电子健康糖尿病预防计划为老年人量身定制的开发和可行性——一项随机对照试验研究的结果。
Development and Feasibility of an eHealth Diabetes Prevention Program Adapted for Older Adults-Results from a Randomized Control Pilot Study.
机构信息
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
出版信息
Nutrients. 2024 Mar 23;16(7):930. doi: 10.3390/nu16070930.
Lifestyle programs that reduce health risks and support weight loss (WL) in older adults face adherence and attendance challenges due to reduced energy requirements, impaired mobility, lack of transportation, and low social support. Tailored lifestyle and weight management programs are needed to better support healthy aging for older adults. Here, we developed and piloted an age-adapted, remotely delivered modification of the Diabetes Prevention Program (DPP). The modification includes age-appropriate goals, visuals, and examples; flexible dietary composition; remote classroom and fitness-monitoring technology; and standardized online classroom materials employing pedagogical and behavior change theory. The modifications were designed to safeguard fidelity and to boost adherence, engagement, and knowledge integration, with the convenience of a fully remote WL program for diverse older adults. Six-month pilot data are presented from older adults (55-85 years, body mass index (BMI) 27-39.9 kg/m, N = 20) randomly allocated to an online DPP intervention with weight, diet, and activity monitored remotely, or into a waitlisted control. The intervention achieved 100% attendance and adherence to self-monitoring. The intervention group mean (±SD) body weight change was -9.5% (±4.1); 90% lost ≥ 5%. By contrast, the control group gained 2.4% (±1.8). Once thought incompatible with older adults, remote interventions are feasible for older adults and can support fidelity, adherence, engagement, and clinically significant WL. Standardized materials are provided for future implementation.
生活方式计划可以降低老年人的健康风险并帮助其减轻体重(WL),但由于能量需求减少、行动不便、缺乏交通工具和社会支持不足,这些计划在老年人中面临着坚持和参与的挑战。需要量身定制的生活方式和体重管理计划,以更好地支持老年人的健康老龄化。在这里,我们开发并试点了一种针对老年人的、远程提供的糖尿病预防计划(DPP)的改编版。该改编版包括适合年龄的目标、视觉效果和示例;灵活的饮食构成;远程课堂和健身监测技术;以及采用教学和行为改变理论的标准化在线课堂材料。这些修改旨在确保一致性,并提高坚持度、参与度和知识整合度,同时为不同的老年人提供了一个完全远程的 WL 计划的便利。从随机分配到在线 DPP 干预组(体重、饮食和活动远程监测)或候补对照组的老年人(55-85 岁,体重指数(BMI)27-39.9 kg/m2,N=20)中呈现了六个月的试点数据。干预组实现了 100%的出勤率和自我监测的坚持度。干预组的平均(±SD)体重变化为-9.5%(±4.1);90%的人减重≥5%。相比之下,对照组的体重增加了 2.4%(±1.8)。曾经被认为不适合老年人的远程干预现在对老年人来说是可行的,并且可以支持一致性、坚持度、参与度和临床意义上的 WL。提供了标准化的材料,以便将来实施。
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