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影响老年人减肥和提高活动能力的项目因素:来自流动性和活力生活方式项目(MOVE UP)的证据。

Program Factors Affecting Weight Loss and Mobility in Older Adults: Evidence From the Mobility and Vitality Lifestyle Program (MOVE UP).

机构信息

University of Pittsburgh, Pittsburgh, PA, USA.

University of South Florida, Tampa, FL, USA.

出版信息

Health Promot Pract. 2024 May;25(3):492-503. doi: 10.1177/15248399231162377. Epub 2023 Mar 28.

Abstract

. The Mobility and Vitality Lifestyle Program (MOVE UP) is a behavioral weight-management intervention for improving mobility among community-dwelling older adults. We examined program factors that affect implementation outcomes and participant-level health outcomes. . The MOVE UP program was implemented in the greater Pittsburgh area from January 2015 to June 2019 to improve lower extremity performance in community-dwelling older adults who were overweight or obese. Thirty-two sessions were delivered over 13 months. All sessions were designed to be 1-hour in length, on-site, group-based, and led by trained and supported community health workers (CHWs). Participants completed weekly Lifestyle Logs for self-monitoring of body weight, diet, and physical activity. We evaluated the MOVE UP program using the RE-AIM framework, and collected quantitative data at baseline, 5-, 9-, and 13-months. Multilevel linear regression models assessed the impacts of program factors (site, CHW, and participant characteristics) on implementation outcomes and participant-level health outcomes. . Twenty-two CHWs delivered MOVE UP program to 303 participants in 26 cohorts. Participants were similar to the target source population in weight but differed in some demographic characteristics. The program was effective for weight loss and lower extremity function in both intervention and maintenance periods (s < .01), with an independent effect for Lifestyle Logs submission but not session attendance. . CHWs were able to deliver a multi-component weight loss intervention effectively in community settings. CHW and site characteristics had independent impacts on participants' adherence. Lifestyle Log submission may be a more potent measure of adherence in weight loss interventions than attendance.

摘要

. 运动活力生活方式项目(MOVE UP)是一项针对改善社区居住的老年人活动能力的行为体重管理干预措施。我们研究了影响实施结果和参与者健康结果的项目因素。. MOVE UP 项目于 2015 年 1 月至 2019 年 6 月在匹兹堡大都市区实施,以改善超重或肥胖的社区居住的老年人的下肢功能。共进行了 32 次课程,历时 13 个月。所有课程均设计为 1 小时,在现场进行,基于小组,由经过培训和支持的社区卫生工作者(CHWs)领导。参与者完成每周的生活方式日志,以自我监测体重、饮食和体育活动。我们使用 RE-AIM 框架评估了 MOVE UP 项目,并在基线、5 个月、9 个月和 13 个月收集定量数据。多级线性回归模型评估了项目因素(地点、CHW 和参与者特征)对实施结果和参与者健康结果的影响。. 22 名 CHW 在 26 个队列中向 303 名参与者提供了 MOVE UP 项目。参与者在体重方面与目标源人群相似,但在一些人口统计学特征上有所不同。该计划在干预和维持期都对体重减轻和下肢功能有效(s <.01),生活方式日志提交具有独立效果,但课程出勤率没有。. CHW 能够在社区环境中有效地提供多组分减肥干预措施。CHW 和地点特征对参与者的依从性有独立影响。生活方式日志提交可能是减肥干预措施中比出勤率更有效的依从性衡量标准。

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