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老年人身体活动促进(PACE):一项随机对照试验的研究方案

Physical ACtivity facilitation for Elders (PACE): study protocol for a randomised controlled trial.

作者信息

Morgan Gemma S, Haase Anne M, Campbell Rona, Ben-Shlomo Yoav

机构信息

School of Social and Community Medicine, 39 Whatley Road, Bristol, BS8 2PS, UK.

School of Policy Studies, 8 Priory Road, Bristol, BS8 1TZ, UK.

出版信息

Trials. 2015 Mar 13;16:91. doi: 10.1186/s13063-015-0610-8.

Abstract

BACKGROUND

As people live longer, their risk of disability increases. Disability affects quality of life and increases health and social care costs. Preventing or delaying disability is therefore an important objective, and identifying an effective intervention could improve the lives of many older people. Observational and interventional evidence suggests that physical activity may reduce the risk of age-related disability, as assessed by physical performance measures. However it is unclear what approach is the most cost-effective intervention in changing long-term physical activity behaviour in older adults. A new theory-driven behavioural intervention has been developed, with the aim of increasing physical activity in the everyday lives of older adults at risk of disability. This pilot study tests the feasibility and acceptability of delivering this intervention to older adults.

METHODS/DESIGN: A randomised controlled trial (RCT) design will be used in the pilot study. Sixty patients aged 65 years and older will be recruited from primary care practices. Patients will be eligible to participate if they are inactive, not disabled at baseline, are at risk of developing disability in the future (Short Physical Performance Battery score <10/12), and have no contraindications to physical activity. Following baseline measures, participants will be randomised in a 2:1 ratio to the intervention or to a control arm and all participants will be followed-up after 6 months. Those randomised to the intervention arm will receive sessions with a trained Physical Activity Facilitator, delivering an intervention based on self-determination theory. Control participants receive a booklet on healthy ageing. The main outcomes of interest are recruitment, adherence, retention and acceptability. Data will also be collected on: self-report and accelerometer-recorded physical activity; physical performance; depression; wellbeing; cognitive function; social support; quality of life, healthcare use, and attitudes to physical activity. A mixed-methods process evaluation will run alongside the RCT.

DISCUSSION

The intervention, if effective, has the potential to reduce disability and improve quality of life in older adults. Before proceeding to a full-scale trial a pilot trial is necessary to ensure intervention feasibility and acceptability, and that the intervention shows evidence of promise.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN80470273 . Registered 25 October 2013.

摘要

背景

随着人们寿命的延长,他们残疾的风险也在增加。残疾会影响生活质量,并增加医疗和社会护理成本。因此,预防或延缓残疾是一个重要目标,确定一种有效的干预措施可以改善许多老年人的生活。观察性和干预性证据表明,通过身体机能指标评估,体育活动可能会降低与年龄相关的残疾风险。然而,目前尚不清楚哪种方法是改变老年人长期体育活动行为最具成本效益的干预措施。一种新的理论驱动的行为干预措施已经开发出来,旨在增加有残疾风险的老年人在日常生活中的体育活动。这项试点研究测试了向老年人提供这种干预措施的可行性和可接受性。

方法/设计:试点研究将采用随机对照试验(RCT)设计。将从基层医疗诊所招募60名65岁及以上的患者。如果患者不活跃、基线时未残疾、未来有发生残疾的风险(简短身体机能测试得分<10/12)且无体育活动禁忌症,则有资格参与。在进行基线测量后,参与者将以2:1的比例随机分配到干预组或对照组,所有参与者将在6个月后接受随访。随机分配到干预组的参与者将与一名经过培训的体育活动促进者进行课程学习,该促进者将基于自我决定理论进行干预。对照组参与者将收到一本关于健康老龄化的小册子。主要关注的结果是招募情况、依从性、保留率和可接受性。还将收集以下数据:自我报告和加速度计记录的体育活动;身体机能;抑郁;幸福感;认知功能;社会支持;生活质量、医疗保健使用情况以及对体育活动的态度。一项混合方法的过程评估将与随机对照试验同时进行。

讨论

如果该干预措施有效,有可能降低老年人的残疾率并改善其生活质量。在进行全面试验之前,有必要进行试点试验,以确保干预措施的可行性和可接受性,并证明该干预措施有成功的迹象。

试验注册

当前受控试验ISRCTN80470273。2013年10月25日注册。

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