社区居住老年人联合生活方式干预的效果评价：实践中的 ProMuscle。
Process Evaluation of a Combined Lifestyle Intervention for Community-Dwelling Older Adults: ProMuscle in Practice.
机构信息
Food, Health & Consumer Research, Wageningen Food & Biobased Research, Wageningen, The Netherlands.
Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
出版信息
Gerontologist. 2020 Nov 23;60(8):1538-1554. doi: 10.1093/geront/gnaa027.
BACKGROUND AND OBJECTIVES
The ProMuscle in Practice intervention combines resistance exercise training and dietary protein intake for community-dwelling older adults, implemented by health care professionals (HCPs). This study aimed to evaluate implementation and context of this intervention in Dutch health care practice.
RESEARCH DESIGN AND METHODS
We conducted a randomized controlled multicenter intervention study in 5 Dutch municipalities. Eighty-two older adults received the 12-week intensive support intervention (resistance exercise training and individual dietary counseling) and the optional 12-week moderate support intervention (resistance exercise training and a nutrition course). Mixed method data were collected from both participants and HCPs (n = 37) on process indicators recruitment, dose received, acceptability, fidelity, applicability, and context.
RESULTS
Overall, the intervention was feasible to implement and accepted by participants and HCPs. About two thirds of participants continued with the moderate support intervention after the first 12 weeks. The mean dose received for the training sessions was 83.6% in the intensive intervention, 63.6% in the moderate intervention, >90% for individual dietitian consultations, and 76.8% for the nutrition course. The intensive support intervention was implemented with high fidelity, whereas for the moderate support intervention resistance exercise trainings varied in implementation between exercise providers.
DISCUSSION AND IMPLICATIONS
A combined resistance exercise training and dietary protein intervention for community-dwelling older adults can be successfully implemented in practice. Well-tailored interventions, intensive supervision by skilled HCPs, social aspects, fidelity, and fit within real-world settings appeared essential for successful implementation. These elements are important for continuous intervention optimization to accomplish broader and successful implementation.
背景与目的
ProMuscle 在实践中的干预措施将抗阻运动训练和社区居住的老年人的膳食蛋白质摄入量相结合，由医疗保健专业人员（HCP）实施。本研究旨在评估该干预措施在荷兰医疗保健实践中的实施情况和背景。
研究设计和方法
我们在 5 个荷兰市进行了一项随机对照多中心干预研究。82 名老年人接受了 12 周的强化支持干预（抗阻运动训练和个性化饮食咨询）和可选的 12 周的适度支持干预（抗阻运动训练和营养课程）。从参与者和 HCP（n=37）收集了关于过程指标（招募、接受剂量、可接受性、保真度、适用性和背景）的混合方法数据。
结果
总体而言，该干预措施在参与者和 HCP 中是可行的，且被接受。大约三分之二的参与者在第一 12 周后继续接受适度支持干预。强化干预中培训课程的平均接受剂量为 83.6%，中度干预中为 63.6%，个别营养师咨询的接受剂量超过 90%，营养课程为 76.8%。高强度支持干预的实施保真度较高，而对于中度支持干预，运动提供者之间的抗阻运动训练实施存在差异。
讨论与意义
一种针对社区居住老年人的抗阻运动训练和膳食蛋白质相结合的干预措施可以在实践中成功实施。量身定制的干预措施、由熟练的 HCP 进行的强化监督、社会方面、保真度以及与真实环境的契合度对于成功实施至关重要。这些要素对于持续的干预优化至关重要，以实现更广泛和成功的实施。
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