Zubala Ania, MacGillivray Stephen, Frost Helen, Kroll Thilo, Skelton Dawn A, Gavine Anna, Gray Nicola M, Toma Madalina, Morris Jacqui
Scottish Improvement Science Collaborating Centre, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom.
Evidence Synthesis Training and Research Group (STAR Group), School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom.
PLoS One. 2017 Jul 10;12(7):e0180902. doi: 10.1371/journal.pone.0180902. eCollection 2017.
While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old.
Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes.
Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended).
The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors.
虽然有强有力的证据表明，定期参加体育活动（PA）能给老年人带来诸多健康益处，并且正在开发和测试有效促进体育活动的干预措施，但最有效干预措施的特征和组成部分仍不明确。这项系统开展的系统评价评估了针对50岁以上社区居民的体育活动促进干预措施的效果和特征。
检索主要数据库中1990年1月至2015年5月期间的综述。TIDieR指南辅助数据提取，ROBIS工具用于评估偏倚风险。主要结局是体育活动的客观水平和自我报告水平。心理健康指标和参与率是次要结局。
在识别出的1284条记录中，19篇综述符合纳入标准，8篇纳入了荟萃分析。干预措施通常包含行为改变技术（BCTs），并以面对面、远程、团体、个体或联合干预的形式实施。尽管干预措施具有异质性，但在研究期间，这些干预措施通常能使体育活动持续改善，通常在12个月时，并能改善总体幸福感。然而，如何确保一年以上的有效维持尚不清楚。某些干预组成部分与积极效果的关联更明显（例如，将认知和行为要素相结合来定制促进策略，推荐低至中等强度的活动）。我们没有发现证据表明某些其他干预特征在实现积极结果方面更具优势（例如，实施方式、环境、干预提供者的专业背景、推荐的体育活动类型）。
证据表明，促进老年人体育活动的干预措施总体上是有效的，但最有益的干预组成部分尚不确定。有迹象表明，纯粹的认知策略和行为改变技术可能不如对老年人更有意义的激励因素适合他们，这些激励因素包括社会和环境支持，以及体育活动带来的乐趣。需要一种以整个系统为导向的方法，该方法应根据老年人的需求进行定制，并与社会、个人和环境因素相协调。
