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原住民老年人的健康老龄化:一项针对群组随机对照试验的“铁木研究”方案。

Healthy ageing among older Aboriginal people: the Ironbark study protocol for a cluster randomised controlled trial.

机构信息

School of Population Health, University of New South Wales, Sydney, New South Wales, Australia

The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.

出版信息

Inj Prev. 2020 Dec;26(6):581-587. doi: 10.1136/injuryprev-2020-043915. Epub 2020 Oct 7.

Abstract

INTRODUCTION

Older Aboriginal people have a strong leadership role in their community including passing on knowledge and teachings around culture and connections to Country. Falls significantly affect older people and are a growing concern for older Aboriginal people and their families. Regular participation in balance and strength exercise has been shown to be efficacious in reducing falls. A pilot study developed in partnership with Aboriginal communities, the Ironbark: Standing Strong and Tall programme, demonstrated high community acceptability and feasibility, and gains in balance and strength in Aboriginal participants. This cluster randomised controlled trial will assess the effectiveness of the programme in reducing the rate of falls in older Aboriginal people.

METHODS

We will examine the effectiveness and cost-effectiveness of the Ironbark group-based fall prevention programme compared with a group-based social programme, with Aboriginal people aged 45 years and older in three Australian states. The primary outcome is fall rates over 12 months, measured using weekly self-reported data. Secondary outcomes measured at baseline and after 12 months include quality of life, psychological distress, activities of daily living, physical activity, functional mobility and central obesity. Differences between study groups in the primary and secondary outcomes at 12 months will be estimated.

CONCLUSION

This is the first trial to investigate the effectiveness and cost-effectiveness of a fall prevention programme for Aboriginal peoples aged ≥45 years. The study has strong cultural and community governance, including Aboriginal investigators and staff, and is guided by a steering committee that includes representatives of Aboriginal community-controlled services.

TRIAL REGISTRATION NUMBER

ACTRN12619000349145.

摘要

介绍

老年原住民在他们的社区中扮演着重要的领导角色,包括传承文化和与土地的联系方面的知识和教义。老年人跌倒的问题非常严重,这也是老年原住民及其家庭越来越关注的问题。定期参加平衡和力量训练已被证明可以有效地减少跌倒。与原住民社区合作开发的一项试点研究表明,“Ironbark:Standing Strong and Tall”项目具有很高的社区可接受性和可行性,并且可以提高原住民参与者的平衡和力量。本项群组随机对照试验将评估该项目对降低老年原住民跌倒率的有效性。

方法

我们将比较“Ironbark”基于群组的防跌倒计划与基于群组的社会计划对澳大利亚三个州的 45 岁及以上的原住民的效果和成本效益。主要结果是 12 个月内的跌倒率,通过每周自我报告的数据进行测量。在基线和 12 个月后测量的次要结果包括生活质量、心理困扰、日常生活活动、身体活动、功能性移动和中心性肥胖。将估计研究组在 12 个月时主要和次要结果之间的差异。

结论

这是第一项针对≥45 岁的原住民进行的防跌倒计划的有效性和成本效益的试验。该研究具有强大的文化和社区治理,包括原住民调查员和工作人员,并由一个指导委员会指导,该委员会包括原住民社区控制服务的代表。

试验注册号

ACTRN12619000349145。

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