Physical Inactivity Clinical Trial
Official title:
Mindful Movement for Physical Activity and Wellbeing in Older Adults: A Community Based Randomized Hybrid Effectiveness-Implementation Study
Physical inactivity has reached pandemic proportions and is associated with increased morbidity, mortality, and healthcare costs. Of particular concern is that most middle to older age adults fall far short of recommendations for health enhancing physical activities. This research takes a novel approach to tackling this problem by combining mindfulness with behavioral strategies in a unique 'Mindful Movement' program offered through YMCA community facilities.
Physical inactivity in the United States has become a critical public health concern for all
age groups. With a large segment of the population rapidly aging, there is growing interest
in ensuring mid to older age adults (50+) stay active and reduce sedentariness, to decrease
their morbidity and mortality risk. While older adults are advised to engage in at least 150
minutes/week of moderate to vigorous physical activity (PA), most do not. Specific theory
based behavioral strategies have been shown to positively affect health and activity
behaviors. There is also emerging evidence that mindfulness based interventions (MBI) may
facilitate PA through increased mind-body awareness and self-regulation. However, research
for MBIs and physical activity is currently limited, both in quantity and methodological
rigor.
The broad long-term objective is to optimize physical and sedentary activity levels in
middle-older age adults through an integrated mindfulness and behavioral approach scalable
for broad dissemination. The University of Minnesota (UMN) will work with the YMCA Greater
Twin Cities, a community based organization committed to providing accessible resources to
"build healthy spirit, mind and body for all" and making healthy aging a priority. To
decrease time between discovery and translation, a two-phase hybrid
effectiveness-implementation design will be used.
Phase I will address the following: 1) project organization, barrier/facilitator assessment,
protocol development, and training; and 2) evaluation of feasibility of project protocols at
multiple levels in a randomized pilot study (n=30) of Mindful Movement versus a modified 10
Keys to Health & Wellbeing educational control using transition milestones.
Phase II will address: 1) investigation of the relative effectiveness of Mindful Movement
versus control in a full-scale randomized controlled trial (RCT, n=182) using accelerometer
based PA at 9 weeks (primary outcome) and at 26 and 52 weeks (secondary outcomes) as well as
other secondary measures include sedentary activity, quality of life, exercise self-efficacy
and expectations, mindfulness, wellbeing, bodily pain, and adverse events; and 2) RCT
interpretation by providing contextual data from participants, staff, and organizational
leadership. These will include: enrollment, adherence, follow up, and fidelity rates; and
perceptions of barriers/facilitators, relevance, practicality, affordability and
acceptability. This information will be used to create a toolkit for implementation at other
YMCA sites.
This project is innovative in that it will be among the first to assess MBIs for enhancing
older adults' physical activity in community based settings using a design intended to
facilitate and accelerate research translation. Through the UMN and YMCA partnership, there
is great potential to develop a sustainable and replicable physical activity intervention
with meaningful impact and nationwide reach.
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