《基于社区的随机试验——“强壮之心，健康社区”（SHHC-2.0）中身体活动结果的变化》。
Changes in physical activity outcomes in the Strong Hearts, Healthy Communities (SHHC-2.0) community-based randomized trial.
机构信息
School of Public Health, Texas A&M University, College Station, TX, 77843, USA.
Texas A&M AgriLife Research and Extension Center, Dallas, TX, 75252, USA.
出版信息
Int J Behav Nutr Phys Act. 2022 Dec 28;19(1):159. doi: 10.1186/s12966-022-01401-1.
BACKGROUND
Physical inactivity is a risk factor for numerous adverse health conditions and outcomes, including all-cause mortality. Aging rural women are at particular risk for physical inactivity based on environmental, sociocultural, and psychosocial factors. This study reports on changes in physical activity and associated factors from a multicomponent community-engaged intervention trial.
METHODS
Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cluster (community) randomized controlled trial building on the results from the previous trial of SHHC-1.0. Rural women (n = 182) aged 40 and over living in 11 rural communities in upstate New York were recruited. The intervention consisted of twice-weekly experiential classes focused on exercise, nutrition, and civic engagement. Physical activity outcomes included accelerometry and self-report as well as related psychosocial measures at midpoint (12 weeks) and post-intervention (24 weeks). Data were analyzed using multilevel linear regression models with the community as the random effect.
RESULTS
Compared to participants from the control communities, participants in the intervention communities showed a significant increase in objectively measured moderate to vigorous intensity physical activity: at 12 weeks (increase of 8.1 min per day, P < 0.001) and at 24 weeks (increase of 6.4 min per day; P = 0.011). Self-reported total MET minutes per week also increased: at 12 weeks (increase of 725.8, P = 0.003) and 24 weeks (increase of 955.9, P = 0.002). Several of the psychosocial variables also showed significant positive changes.
CONCLUSIONS
The SHHC-2.0 intervention successfully increased physical activity level and related outcome measures. Modifications made based upon in-depth process evaluation from SHHC-1.0 appear to have been effective in increasing physical activity in this at-risk population.
TRIAL REGISTRATION
Clinicaltrials.gov: NCT03059472. Registered 23 February 2017.
背景
身体活动不足是许多不良健康状况和结局的一个风险因素，包括全因死亡率。农村老年女性由于环境、社会文化和心理社会因素，特别容易出现身体活动不足的情况。本研究报告了一项多组分社区参与干预试验中身体活动的变化及其相关因素。
方法
Strong Hearts, Healthy Communities 2.0（SHHC-2.0）是一项为期 24 周的群组（社区）随机对照试验，基于之前的 SHHC-1.0 试验的结果。招募了居住在纽约州北部 11 个农村社区的年龄在 40 岁及以上的农村女性（n=182）。干预措施包括每周两次的体验式课程，重点是锻炼、营养和公民参与。身体活动结果包括加速度计和自我报告，以及在中点（12 周）和干预后（24 周）的相关心理社会测量。使用社区作为随机效应的多层次线性回归模型进行数据分析。
结果
与对照组社区的参与者相比，干预组社区的参与者的中高强度身体活动量有显著增加：在 12 周时（每天增加 8.1 分钟，P<0.001）和 24 周时（每天增加 6.4 分钟；P=0.011）。每周自我报告的总代谢当量分钟数也有所增加：在 12 周时（增加 725.8，P=0.003）和 24 周时（增加 955.9，P=0.002）。几个心理社会变量也显示出显著的积极变化。
结论
SHHC-2.0 干预成功地提高了身体活动水平和相关的结果测量。根据 SHHC-1.0 的深入过程评估进行的修改似乎有效地增加了这个高危人群的身体活动量。
试验注册
Clinicaltrials.gov：NCT03059472。于 2017 年 2 月 23 日注册。
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