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为低收入社区居住的拉丁裔老年人提供定制的中医身心锻炼以促进健康老龄化:可行性和可接受性研究

Examining the Delivery of a Tailored Chinese Mind-Body Exercise to Low-Income Community-Dwelling Older Latino Individuals for Healthy Aging: Feasibility and Acceptability Study.

作者信息

Du Yan, Patel Neela, Hernandez Arthur, Zamudio-Samano Maria, Li Shiyu, Zhang Tianou, Fernandez Roman, Choi Byeong Yeob, Land William M, Ullevig Sarah, Estrada Coats Vanessa, Moussavou Jessh Mondesir Mavoungou, Parra-Medina Deborah, Yin Zenong

机构信息

Center on Smart and Connected Health Technology, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.

Department of Family and Community Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.

出版信息

JMIR Form Res. 2022 Sep 13;6(9):e40046. doi: 10.2196/40046.

Abstract

BACKGROUND

Older Latino individuals are disproportionally affected by various chronic conditions including impairments in physical and cognitive functions, which are essential for healthy aging and independent living.

OBJECTIVE

This study aimed to evaluate the feasibility and acceptability of FITxOlder, a 12-week mind-body exercise program, in community-dwelling low-income, predominantly older Latino individuals, and assess its preliminary effects on health parameters relevant to healthy aging and independent living.

METHODS

This 12-week, single-arm, stage 1B feasibility study had a pre- and poststudy design. A total of 13 older adults (mean age 76.4, SD 7.9 years; 11/13, 85% Latino) of a congregate meal program in a senior center were enrolled. FITxOlder was a tailored Chinese mind-body exercise program using Five Animal Frolics led by a bilingual community health worker (CHW) participating twice a week at the senior center and facilitated by mobile health technology for practice at home, with incrementally increasing goals moving from once a week to at least 3 times a week. The feasibility and acceptability of the study were examined using both quantitative and qualitative data. Healthy aging-related outcomes (eg, physical and cognitive function) were assessed using paired 2-tailed t tests. Qualitative interview data were analyzed using thematic analysis.

RESULTS

The attendance rate for the 24 exercise sessions was high (22.7/24, 95%), ranging from 93% (1.8/2) to 97% (1.9/2) over the 12 weeks. Participants were compliant with the incremental weekly exercise goals, with 69.2% (9/13) and 75.0% (9/12) meeting the home and program goals in the last 4 weeks, respectively. Approximately 83% (10/12) to 92% (11/12) of the participants provided favorable feedback on survey questions regarding the study and program implementation, such as program content and support, delivery by the CHW, enjoyment and appeal of the Five Animal Frolics, study burden and incentives, and safety concerns. The qualitative interview data revealed that FITxOlder was well accepted; participants reported enjoyment and health benefits and the desire to continue to practice and share it with others. The 5-time sit-to-stand test (mean change at posttest assessment=-1.62; P<.001; Cohen d=0.97) and 12-Item Short Form Health Survey physical component scores (mean change at post intervention=5.71; P=.01; Cohen d=0.88) exhibited changes with large effect sizes from baseline to 12 weeks; the other parameters showed small or medium effect sizes.

CONCLUSIONS

The research findings indicated that the CHW-led and mobile health-facilitated Chinese qigong exercise program is feasible and acceptable among low-income Latino older adults. The trending health benefits of the 12-week FITxOlder program suggest it is promising to promote physical activity engagement in underserved older populations to improve health outcomes for healthy aging and independent living. Future research with larger samples and longer interventions is warranted to assess the health benefits and suitability of FITxOlder.

摘要

背景

老年拉丁裔个体受到各种慢性疾病的影响尤为严重,包括身体和认知功能的损害,而这些功能对于健康老龄化和独立生活至关重要。

目的

本研究旨在评估为期12周的身心锻炼项目FITxOlder在社区居住的低收入、以老年拉丁裔个体为主的人群中的可行性和可接受性,并评估其对与健康老龄化和独立生活相关的健康参数的初步影响。

方法

这项为期12周的单臂1B期可行性研究采用了研究前和研究后的设计。在一个老年中心的集体用餐项目中,共招募了13名老年人(平均年龄76.4岁,标准差7.9岁;13人中有11人,即85%为拉丁裔)。FITxOlder是一个量身定制的中式身心锻炼项目,采用五禽戏,由一名双语社区卫生工作者(CHW)在老年中心每周带领两次,并通过移动健康技术辅助在家中练习,目标逐渐增加,从每周一次增加到每周至少三次。使用定量和定性数据来检验该研究的可行性和可接受性。使用配对双尾t检验评估与健康老龄化相关的结果(如身体和认知功能)。使用主题分析对定性访谈数据进行分析。

结果

24次锻炼课程的出勤率很高(22.7/24,95%),在12周内从93%(1.8/2)到97%(1.9/2)不等。参与者遵守每周递增的锻炼目标,在最后4周,分别有69.2%(9/13)和75.0%(9/12)的人达到了在家和项目中的目标。大约83%(10/12)至92%(11/12)的参与者对关于研究和项目实施的调查问题给出了积极反馈,如项目内容和支持、CHW的授课、五禽戏的趣味性和吸引力、研究负担和激励措施以及安全问题。定性访谈数据显示FITxOlder很受欢迎;参与者表示从中获得了乐趣和健康益处,并希望继续练习并与他人分享。五次坐立试验(测试后评估的平均变化=-1.62;P<.001;科恩d=0.97)和12项简短健康调查问卷身体成分得分(干预后平均变化=5.71;P=.01;科恩d=0.88)从基线到12周显示出具有大效应量的变化;其他参数显示出小或中等效应量。

结论

研究结果表明,由CHW主导并通过移动健康辅助的中式气功锻炼项目在低收入拉丁裔老年人中是可行且可接受的。为期12周的FITxOlder项目在健康方面的有益趋势表明,它有望促进服务不足的老年人群体的身体活动参与,以改善健康老龄化和独立生活的健康结果。有必要进行更大样本量和更长干预时间的未来研究,以评估FITxOlder的健康益处和适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3856/9516366/b07532eede3d/formative_v6i9e40046_fig1.jpg

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