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增加中老年人身体活动的个性化(单病例)试验的可行性测试。

Feasibility Test of Personalized (N-of-1) Trials for Increasing Middle-Aged and Older Adults' Physical Activity.

作者信息

Friel Ciarán P, Goodwin Ashley M, Robles Patrick L, Butler Mark J, Pahlevan-Ibrekic Challace, Duer-Hefele Joan, Vicari Frank, Gordon Samantha, Chandereng Thevaa, Cheung Ying Kuen Ken, Suls Jerry, Davidson Karina W

机构信息

Northwell, New Hyde Park, NY, USA.

Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.

出版信息

Int J Behav Med. 2025 Jun;32(3):394-404. doi: 10.1007/s12529-024-10319-w. Epub 2024 Sep 4.

Abstract

PURPOSE

To test the effectiveness and feasibility of a remotely delivered intervention to increase physical activity (walking) in middle-aged and older adults.

DESIGN

This study used a personalized (N-of-1) trial design.

SETTING

This study took place at a major healthcare system from November 2021 to February 2022.

SUBJECTS

Sixty adults (45-75 years, 92% female, 80% white) were recruited.

INTERVENTION

A 10-week study comprising a 2-week baseline, followed by four 2-week periods where four behavior change techniques (BCTs) - self-monitoring, goal setting, action planning, and feedback - were delivered one at a time in random order.

MEASURES

Activity was measured by a Fitbit, and intervention components delivered by email/text. Average daily steps were compared between baseline and intervention. Participants completed satisfaction items derived from the System Usability Scale and reported attitudes and opinions about personalized trials.

RESULTS

Participants rated personalized trial components as feasible and acceptable. Changes in steps between baseline and intervention were not significant, but a large heterogeneity of treatment effects existed, suggesting some participants significantly increased walking while others significantly decreased.

CONCLUSIONS

Our intervention was well-accepted but use of BCTs delivered individually did not result in a significant increase in steps. Feasibility and heterogeneity of treatment effects support adopting a personalized trial approach to optimize intervention results.

摘要

目的

测试一种远程提供的干预措施对增加中老年人身体活动(步行)的有效性和可行性。

设计

本研究采用个性化(单病例)试验设计。

背景

本研究于2021年11月至2022年2月在一个大型医疗保健系统中进行。

研究对象

招募了60名成年人(45 - 75岁,92%为女性,80%为白人)。

干预措施

一项为期10周的研究,包括2周的基线期,随后是四个2周的阶段,在这四个阶段中,四种行为改变技术(BCTs)——自我监测、目标设定、行动计划和反馈——以随机顺序依次提供。

测量方法

通过Fitbit测量活动量,通过电子邮件/短信提供干预内容。比较基线期和干预期的平均每日步数。参与者完成了源自系统可用性量表的满意度项目,并报告了对个性化试验的态度和看法。

结果

参与者对个性化试验内容的评价为可行且可接受。基线期和干预期之间的步数变化不显著,但存在较大的治疗效果异质性,这表明一些参与者的步行量显著增加,而另一些参与者则显著减少。

结论

我们的干预措施被广泛接受,但单独使用行为改变技术并没有导致步数显著增加。治疗效果的可行性和异质性支持采用个性化试验方法来优化干预结果。

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