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促进智障老年人身体活动的结构化方案的制定与评估:一项群组随机试验研究方案。

Development and evaluation of a structured programme for promoting physical activity among seniors with intellectual disabilities: a study protocol for a cluster randomized trial.

机构信息

Department of General Practice, Intellectual Disability Medicine, Erasmus Medical Centre Rotterdam, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands.

出版信息

BMC Public Health. 2013 Aug 12;13:746. doi: 10.1186/1471-2458-13-746.

Abstract

BACKGROUND

Older people with intellectual disabilities have very low physical activity levels. Well designed, theory-driven and evidence-based health promotion programmes for the target population are lacking. This paper describes the design of a cluster-randomised trial for a systematically developed health promotion programme aimed at improving physical activity and increasing fitness among seniors with intellectual disabilities.

METHODS AND DESIGN

The Intervention Mapping protocol was used for programme development. After defining the programme's objectives, the following behavioural techniques were selected to achieve them: Tailoring, Education, Modelling, Mirroring, Feedback, Reinforcement and Grading. With professionals and managers of provider services for people with intellectual disabilities, we translated these strategies into a structured day-activity programme, that consisted of a physical activity and an education programme. The programme will be executed in five day-activity centres in groups of eight to ten seniors during eight months, whereas seniors in five other centres receive care as usual. The physical activity level, as measured in number of steps a day, will be used as primary outcome measurement. Secondary outcome measurements include motor fitness, cardio respiratory fitness, morphological and metabolic fitness, ADL, functional deterioration and depressive symptoms. Differences in the primary and secondary outcome measures between participants and controls will be analysed using generalized estimation equations, correcting for day-activity center as cluster.

DISCUSSION

This paper provides insight into the development and content of a theory-driven intervention aimed at behavioural change in a population with a low intellectual level. Its evaluation design is described. The programme's applicability to other populations is discussed.

摘要

背景

老年智障人士的身体活动水平非常低。针对目标人群的精心设计、基于理论且有证据支持的健康促进计划非常匮乏。本文介绍了一项集群随机试验的设计,该试验针对的是一项系统开发的健康促进计划,旨在提高智障老年人的身体活动水平和增强他们的健康。

方法与设计

采用干预映射方案进行方案开发。在确定了方案的目标后,选择了以下行为技术来实现这些目标:定制、教育、示范、镜像、反馈、强化和分级。我们与智障人士服务提供者的专业人员和管理人员合作,将这些策略转化为一个结构化的日间活动计划,该计划包括一个体育活动和一个教育计划。该计划将在五个日间活动中心进行,每个中心有八到十名老年人,为期八个月,而其他五个中心的老年人则接受常规护理。每天的步数将作为主要的结果测量指标。次要的结果测量指标包括运动能力、心肺健康、形态和代谢健康、日常生活活动、功能恶化和抑郁症状。使用广义估计方程分析参与者和对照组之间的主要和次要结果测量指标的差异,校正日间活动中心的聚类效应。

讨论

本文提供了对一种针对低智力水平人群进行行为改变的基于理论的干预措施的开发和内容的深入了解。本文还描述了其评估设计。讨论了该计划对其他人群的适用性。

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