College of Computer and Information Science, Northeastern University, Boston, Massachusetts.
J Am Geriatr Soc. 2013 Oct;61(10):1676-83. doi: 10.1111/jgs.12449. Epub 2013 Sep 3.
To compare the efficacy of a computer-based physical activity program (Embodied Conversational Agent-ECA) with that of a pedometer control condition in sedentary older adults.
Single-blind block-randomized controlled trial stratified according to clinic site and health literacy status.
Three urban ambulatory care practices at Boston Medical Center between April 2009 and September 2011.
Older adults (N = 263; mean age 71.3; 61% female; 63% African American; 51% high school diploma or less).
ECA participants were provided with portable tablet computers with touch screens to use for 2 months and were directed to connect their pedometers to the computer using a data cable and interact with a computer-animated virtual exercise coach daily to discuss walking and to set walking goals. Intervention participants were then given the opportunity to interact with the ECA in a kiosk in their clinic waiting room for the following 10 months. Control participants were given a control pedometer intervention that only tracked step counts for an equivalent period of time. Intervention participants were also provided with pedometers.
The primary outcome was average daily step count for the 30 days before the 12-month interview. Secondary outcomes were average daily step count for the 30 days before the 2-month interview. Outcomes were also stratified according to health literacy level.
ECA participants walked significantly more steps than control participants at 2 months (adjusted mean 4,041 vs 3,499 steps/day, P = .01), but this effect waned by 12 months (3,861 vs 3,383, P = .09). For participants with adequate health literacy, those in the ECA group walked significantly more than controls at both 2 months (P = .03) and 12 months (P = .02), while those with inadequate health literacy failed to show significant differences between treatment groups at either time point. Intervention participants were highly satisfied with the program.
An automated exercise promotion system deployed from outpatient clinics increased walking among older adults over the short-term. Effective methods for long-term maintenance of behavior change are needed.
比较基于计算机的身体活动程序（具身对话代理-ECA）与计步器对照条件在久坐的老年人群中的疗效。
根据诊所地点和健康素养状况进行单盲分组随机对照试验。
2009 年 4 月至 2011 年 9 月期间，在波士顿医疗中心的三个城市门诊护理实践中进行。
老年成年人（N=263；平均年龄 71.3；61%为女性；63%为非裔美国人；51%仅完成高中学业）。
ECA 参与者配备了带有触摸屏的便携式平板电脑，供其使用 2 个月，并指导他们使用数据电缆将计步器与计算机连接，并每天与计算机动画虚拟锻炼教练互动，讨论步行和设定步行目标。然后，干预参与者有机会在他们诊所候诊室的信息亭中与 ECA 进行互动，为期 10 个月。对照组参与者接受了仅在等效时间段内跟踪步数的控制计步器干预。干预参与者还配备了计步器。
主要结果是 12 个月访谈前 30 天的平均每日步数。次要结果是 2 个月访谈前 30 天的平均每日步数。根据健康素养水平对结果进行分层。
在 2 个月时，ECA 参与者比对照组参与者走的步数明显更多（调整后的平均步数分别为 4041 步/天和 3499 步/天，P=0.01），但这一效果在 12 个月时减弱（3861 步/天和 3383 步/天，P=0.09）。对于健康素养足够的参与者，在 ECA 组中，与对照组相比，在 2 个月（P=0.03）和 12 个月（P=0.02）时，走的步数明显更多，而健康素养不足的参与者在两个时间点都未能显示出治疗组之间的显著差异。干预参与者对该程序非常满意。
从门诊诊所部署的自动锻炼促进系统在短期内在老年人群中增加了步行量。需要有效的方法来维持行为改变的长期效果。
