Crombie Kevin M, Leitzelar Brianna N, Almassi Neda E, Mahoney Jane E, Koltyn Kelli F
Department of Kinesiology, University of Wisconsin-Madison.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Medicine (Baltimore). 2019 Jul;98(27):e16272. doi: 10.1097/MD.0000000000016272.
As aging is associated with functional decline, preventing functional limitations and maintaining independence throughout later life has emerged as an important public health goal. Research indicates that sedentary behavior (prolonged sitting) is associated with functional loss and diminished ability to carry out activities of daily living. Despite many efforts to increase physical activity, which can be effective in countering functional loss, only an estimated 8% of older adults meet national physical activity guidelines. Thus, shifting the focus to reducing sitting time is emerging as a potential new intervention strategy but little research has been conducted in this area. With community support and funding, we developed and pilot tested a 4-week "Stand Up and Move More" intervention and found decreases in sedentary behavior, increases in physical activity, and improvements in mobility and vitality in a small sample of older adults. The purpose of this project is to expand upon these pilot results and examine the effectiveness and feasibility of translating a "Stand Up and Move More" intervention by State Aging Units to older adults in underserved communities. Eighty older adults from 4 counties across Wisconsin predominantly made up of rural older adults and older African American adults are randomly assigned to intervention (n = 40) or wait-list control (n = 40) groups. The intervention consists of 4 weekly sessions plus a refresher session at 8 weeks, and is delivered by community partners in each county. The sessions are designed to elicit ideas from older adults regarding how they can reduce their sitting time, help them set practical goals, develop action plans to reach their goals, and refine their plans across sessions to promote behavior change. Sedentary behavior, physical activity levels, functional performance, and health-related quality of life are assessed before and after the intervention to examine the effectiveness of the program. Feasibility of implementing the program by our community partners is assessed via semi-structured interviews. Strengths of this project include strong community collaborations and a high need given that the older adult population is projected to increase substantially in the next 15 years.
This project will provide an important step in developing effective strategies for maintaining independence in older adults through determining the feasibility and impact of a community-based intervention to break up sitting time.
由于衰老与功能衰退相关，预防功能受限并在晚年保持独立已成为一项重要的公共卫生目标。研究表明，久坐行为（长时间坐着）与功能丧失以及进行日常生活活动的能力下降有关。尽管为增加身体活动做出了许多努力，而增加身体活动在对抗功能丧失方面可能有效，但估计只有8%的老年人达到国家身体活动指南的要求。因此，将重点转向减少久坐时间正成为一种潜在的新干预策略，但该领域的研究很少。在社区支持和资金资助下，我们开发并进行了一项为期4周的“多站立多动”干预试验，发现一小部分老年人的久坐行为减少、身体活动增加，并且 mobility 和 vitality 得到改善。本项目的目的是在这些试验结果的基础上进行拓展，研究由州老龄单位将“多站立多动”干预措施推广到服务不足社区的老年人中的有效性和可行性。来自威斯康星州4个县的80名老年人主要由农村老年人和非裔美国老年人组成，他们被随机分配到干预组（n = 40）或等待名单对照组（n = 40）。干预包括每周一次的4次课程以及在第8周的一次复习课程，由每个县的社区合作伙伴提供。这些课程旨在激发老年人关于如何减少久坐时间的想法，帮助他们设定实际目标，制定实现目标的行动计划，并在各课程中完善计划以促进行为改变。在干预前后评估久坐行为、身体活动水平、功能表现以及与健康相关的生活质量，以检验该项目的有效性。通过半结构化访谈评估我们的社区合作伙伴实施该项目的可行性。本项目的优势包括强大的社区合作以及鉴于老年人口预计在未来15年将大幅增加而产生的高需求。
本项目将通过确定基于社区的干预措施以打破久坐时间的可行性和影响，为制定有效策略以维持老年人的独立性迈出重要一步。
