Wingood Mariana, Bean Jonathan F, Linsky Amy M
Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC.
Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.
Arch Rehabil Res Clin Transl. 2023 Aug 20;5(4):100293. doi: 10.1016/j.arrct.2023.100293. eCollection 2023 Dec.
Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What Matters to the older adult, Mentation, Mobility, and Medications).
65岁及以上的成年人中有91%未达到推荐的身体活动(PA)水平,这导致残疾、发病和死亡风险增加。尽管了解身体活动的益处,并承认评估和解决不足的身体活动水平的重要性,但50%-75%的医疗保健提供者并未将行为改变技巧纳入临床实践。这种临床差距可以通过以下方面的知识或信心不足来解释:(1)评估身体活动水平;(2)解决不足的身体活动水平;(3)证明在临床实践中使用这些技巧所需的时间合理。在这篇特别通讯中,我们通过提供一个基于理论的三步临床决策路径来解决这一差距,该路径指导医疗保健提供者如何识别身体活动水平不足的老年人,确定增加身体活动的意愿,并促使患者制定提高其身体活动水平的行动计划。我们还提供了一个概念模型,通过将身体活动与老年友好型卫生系统的4M(即,对老年人重要的事情、心理状态、活动能力和药物治疗)联系起来,支持使用评估和解决不足的身体活动的技巧。