Lachman Margie E, Lipsitz Lewis, Lubben James, Castaneda-Sceppa Carmen, Jette Alan M
Department of Psychology, Brandeis University, Waltham, Massachusetts.
Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts.
Innov Aging. 2018 Jan;2(1):igy007. doi: 10.1093/geroni/igy007. Epub 2018 Apr 5.
Physical activity is one of the most promising nonpharmacological, noninvasive, and cost-effective methods of health-promotion, yet statistics show that only a small percentage of middle-aged and older adults engage in the recommended amount of regular exercise. This state of affairs is less likely due to a lack of knowledge about the benefits of exercise than to failures of motivation and self-regulatory mechanisms. Many types of intervention programs target exercise in later life, but they typically do not achieve sustained behavior change, and there has been very little increase in the exercise rate in the population over the last decade. The goal of this paper is to consider the use of effective low-cost motivational and behavioral strategies for increasing physical activity, which could have far-reaching benefits at the individual and population levels. We present a multicomponent framework to guide development of behavior change interventions to increase and maintain physical activity among sedentary adults and others at risk for health problems. This involves a personalized approach to motivation and behavior change, which includes social support, goal setting, and positive affect coupled with cognitive restructuring of negative and self-defeating attitudes and misconceptions. These strategies can lead to increases in exercise self-efficacy and control beliefs as well as self- management skills such as self-regulation and action planning, which in turn are expected to lead to long-term increases in activity. These changes in activity frequency and intensity can ultimately lead to improvements in physical and psychological well-being among middle-aged and older adults, including those from underserved, vulnerable populations. Even a modest increase in physical activity can have a significant impact on health and quality of life. Recommendations for future interventions include a focus on ways to achieve personalized approaches, broad outreach, and maintenance of behavior changes.
体育活动是最具前景的非药物、非侵入性且具成本效益的健康促进方法之一，但统计数据显示，只有一小部分中老年人进行了建议量的定期锻炼。这种情况不太可能是由于对锻炼益处缺乏了解，而更可能是由于动机和自我调节机制的失效。许多类型的干预项目都针对晚年的锻炼，但它们通常无法实现持续的行为改变，而且在过去十年中，人群的锻炼率几乎没有增加。本文的目的是考虑使用有效的低成本动机和行为策略来增加体育活动，这在个体和人群层面可能会带来深远的益处。我们提出了一个多成分框架，以指导行为改变干预措施的制定，以增加和维持久坐不动的成年人以及其他有健康问题风险的人的体育活动。这涉及到一种个性化的动机和行为改变方法，包括社会支持、目标设定和积极情绪，同时对消极和自我挫败的态度及误解进行认知重构。这些策略可以导致锻炼自我效能感和控制信念的增加，以及自我管理技能（如自我调节和行动计划）的提高，进而有望导致活动的长期增加。活动频率和强度的这些变化最终可以改善中老年人的身心健康，包括那些来自服务不足、弱势群体的人。即使体育活动有适度增加，也会对健康和生活质量产生重大影响。对未来干预措施的建议包括关注实现个性化方法、广泛推广和维持行为改变的方式。
