Ashe Maureen C, Edwards Nicola Y, Taylor Amanda, Burnett Laura, Giangregorio Lora, Milne Kate, Clemson Lindy, Fleig Lena
1Department of Family Practice, Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9 Canada.
2The University of British Columbia, Vancouver, Canada.
Pilot Feasibility Stud. 2019 Jun 28;5:84. doi: 10.1186/s40814-019-0467-9. eCollection 2019.
Many interventions designed to meet physical activity guideline recommendations focus on a single component (e.g., walking), to the detriment of other elements of a healthy lifestyle, such as reducing prolonged sitting and doing balance and strength exercises (i.e., bundled multiple behaviors). Adopting these multiple health behaviors within daily life routines may facilitate uptake and support longer-term behavior change. We tested feasibility for a three-part lifestyle intervention to support older women to sit less, move more, and complete balance and strength exercises.
We used a convergent parallel mixed-methods, single-arm study design to test feasibility for a 6-week lifestyle intervention: Return to Everyday Activities in the Community and Home (REACH). We collected information at baseline, 3 and 6 weeks (final), and 6 months (follow-up) using questionnaires, semi-structured interviews, and performance-based measures. We describe three key elements: (1) implementation factors such as recruitment, retention, program delivery, and adherence; (2) participants' acceptability and experience with the program; and (3) health outcomes, including participants' global mobility, activity, and perceptions of their physical activity identity, and habit strength for (i) physical activity, (ii) breaking up sitting time, and (iii) balance and strength exercises.
We were able to recruit enough participants in the allotted time to conduct one cycle of the REACH group-based program. There were 10 community-dwelling women, median (p25, p75) age 61 (57.5, 71) years, who completed the study. The program was feasible to deliver, with high attendance (mean 5/6 sessions) and positive overall ratings (8/10). Participants rated session content and length high, and educational materials as highly acceptable and understandable. Although participants were active walkers at baseline, few were breaking up prolonged sitting or participating in any balance and strength exercises. At final and follow-up assessments, participants reported developing habits for all three health behaviors, without diminishing physical activity.
These results show acceptability of the program and its materials, and feasibility for bundling multiple health behaviors within the REACH program. It also provides confirmation to advance to testing feasibility of this three-part lifestyle intervention with older, less active, adults.
ClinicalTrials.gov Identifier, NCT02786394; May 18, 2016.
许多旨在满足身体活动指南建议的干预措施都聚焦于单一组成部分（如步行），这对健康生活方式的其他要素不利，比如减少久坐以及进行平衡和力量训练（即综合多种行为）。在日常生活中采用这些多种健康行为可能有助于接受并支持长期行为改变。我们测试了一项三部分生活方式干预措施的可行性，该措施旨在帮助老年女性减少久坐、增加活动量并完成平衡和力量训练。
我们采用了一种收敛性平行混合方法、单臂研究设计来测试一项为期6周的生活方式干预措施“回归社区和家庭日常活动（REACH）”的可行性。我们在基线、第3周和第6周（最后）以及第6个月（随访）时，通过问卷调查、半结构化访谈和基于表现的测量方法收集信息。我们描述了三个关键要素：（1）实施因素，如招募、留存、项目实施和依从性；（2）参与者对该项目的可接受性和体验；（3）健康结果，包括参与者的整体活动能力、活动情况以及对其身体活动身份的认知，以及（i）身体活动、（ii）中断久坐时间、（iii）平衡和力量训练的习惯强度。
我们能够在规定时间内招募到足够的参与者来开展一轮基于REACH小组的项目。有10名居住在社区的女性完成了研究，她们的年龄中位数（第25百分位数，第75百分位数）为61（57.5，71）岁。该项目实施可行，出勤率高（平均6次课程中参加5次）且总体评价积极（8分/10分）。参与者对课程内容和时长评价很高，对教育材料的接受度和理解度也很高。尽管参与者在基线时是积极的步行者，但很少有人能中断长时间久坐或参加任何平衡和力量训练。在最后和随访评估中，参与者报告称已养成了所有这三种健康行为的习惯，且身体活动并未减少。
这些结果表明了该项目及其材料的可接受性，以及在REACH项目中综合多种健康行为的可行性。这也为推进对这一针对年龄较大、活动较少的成年人的三部分生活方式干预措施的可行性测试提供了依据。
ClinicalTrials.gov标识符，NCT02786394；2016年5月18日。
