetings and after the intervention.
UNASSIGNED: The primary outcome was daily minutes of objectively measured total PA (light, moderate, or vigorous intensities) averaged over 7 to 10 days, measured at baseline and after the intervention at 1 week, 6 months, and 12 months.
UNASSIGNED: Among 309 participants (mean [SD] age, 77.4 [5.0] years; 240 women [77.7%]), 305 (98.7%) completed the intervention, and 302 (97.7%) had complete data. Participants receiving PA interventions with interpersonal BCS components exhibited greater increases in total PA than did those who did not at 1 week (204 vs 177 PA minutes per day; adjusted difference, 27.1 [95% CI, 17.2-37.0]; P < .001), 6 months (195 vs 175 PA minutes per day; adjusted difference, 20.8 [95% CI, 10.0-31.6]; P < .001), and 12 months (195 vs 168 PA minutes per day; adjusted difference, 27.5 [95% CI, 16.2-38.8]; P < .001) after the intervention. Compared with participants who did not receive interventions with intrapersonal BCS components, participants who received intrapersonal BCSs exhibited no significant changes in total PA at 1 week (192 vs 190 PA minutes per day; adjusted difference, 1.8 [95% CI, -8.6 to 12.2]; P = .73), 6 months (183 vs 187 PA minutes per day; adjusted difference, -3.9 [95% CI, -15.0 to 7.1]; P = .49), or 12 months (177 vs 186 PA minutes per day; adjusted difference, -8.8 [95% CI, -20.5 to 2.9]; P = .14) after the intervention. Interactions between intrapersonal and interpersonal BCSs were not significant.
UNASSIGNED: In this randomized clinical trial, older adults with low levels of PA who received interpersonal BCSs, the exercise program, and a PA monitor exhibited significant increases in their PA for up to 12 months after the intervention. Intrapersonal BCSs elicited no significant PA changes and did not interact with interpersonal BCSs. Our findings suggest that because effects of a PA intervention on sustained increases in older adults\' PA were augmented with interpersonal but not intrapersonal BCSs, approaches to disseminating and implementing the intervention should be considered.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT03326141.
UNASSIGNED: To determine whether intrapersonal BCSs (eg, goal setting) or interpersonal BCSs (eg, peer-to-peer sharing or learning) combined with the Otago Exercise Program (17 strength and balance exercises and a walking program that are learned and individually tailored, with instruction to perform 3 times per week at home or location of choice) and a wearable PA monitor help older adults sustain increases in their PA.
UNASSIGNED: This 2 × 2 factorial randomized clinical trial (Community-Based Intervention Effects on Older Adults\' Physical Activity) of community-dwelling older adults 70 years or older with PA levels below minimum national PA guidelines was conducted in urban community centers. Dates of enrollment were from November 17, 2017, to June 15, 2021, with final follow-up assessments completed on September 2, 2022.
UNASSIGNED: Participants were randomized to intrapersonal (eg, goal setting) BCSs, interpersonal (eg, problem-solving with peer-to-peer sharing and learning) BCSs, intrapersonal and interpersonal BCSs, or an attention control group. All interventions included a PA monitor and 8 weekly small-group meetings with discussion, practice, and instructions to implement the exercise program and relevant BCSs independently between meetings and after the intervention.
UNASSIGNED: The primary outcome was daily minutes of objectively measured total PA (light, moderate, or vigorous intensities) averaged over 7 to 10 days, measured at baseline and after the intervention at 1 week, 6 months, and 12 months.
UNASSIGNED: Among 309 participants (mean [SD] age, 77.4 [5.0] years; 240 women [77.7%]), 305 (98.7%) completed the intervention, and 302 (97.7%) had complete data. Participants receiving PA interventions with interpersonal BCS components exhibited greater increases in total PA than did those who did not at 1 week (204 vs 177 PA minutes per day; adjusted difference, 27.1 [95% CI, 17.2-37.0]; P < .001), 6 months (195 vs 175 PA minutes per day; adjusted difference, 20.8 [95% CI, 10.0-31.6]; P < .001), and 12 months (195 vs 168 PA minutes per day; adjusted difference, 27.5 [95% CI, 16.2-38.8]; P < .001) after the intervention. Compared with participants who did not receive interventions with intrapersonal BCS components, participants who received intrapersonal BCSs exhibited no significant changes in total PA at 1 week (192 vs 190 PA minutes per day; adjusted difference, 1.8 [95% CI, -8.6 to 12.2]; P = .73), 6 months (183 vs 187 PA minutes per day; adjusted difference, -3.9 [95% CI, -15.0 to 7.1]; P = .49), or 12 months (177 vs 186 PA minutes per day; adjusted difference, -8.8 [95% CI, -20.5 to 2.9]; P = .14) after the intervention. Interactions between intrapersonal and interpersonal BCSs were not significant.
UNASSIGNED: In this randomized clinical trial, older adults with low levels of PA who received interpersonal BCSs, the exercise program, and a PA monitor exhibited significant increases in their PA for up to 12 months after the intervention. Intrapersonal BCSs elicited no significant PA changes and did not interact with interpersonal BCSs. Our findings suggest that because effects of a PA intervention on sustained increases in older adults\' PA were augmented with interpersonal but not intrapersonal BCSs, approaches to disseminating and implementing the intervention should be considered.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT03326141.
摘要：
■尽管指南建议进行体育锻炼（PA），对于哪些类型的行为改变策略(BCSs)有效促进活动不足的老年人PA持续升高,人们知之甚少.
■为了确定是否存在内部BCS（例如，目标设定)或人际BCS(例如，点对点共享或学习）与奥塔哥运动计划（17种力量和平衡练习以及一项学习和量身定制的步行计划相结合，指导在家中或选择的位置每周执行3次）和可穿戴PA监测器可帮助老年人维持PA的增加。
■这项2×2因子随机临床试验（基于社区的干预对老年人身体活动的影响）是在城市社区中心进行的70岁或70岁以上的社区居住老年人PA水平低于最低国家PA指南。入学日期为2017年11月17日至2021年6月15日，最终随访评估于2022年9月2日完成。
■参与者被随机分配到个人内部（例如，目标设定)BCS，人际关系(例如，通过点对点共享和学习解决问题)BCS，内部和人际BCS，或注意力控制组。所有干预措施都包括一名PA监测员和每周8次小团体会议，并进行讨论。实践,以及在会议之间和干预后独立实施锻炼计划和相关BCS的指示。
■主要结果是每天客观测量的总PA（光照，中度,或剧烈强度)平均7到10天，在基线和干预后1周测量，6个月,和12个月。
■在309名参与者中(平均[SD]年龄，77.4[5.0]岁；240名妇女[77.7%])，305（98.7%）完成干预，302(97.7%)有完整数据.接受PA干预的参与者与人际BCS成分相比，在1周时没有接受PA干预的参与者显示出总PA的增加更大（每天204对177PA分钟；调整后的差异，27.1[95%CI，17.2-37.0]；P<.001)，6个月（每天195对175PA分钟；调整后的差异，20.8[95%CI，10.0-31.6]；P<.001），和12个月(每天195分钟vs168分钟；调整后的差额，干预后27.5[95%CI，16.2-38.8]；P<.001）。与未接受内部BCS成分干预的参与者相比，接受BCSs的参与者在1周时总PA没有显着变化（每天192对190PA分钟；调整后的差异，1.8[95%CI，-8.6至12.2]；P=.73)，6个月（每天183对187PA分钟；调整后的差异，-3.9[95%CI，-15.0至7.1]；P=.49)，或12个月(每天177分钟vs186PA分钟；调整后的差异，-8.8[95%CI，-20.5至2.9]；P=.14）干预后。内部和人际BCS之间的相互作用并不显着。
■在这项随机临床试验中，接受人际BCS的PA水平较低的老年人，锻炼计划，PA监测器在干预后的12个月内显示PA显着增加。个人BCS不会引起明显的PA变化，也不会与个人BCS相互作用。我们的研究结果表明，由于PA干预对老年人PA持续增加的影响是通过人际而非人际BCS增强的，应考虑传播和实施干预措施的方法。
■ClinicalTrials.gov标识符：NCT03326141。
■为了确定是否存在内部BCS（例如，目标设定)或人际BCS(例如，点对点共享或学习）与奥塔哥运动计划（17种力量和平衡练习以及一项学习和量身定制的步行计划相结合，指导在家中或选择的位置每周执行3次）和可穿戴PA监测器可帮助老年人维持PA的增加。
■这项2×2因子随机临床试验（基于社区的干预对老年人身体活动的影响）是在城市社区中心进行的70岁或70岁以上的社区居住老年人PA水平低于最低国家PA指南。入学日期为2017年11月17日至2021年6月15日，最终随访评估于2022年9月2日完成。
■参与者被随机分配到个人内部（例如，目标设定)BCS，人际关系(例如，通过点对点共享和学习解决问题)BCS，内部和人际BCS，或注意力控制组。所有干预措施都包括一名PA监测员和每周8次小团体会议，并进行讨论。实践,以及在会议之间和干预后独立实施锻炼计划和相关BCS的指示。
■主要结果是每天客观测量的总PA（光照，中度,或剧烈强度)平均7到10天，在基线和干预后1周测量，6个月,和12个月。
■在309名参与者中(平均[SD]年龄，77.4[5.0]岁；240名妇女[77.7%])，305（98.7%）完成干预，302(97.7%)有完整数据.接受PA干预的参与者与人际BCS成分相比，在1周时没有接受PA干预的参与者显示出总PA的增加更大（每天204对177PA分钟；调整后的差异，27.1[95%CI，17.2-37.0]；P<.001)，6个月（每天195对175PA分钟；调整后的差异，20.8[95%CI，10.0-31.6]；P<.001），和12个月(每天195分钟vs168分钟；调整后的差额，干预后27.5[95%CI，16.2-38.8]；P<.001）。与未接受内部BCS成分干预的参与者相比，接受BCSs的参与者在1周时总PA没有显着变化（每天192对190PA分钟；调整后的差异，1.8[95%CI，-8.6至12.2]；P=.73)，6个月（每天183对187PA分钟；调整后的差异，-3.9[95%CI，-15.0至7.1]；P=.49)，或12个月(每天177分钟vs186PA分钟；调整后的差异，-8.8[95%CI，-20.5至2.9]；P=.14）干预后。内部和人际BCS之间的相互作用并不显着。
■在这项随机临床试验中，接受人际BCS的PA水平较低的老年人，锻炼计划，PA监测器在干预后的12个月内显示PA显着增加。个人BCS不会引起明显的PA变化，也不会与个人BCS相互作用。我们的研究结果表明，由于PA干预对老年人PA持续增加的影响是通过人际而非人际BCS增强的，应考虑传播和实施干预措施的方法。
■ClinicalTrials.gov标识符：NCT03326141。
