Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan.
Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Am Med Dir Assoc. 2021 Feb;22(2):459-463. doi: 10.1016/j.jamda.2020.05.014. Epub 2020 Jul 4.
Sustaining benefits of an exercise program is difficult as adherence is often poor after supervised intervention is over. This study aimed to determine whether the effects of active learning education on physical activity, dietary habits, and physical function were maintained 24 weeks after intervention termination in older adults.
Non-randomized controlled trial.
Community-dwelling older adults aged ≥65 years who were independent in activities of daily living.
The intervention group (n = 36) underwent 24 weeks of active learning education. The control group (n = 59) attended a health education class didactically. In both groups, the education program focused on exercise, diet and nutrition, and cognitive activity for health promotion. Active learning included exploratory learning, group work, and self-planning for behavior change that promoted healthy lifestyles. Outcome measures were obtained at baseline (pre), 24 weeks (post), and 48 weeks (follow-up). Physical activity was objectively measured as physical activity level (PAL) using a triaxial accelerometer. Food intake was assessed by obtaining a dietary variety score. Physical function, including gait speed and Timed Up & Go score, was tested as secondary outcome. We used a linear mixed model to estimate the effects of intervention in intention-to-treat analyses.
All outcomes in the intervention group significantly improved compared with the control group at 24 weeks, and the improvements were sustained over a 48-week follow-up period. For PAL, between-group difference in change from baseline was 0.043 (95% confidence interval = 0.007, 0.080) at 24 weeks and 0.061 (0.023, 0.099) at 48 weeks.
Active learning education is effective in enhancing healthy lifestyles and physical function sustainability beyond intervention cessation. A randomized controlled trial with a larger sample size is needed to conclusively clarify the beneficial effects of active health education learning on sustainable behavior change and functional improvement.
由于监督干预结束后依从性往往较差，因此维持运动计划的益处具有一定难度。本研究旨在确定在干预结束后 24 周，积极学习教育对老年人的身体活动、饮食习惯和身体功能的影响是否仍然存在。
非随机对照试验。
能够独立完成日常生活活动的社区居住的 65 岁以上老年人。
干预组（n=36）接受了 24 周的积极学习教育。对照组（n=59）参加了健康教育课程。在两组中，教育计划都侧重于运动、饮食和营养以及认知活动以促进健康。积极学习包括探索性学习、小组作业和自我规划，以促进健康的生活方式。主要结局指标包括基线（预）、24 周（后）和 48 周（随访）。使用三轴加速度计客观测量身体活动水平（PAL）。通过获得饮食多样性评分来评估食物摄入量。步态速度和计时起立行走测试得分是作为次要结局进行测试的身体功能。我们使用线性混合模型进行意向性治疗分析，以估计干预的效果。
与对照组相比，干预组所有结局在 24 周时均显著改善，并且在 48 周随访期间，改善持续存在。对于 PAL，从基线变化的组间差异在 24 周时为 0.043（95%置信区间=0.007，0.080），在 48 周时为 0.061（0.023，0.099）。
积极学习教育在停止干预后有效增强健康的生活方式和身体功能的可持续性。需要进行更大样本量的随机对照试验，以明确积极健康学习教育对可持续行为改变和功能改善的有益效果。
