期刊论文详细信息
BMC Public Health
Randomised controlled trial of a complex intervention by primary care nurses to increase walking in patients aged 60–74 years: protocol of the PACE-Lift (Pedometer Accelerometer Consultation Evaluation - Lift) trial
Derek Cook2  Annabelle Rogers2  Fredrika Adams2  Debbie Brewin8  Lee David8  Michael Ussher2  Carole Beighton6  Peter Whincup2  Steve Iliffe3  Alison Woodcock1  Ulf Ekelund4  Christina Victor5  Sally Kerry7  Tess Harris2 
[1] Psychology Dept, Royal Holloway, University of London, London, TW20 OEX, UK;Population Health Research Centre, St George’s University of London, London SW17 ORE, UK;Department of Population Health Sciences, University College, London, NW3 2PF, UK;Department of Sport Medicine, Norwegian School of Sport Sciences, PO Box 4014, Oslo, 0806, Norway;Gerontology and Health Services Research Unit, Brunel University, London, UB8 3PH, UK;Faculty of Health and Social Care, London South Bank University, London, SE1 0AA, UK;Pragmatic Clinical Trials Unit, Queen Mary’s University of London, London, E12AT, UK;10 Minute CBT, Devonshire Business Centre, Letchworth Garden City, Herts, SG61GJ, UK
关键词: Practice nurse;    Primary care;    Cognitive behavioural;    Walking intervention;    Accelerometers;    Pedometers;    Older people;    Physical activity;   
Others  :  1162674
DOI  :  10.1186/1471-2458-13-5
 received in 2012-12-10, accepted in 2013-01-03,  发布年份 2013
PDF
【 摘 要 】

Background

Physical activity is essential for older peoples’ physical and mental health and for maintaining independence. Guidelines recommend at least 150 minutes weekly, of at least moderate intensity physical activity, with activity on most days. Older people’s most common physical activity is walking, light intensity if strolling, moderate if brisker. Less than 20% of United Kingdom 65–74 year olds report achieving the guidelines, despite most being able to. Effective behaviour change techniques include strategies such as goal setting, self-monitoring, building self-efficacy and relapse prevention. Primary care physical activity consultations allow individual tailoring of advice. Pedometers measure step-counts and accelerometers measure physical activity intensity. This protocol describes an innovative intervention to increase walking in older people, incorporating pedometer and accelerometer feedback within a primary care nurse physical activity consultation, using behaviour change techniques.

Methods/Design

Design: Randomised controlled trial with intervention and control (usual care) arms plus process and qualitative evaluations.

Participants: 300 people aged 60–74 years registered with 3 general practices within Oxfordshire and Berkshire West primary care trusts, able to walk outside and with no restrictions to increasing their physical activity.

Intervention: 3 month pedometer and accelerometer based intervention supported by practice nurse physical activity consultations. Four consultations based on behaviour change techniques, physical activity diary, pedometer average daily steps and accelerometer feedback on physical activity intensity. Individual physical activity plans based on increasing walking and other existing physical activity will be produced.

Outcomes: Change in average daily steps (primary outcome) and average time spent in at least moderate intensity physical activity weekly (secondary outcome) at 3 months and 12 months, assessed by accelerometry. Other outcomes include quality of life, mood, exercise self-efficacy, injuries. Qualitative evaluations will explore reasons for trial non-participation, the intervention’s acceptability to patients and nurses and factors enhancing or acting as barriers for older people in increasing their physical activity levels.

Discussion

The PACE-Lift trial will determine the feasibility and efficacy of an intervention for increasing physical activity among older primary care patients. Steps taken to minimise bias and the challenges anticipated will be discussed. Word count 341.

Trial registration number

ISRCTN42122561

【 授权许可】

   
2013 Harris et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413074143737.pdf 287KB PDF download
Figure 1. 88KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Department of Health: Start Active, Stay Active. A report on physical activity for health from the four home countries' Chief Medical Officers. 2011. http://www.dh.gov/uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_128209 webcite
  • [2]Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP: American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011, 43:1334-1359.
  • [3]O'Donovan G, Blazevich AJ, Boreham C, Cooper AR, Crank H, Ekelund U, Fox KR, Gately P, Giles-Corti B, Gill JM, Hamer M, McDermott I, Murphy M, Mutrie M, Mutrie N, Reilly JJ, Saxton JM, Stamatakis E: The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences. J Sports Sci 2010, 28:573-591.
  • [4]Morris JN, Hardman AE: Walking to health. Sports Med 1997, 23:306-332.
  • [5]Dumurgier J, Elbaz A, Ducimetiere P, Tavernier B, Alperovitch A, Tzourio C: Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study. BMJ 2009, 339:b4460.
  • [6]Department of Health: Choosing Activity: a Physical Activity Plan. 2005. http://www.dh.gov/uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4105354 webcite
  • [7]National Institute for Health and Clinical Excellence: Mental wellbeing and older people. NICE Public Health Guidance; 2008:16. http://www.nice.org.uk/PH16 webcite
  • [8]National Centre for Social Research: Health Survey for England 2004. London: Department of Health; 2005.
  • [9]Simonsick EM, Guralnik JM, Volpato S, Balfour J, Fried LP: Just get out the door! Importance of walking outside the home for maintaining mobility: findings from the women's health and aging study. J Am Geriatr Soc 2005, 53:198-203.
  • [10]Tudor-Locke CE, Myers AM: Challenges and opportunities for measuring physical activity in sedentary adults. Sports Med 2001, 31:91-100.
  • [11]Harris TJ, Owen CG, Victor CR, Adams R, Cook DG: What factors are associated with physical activity in older people, assessed objectively by accelerometry? Br J Sports Med 2009, 43:442-450.
  • [12]King AC, Rejeski WJ, Buchner DM: Physical activity interventions targeting older adults. A critical review and recommendations. Am J Prev Med 1998, 15:316-333.
  • [13]Cress ME, Buchner DM, Prohaska T, Rimmer J, Brown M, Macera C, Dipietro L, Chodzko-Zajko W: Best practices for physical activity programs and behavior counseling in older adult populations. J Aging Phys Act 2005, 13:61-74.
  • [14]Michie S, Rumsey N, Fussell A, Hardeman W, Johnston M, Newman S, Yardley L, British Psychological Society Health Psychology Team: Changing Behaviour: NHS Health Trainer Handbook. 2008. http://www.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085779 webcite
  • [15]National Institute for Health and Clinical Excellence: Behaviour change at population, community and individual levels. London: National Institute of Health and Clinical Excellence; 2007.
  • [16]Ogilvie D, Foster CE, Rothnie H, Cavill N, Hamilton V, Fitzsimons CF, Mutrie N: Interventions to promote walking: systematic review. BMJ 2007, 334:1204.
  • [17]Thompson PD, Buchner D, Pina IL, Balady GJ, Williams MA, Marcus BH, Berra K, Blair SN, Costa F, Franklin B, Fletcher GF, Gordon NF, Pate RR, Rodrigues BL, Yancey AK, Wenger NK: Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation 2003, 107:3109-3116.
  • [18]Hootman JM, Macera CA, Ainsworth BE, Martin M, Addy CL, Blair SN: Association among physical activity level, cardiorespiratory fitness, and risk of musculoskeletal injury. Am J Epidemiol 2001, 154:251-258.
  • [19]Ory M, Resnick B, Jordan PJ, Coday M, Riebe D, Ewing GC, Pruitt L, Bazzarre T: Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. Ann Behav Med 2005, 29(Suppl):20-28.
  • [20]Morey MC, Sullivan RJ Jr: Medical assessment for health advocacy and practical strategies for exercise initiation. Am J Prev Med 2003, 25:204-208.
  • [21]Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, Stave CD, Olkin I, Sirard JR: Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007, 298:2296-2304.
  • [22]Croteau KA, Richeson NE, Farmer BC, Jones DB: Effect of a pedometer-based intervention on daily step counts of community-dwelling older adults. Res Q Exerc Sport 2007, 78:401-406.
  • [23]McMurdo ME, Sugden J, Argo I, Boyle P, Johnston DW, Sniehotta FF, Donnan PT: Do pedometers increase physical activity in sedentary older women? A randomized controlled trial. J Am Geriatr Soc 2010, 58:2099-2106.
  • [24]Macmillan F, Fitzsimons C, Black K, Granat MH, Grant MP, Grealy M, Macdonald H, McConnachie A, Rowe DA, Shaw R, Skelton DA, Mutrie N: West End Walkers 65+: a randomised controlled trial of a primary care-based walking intervention for older adults: study rationale and design. BMC Public Health 2011, 11:120. BioMed Central Full Text
  • [25]Mutrie N, Doolin O, Fitzsimons CF, Grant PM, Granat M, Grealy M, Macdonald H, Macmillan F, McConnachie A, Rowe DA, Shaw R, Skelton DA: Increasing older adults' walking through primary care: results of a pilot randomized controlled trial. Fam Pract 2012.
  • [26]Houle J, Doyon O, Vadeboncoeur N, Turbide G, Diaz A, Poirier P: Innovative program to increase physical activity following an acute coronary syndrome: randomized controlled trial. Patient Educ Couns 2011, 85:e237-e244.
  • [27]Yates T, Davies M, Gorely T, Bull F, Khunti K: Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: a randomized controlled trial. Diabetes Care 2009, 32:1404-1410.
  • [28]Roemmich JN, Gurgol CM, Epstein LH: Open-loop feedback increases physical activity of youth. Med Sci Sports Exerc 2004, 36:668-673.
  • [29]Paschali AA, Goodrick GK, Kalantzi-Azizi A, Papadatou D, Balasubramanyam A: Accelerometer feedback to promote physical activity in adults with type 2 diabetes: a pilot study. Percept Mot Skills 2005, 100:61-68.
  • [30]Davis MG, Fox KR: Physical activity patterns assessed by accelerometry in older people. Eur J Appl Physiol 2007, 100:581-589.
  • [31]NHS Health Checks Programme: Putting prevention first: NHS Health Checks: Vascular Risk Assessment and Management Best Practice Guidelines. 2009. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_097489 webcite
  • [32]Brawley LR, Rejeski WJ, King AC: Promoting physical activity for older adults: the challenges for changing behavior. Am J Prev Med 2003, 25:172-183.
  • [33]Tai SS, Gould M, Iliffe S: Promoting healthy exercise among older people in general practice: issues in designing and evaluating therapeutic interventions. [see comment]. Br J Gen Pract 1997, 47:119-122.
  • [34]Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA: Exercise on prescription for women aged 40–74 recruited through primary care: two year randomised controlled trial. BMJ 2008, 337:a2509.
  • [35]Goodman C, Davies S, Tai SS, Dinan S, Iliffe S: Promoting older peoples' participation in activity, whose responsibility? A case study of the response of health, local government and voluntary organizations. J Interprof Care 2007, 21:515-528.
  • [36]Khan KM, Weiler R, Blair SN: Prescribing exercise in primary care. BMJ 2011, 343:d4141.
  • [37]Iliffe S, Kendrick D, Morris R, Skelton D, Gage H, Dinan S, Stevens Z, Pearl M, Masud T: Multi-centre cluster randomised trial comparing a community group exercise programme with home based exercise with usual care for people aged 65 and over in primary care: protocol of the ProAct 65+ trial. Trials 2010, 11:6. BioMed Central Full Text
  • [38]McKay J, Wright A, Lowry R, Steele K, Ryde G, Mutrie N: Walking on prescription: the utility of a pedometer pack for increasing physical activity in primary care. Patient Educ Couns 2009, 76:71-76.
  • [39]Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P: Methods and processes of the CONSORT Group: example of an extension for trials assessing nonpharmacologic treatments. Ann Intern Med 2008, 148:W60-W66.
  • [40]Caspersen CJ, Bloemberg BP, Saris WH, Merritt RK, Kromhout D: The prevalence of selected physical activities and their relation with coronary heart disease risk factors in elderly men: the Zutphen Study, 1985. Am J Epidemiol 1991, 133:1078-1092.
  • [41]McGee MA, Johnson A, Kay D: The Medical Research Council Cognitive Functioning and Ageing Study (MRC CFAS).The description of activities of daily living in five centres in England and Wales. Age & Ageing 1998, 27:605-613.
  • [42]D'Ath P, Katona P, Mullan E, Evans S, Katona C: Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Fam Pract 1994, 11:260-266.
  • [43]Krasucki C, Ryan P, Ertan T, Howard R, Lindesay J, Mann A: The FEAR: a rapid screening instrument for generalized anxiety in elderly primary care attenders. Int J Geriatr Psychiatry 1999, 14:60-68.
  • [44]Jette AM, Rooks D, Lachman M, Lin TH, Levenson C, Heislein D, Giorgetti MM, Harris BA: Home-based resistance training: predictors of participation and adherence. Gerontologist 1998, 38:412-421.
  • [45]Brooks R: EuroQol: the current state of play. Health Policy 1996, 37:53-72.
  • [46]Tunstall J: Old and Alone. London: Routledge and Kegan; 1957.
  • [47]Department of Health: General Practice Physical Activity Questionnaire. 2006. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_063812 webcite
  • [48]Booth ML: Assessment of physical activity: an international perspective. Res Q Exerc Sport 2000, 71:s114-s120.
  • [49]Nandy S, Parsons S, Cryer C, Underwood M, Rashbrook E, Carter Y, Eldridge S, Close J, Skelton D, Taylor S, Feder G: Development and preliminary examination of the predictive validity of the Falls Risk Assessment Tool (FRAT) for use in primary care. J Public Health (Oxf) 2004, 26:138-143.
  • [50]Bassett DR Jr, Ainsworth BE, Leggett SR, Mathien CA, Main JA, Hunter DC, Duncan GE: Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exerc 1996, 28:1071-1077.
  • [51]Schneider PL, Crouter SE, Bassett DR: Pedometer measures of free-living physical activity: comparison of 13 models. Med Sci Sports Exerc 2004, 36:331-335.
  • [52]Le Masurier GC, Lee SM, Tudor-Locke C: Motion sensor accuracy under controlled and free-living conditions. Med Sci Sports Exerc 2004, 36:905-910.
  • [53]Ekelund U, Tingstrom P, Kamwendo K, Krantz M, Nylander E, Sjostrom M, Bergdahl B: The validity of the Computer Science and Applications activity monitor for use in coronary artery disease patients during level walking. Clin Physiol Funct Imaging 2002, 22:248-253.
  • [54]Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP: A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health 2011, 26:1479-1498.
  • [55]David L: Using CBT in General Practice. The 10 minute consultation. Oxfordshire: Scion; 2006.
  • [56]Harris TJ, Owen CG, Victor CR, Adams R, Ekelund U, Cook DG: A comparison of questionnaire, accelerometer, and pedometer: measures in older people. Med Sci Sports Exerc 2009, 41:1392-1402.
  • [57]Harris TJ, Carey IM, Victor CR, Adams R, Cook DG: Optimising recruitment into a study of physical activity in older people: a randomised controlled trial of different approaches. Age Ageing 2008, 37:659-665.
  • [58]Little P, Dorward M, Gralton S, Hammerton L, Pillinger J, White P, Moore M, McKenna J, Payne S: A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease. Br J Gen Pract 2004, 54:189-195.
  • [59]Stevens W, Hillsdon M, Thorogood M, McArdle D: Cost-effectiveness of a primary care based physical activity intervention in 45–74 year old men and women: a randomised controlled trial. Br J Sports Med 1998, 32:236-241.
  • [60]Sugden JA, Sniehotta FF, Donnan PT, Boyle P, Johnston DW, McMurdo ME: The feasibility of using pedometers and brief advice to increase activity in sedentary older women - a pilot study. BMC Health Serv Res 2008, 8:169. BioMed Central Full Text
  • [61]White IR, Horton NJ, Carpenter J, Pocock SJ: Strategy for intention to treat analysis in randomised trials with missing outcome data. BMJ 2011, 342:d40.
  文献评价指标  
  下载次数:8次 浏览次数:16次