Maxwell Cathy A, Grubbs Brandon, Dietrich Mary S, Boon Jeffrey T, Dunavan John, Knickerbocker Kelly J, Patel Maulik R
College of Nursing, University of Utah, Salt Lake City, UT, United States.
Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN, United States.
JMIR Form Res. 2024 Dec 13;8:e64437. doi: 10.2196/64437.
A key driver that leads to age-associated decline and chronic disease is mitochondrial dysfunction. Our previous work revealed strong community interest in the concept of mitochondrial fitness, which led to the development of a video-based science communication intervention to prompt behavior change in adults aged 50 years and older.
This study aimed to conduct formative and summative evaluations of MitoFit, an instructional, biologically based communication intervention aimed at improving physical activity in older adults aged 50 years and older.
In the phase-1 formative evaluation, community-dwelling older adults (N=101) rated the acceptability, appropriateness, and helpfulness of our MitoFit video series, titled "How to Slow Down Aging Through Mitochondrial Fitness." In the phase-2 summative evaluation, a subgroup of phase-1 participants (n=19) participated in a 1-month MitoFit intervention prototype to evaluate the intervention and data collection feasibility.
In phase 1, participants (mean age 67.8, SD 8.9 y; 75/100, 75% female) rated the MitoFit videos as acceptable (≥4 out of 5 on a Likert-scale survey; from 97/101, 96% to 100/101, 99%), appropriate (101/101, 100%), and helpful (from 95/101, 94% to 100/101, 99%) to support adaptation and continued work on our novel approach. Previous knowledge of mitochondria ranged from 52% (50/97; What are mitochondria?) to 80% (78/97; What are the primary functions of mitochondria?). In phase 2, participants (mean age 71.4, SD 7.9 y; 13/19, 72% female) scored better than the national average (50) on the Patient-Reported Outcomes Measurement Information System-19 for physical function (57), social activities (55.5), depression (41), fatigue (48.6), and sleep disturbance (49.6) but worse for anxiety (55.3) and pain interference (52.4). Additionally, 95% (18/19) of participants demonstrated MitoFit competencies within 2 attempts (obtaining pulse: 19/19, 100%; calculating maximum and zone 2 heart rate: 18/19, 95%; and demonstration of exercises: 19/19, 100%). At 1 month after instruction, 68% (13/19) had completed a self-initiated daily walking/exercise plan and submitted a daily activity log. A walking pulse was documented by 85% (11/13) of participants. The time needed to walk 1 mile ranged from 17.4 to 27.1 minutes. The number of miles walked in 1 month was documented by 62% (8/13) of participants and ranged from 10 miles to 31 miles. The number of days of strength training ranged from 2 to 31 days/month. Intervention feasibility scores ranged from 89% (17/19; seems easy to follow) to 95% (18/19; seems implementable, possible, and doable). Overall, 79% (15/19) stated an intention to continue the MitoFit intervention. Furthermore, 4 weeks after delivery of the prototype intervention, the percentage of participants doing aerobic activity for regular moderate activity increased from 35% (6/17) to 59% (10/17; P=.03).
MitoFit was enthusiastically embraced and is a cost-effective, scalable, and potentially efficacious intervention to advance with community-dwelling older adults.
导致与年龄相关的机能衰退和慢性病的一个关键因素是线粒体功能障碍。我们之前的研究表明，社区对线粒体健康概念有着浓厚兴趣，这促使我们开发了一种基于视频的科学传播干预措施，以促使50岁及以上成年人改变行为。
本研究旨在对MitoFit进行形成性和总结性评估。MitoFit是一种基于生物学的指导性传播干预措施，旨在提高50岁及以上老年人的身体活动水平。
在第1阶段的形成性评估中，社区居住的老年人（N = 101）对我们名为《如何通过线粒体健康延缓衰老》的MitoFit视频系列的可接受性、适宜性和帮助程度进行了评分。在第2阶段的总结性评估中，第1阶段的一部分参与者（n = 19）参与了为期1个月的MitoFit干预原型，以评估干预措施和数据收集的可行性。
在第1阶段，参与者（平均年龄67.8岁，标准差8.9岁；75/100，75%为女性）对MitoFit视频的评分表明其可接受性（李克特量表调查中≥4分；97/101，96%至100/101，99%）、适宜性（101/101，100%）和帮助程度（95/101，94%至100/101，99%），支持对我们的新方法进行调整和继续研究。之前对线粒体的了解程度从52%（50/97；线粒体是什么？）到80%（78/97；线粒体的主要功能是什么？）不等。在第2阶段，参与者（平均年龄71.4岁，标准差7.9岁；13/19，72%为女性）在患者报告结局测量信息系统-19的身体功能（57）、社交活动（55.5）、抑郁（41）、疲劳（48.6）和睡眠障碍（49.6）方面的得分高于全国平均水平（50），但在焦虑（55.3）和疼痛干扰（52.4）方面得分较低。此外，95%（18/19）的参与者在2次尝试内就掌握了MitoFit技能（获取脉搏：19/19，100%；计算最大心率和二区心率：18/19，95%；演示练习：19/19，100%）。在指导后的1个月，68%（13/19）的参与者完成了自我发起的每日步行/锻炼计划并提交了每日活动日志。85%（11/13）的参与者记录了步行脉搏。步行1英里所需时间为17.4至27.1分钟。62%（8/13）的参与者记录了1个月内步行的英里数，范围为10英里至31英里。力量训练的天数为每月2至31天。干预可行性得分从89%（17/19；似乎易于遵循）到95%（18/19；似乎可实施、可行且能做到）不等。总体而言，79%（15/19）的参与者表示打算继续进行MitoFit干预。此外，在原型干预实施4周后，进行有规律适度活动的有氧运动的参与者百分比从35%（6/17）增加到59%（10/17；P = 0.03）。
MitoFit受到了热烈欢迎，是一种具有成本效益、可扩展且可能有效的干预措施，可用于社区居住的老年人。
