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社区居住成年人身体活动实施研究(PHISICAL):研究方案。

PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL): study protocol.

机构信息

Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.

Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK.

出版信息

Inj Prev. 2019 Oct;25(5):453-458. doi: 10.1136/injuryprev-2017-042627. Epub 2018 Jan 5.

Abstract

BACKGROUND

Falls in older people are a leading causes of unintentional injury. Due to an ageing population, injuries are likely to increase unless more is done to reduce older people's falls risk. In clinical trials, the Falls Management Exercise (FaME) programme has reduced the rate of falls and falls-related injuries in community-dwelling older adults. However, the commissioning of FaME is inconsistent across England, potentially due to a lack of evidence that FaME can be delivered effectively in a 'real world' setting. The PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL) study is designed to study the implementation of FaME in a range of different settings in England.

METHODS

The PHISICAL study will use a mixed-methods, triangulation, multilevel design to explore the implementation of FaME. Framework analysis of semistructured interviews with up to 90 stakeholders (exercise programme users, service providers, referrers and commissioners) and observational data from locally led communities of practice will identify the factors that influence FaME's implementation. Quantitative, anonymised, routine service data from up to 650 exercise programme users, including measures of falls and physical activity, will allow assessment of whether the benefits of FaME reported in clinical trials translate to the 'real world' setting.

CONCLUSION

The findings from this study will be used to develop a toolkit of resources and guidance to inform the commissioning and delivery of future FaME programmes. This study has the potential to inform public health prevention strategies, and in doing so may reduce the number of falls in the older population while delivering cost savings to health and social care services.

摘要

背景

老年人跌倒已成为意外伤害的主要原因。由于人口老龄化,受伤人数可能会增加,除非采取更多措施降低老年人跌倒风险。在临床试验中,跌倒管理锻炼(FaME)计划已降低了社区居住的老年人跌倒率和与跌倒相关的伤害率。然而,FaME 在英格兰各地的推广情况并不一致,这可能是由于缺乏证据表明 FaME 可以在“真实世界”环境中有效地实施。PHysical activity Implementation Study In Community-dwelling AduLts(PHISICAL)研究旨在研究 FaME 在英格兰各种不同环境中的实施情况。

方法

PHISICAL 研究将采用混合方法、三角测量、多层次设计来探索 FaME 的实施情况。对多达 90 名利益相关者(运动项目使用者、服务提供者、推荐者和决策者)的半结构化访谈进行框架分析,并对当地领导的实践社区进行观察数据收集,以确定影响 FaME 实施的因素。对多达 650 名运动项目使用者的匿名、常规服务数据(包括跌倒和身体活动测量)进行定量分析,将评估临床试验中报告的 FaME 益处是否转化为“真实世界”环境。

结论

这项研究的结果将用于开发一套资源和指南工具包,为未来的 FaME 计划提供信息,指导其推广和实施。这项研究有可能为公共卫生预防策略提供信息,从而在为卫生和社会保健服务节省成本的同时,减少老年人群的跌倒人数。

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