Coronary Heart Disease Clinical Trial
Official title:
A Lifestyle Physical Activity Intervention for Older Sedentary Women
Making physical activity an integral part of daily life is imperative to the health and well-being of our nation's older adults. However, no intervention strategy to encourage daily physical activity for older adults, especially older women, has been effective. This feasibility study will test a multi-tailored motivational intervention to increase usual lifestyle physical activity of older sedentary women to reduce their coronary heart disease risks.
Over 98% of older women do not meet national guidelines for physical activity (PA). There is
clear evidence that a physically active lifestyle reduces the human and economic cost of
heart disease in a dose-response relationship; but current efforts to increase long-term PA
in older women are inadequate. The aims of this proposed research are to: 1) determine the
feasibility of using an individually tailored motivational counseling intervention method to
promote lifestyle physical activity (LPA) in older sedentary women; 2) examine intervention
effects by comparing baseline to outcome measures at 3 and 6 months in treatment and
information/attention comparison groups; and 3) explore stage of behavior change and
self-efficacy and their relationship to LPA, along with functional health.
This will be a single blinded randomized controlled study of sedentary women aged 60 years
and older. We will replace "structured aerobic exercise" with lifestyle physical activity
(LPA), i.e., self-selected activities performed daily in a purposeful manner to meet the
national PA guidelines. A total of 120 older women who are ambulatory and cognitively intact
will be recruited from a senior health clinic and randomized to receive either the
motivational LPA intervention or information/attention. Women will be assessed at baseline, 3
and 6 months. The theoretically based behavioral intervention is derived from the
Transtheoretical Model and other evidence-based physical activity research. We will use a
Motivational Interviewing counseling technique delivered by a social worker to individually
tailor the LPA intervention to participant preferences, taking into consideration their
functional ability and need for information, readiness to change, and self-efficacy. Outcomes
of the LPA intervention sessions will include tailored goals and an LPA plan. Intervention
participants will also receive the newly developed NIA "Exercise & You" LPA informational
booklet with companion digital video disc (DVD) as well as motivational coaching via
telephone calls, tapering in frequency for 6 months. The control group will receive the NIA
LPA booklet with DVD and attention telephone calls. We will assess changes from baseline in
LPA (primary outcome), readiness to change, self-efficacy and function (secondary outcomes)
and examine the associations between primary and secondary outcomes in both groups. The
allied disciplines of Nursing, Gerontology, Social Work, and Medicine will collaborate to
promote PA and cardiovascular health of older women. Undergraduate and graduate student
research assistants will contribute to this project. This research has the potential to
increase PA of sedentary older women and reduce coronary heart disease risks. If we could
increase physical activity in our rapidly growing older population —even modestly, we could
make a significant impact to the health of our nation.
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