Wilcox Sara, Dowda Marsha, Leviton Laura C, Bartlett-Prescott Jenny, Bazzarre Terry, Campbell-Voytal Kimberly, Carpenter Ruth Ann, Castro Cynthia M, Dowdy Diane, Dunn Andrea L, Griffin Sarah F, Guerra Michele, King Abby C, Ory Marcia G, Rheaume Carol, Tobnick Jocelyn, Wegley Stacy
University of South Carolina (USC), Department of Exercise Science, Arnold School of Public Health, Columbia, South Carolina 29208, USA.
Am J Prev Med. 2008 Oct;35(4):340-51. doi: 10.1016/j.amepre.2008.07.001.
Most evidence-based programs are never translated into community settings and thus never make a public health impact.
Active for Life (AFL) was a 4-year translational initiative using a pre-post, quasi-experimental design. Data were collected from 2003 to 2007. Analyses were conducted in 2005 and 2008.
SETTING/PARTICIPANTS: Nine lead organizations at 12 sites participated. Active Choices participants (n=2503) averaged 65.8 years (80% women, 41% non-Hispanic white). Active Living Every Day (ALED) participants (n=3388) averaged 70.6 years (83% women, 64% non-Hispanic white).
In AFL, Active Choices was a 6-month telephone-based and ALED a 20-week group-based lifestyle behavior change program designed to increase physical activity, and both were grounded in social cognitive theory and the transtheoretical model. The interventions were evaluated in Years 1, 3, and 4. An adapted shortened ALED program was evaluated in Year 4.
Moderate- to vigorous-intensity physical activity, assessed with the CHAMPS self-reported measure.
Posttest survey response rates were 61% for Active Choices and 70% for ALED. Significant increases in moderate- to vigorous-intensity physical activity, total physical activity, and satisfaction with body appearance and function, and decreases in BMI were seen for both programs. Depressive symptoms and perceived stress, both low at pretest, also decreased over time in ALED. Results were generally consistent across years and sites.
Active Choices and ALED were successfully translated across a range of real-world settings. Study samples were substantially larger, more ethnically and economically diverse, and more representative of older adult's health conditions than in efficacy studies, yet the magnitude of effect sizes were comparable.
大多数基于证据的项目从未转化为社区实践,因此从未对公共卫生产生影响。
“积极生活”(AFL)是一项为期4年的转化性倡议,采用前后对照的准实验设计。数据收集时间为2003年至2007年。分析在2005年和2008年进行。
地点/参与者:12个地点的9个牵头组织参与。“积极选择”参与者(n = 2503)平均年龄65.8岁(80%为女性,41%为非西班牙裔白人)。“每日积极生活”(ALED)参与者(n = 3388)平均年龄70.6岁(83%为女性,64%为非西班牙裔白人)。
在AFL中,“积极选择”是一个为期6个月的电话干预项目,“每日积极生活”是一个为期20周的基于小组的生活方式行为改变项目,旨在增加身体活动,两者均基于社会认知理论和跨理论模型。干预措施在第1年、第3年和第4年进行评估。第4年对一个经过改编的缩短版ALED项目进行了评估。
采用CHAMPS自我报告测量法评估中度至剧烈强度的身体活动。
“积极选择”的测试后调查回复率为61%,“每日积极生活”为70%。两个项目的中度至剧烈强度身体活动、总身体活动以及对身体外观和功能的满意度均显著增加,体重指数下降。抑郁症状和感知压力在测试前均较低,在“每日积极生活”中也随时间下降。结果在各年份和各地点总体一致。
“积极选择”和“每日积极生活”在一系列现实世界环境中成功实现了转化。与疗效研究相比,本研究样本规模更大,种族和经济背景更多样化且更能代表老年人的健康状况,但效应大小的量级相当。