Translation of a tailored nutrition and resistance exercise intervention for elderly people to a real-life setting: adaptation process and pilot study

BMC Geriatrics

Research Article

Michael Tieland¹  Joanne N. Leerlooijer¹  Lisette CPGM. de Groot¹  Ellen JI. van Dongen¹  Annemien Haveman-Nies¹  Jan M. Steijns² 

[1] Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV, Wageningen, The Netherlands;FrieslandCampina Institute, P.O. Box 1551, 3800 BN, Amersfoort, The Netherlands;

关键词: Adaptation;    Feasibility;    Resistance exercise;    Protein-rich products;    Elderly;    Real-life setting;   

DOI  :  10.1186/s12877-017-0413-8

 received in 2016-03-29, accepted in 2017-01-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCombining increased dietary protein intake and resistance exercise training for elderly people is a promising strategy to prevent or counteract the loss of muscle mass and decrease the risk of disabilities. Using findings from controlled interventions in a real-life setting requires adaptations to the intervention and working procedures of healthcare professionals (HCPs). The aim of this study is to adapt an efficacious intervention for elderly people to a real-life setting (phase one) and test the feasibility and potential impact of this prototype intervention in practice in a pilot study (phase two).MethodsThe Intervention Mapping approach was used to guide the adaptation in phase one. Qualitative data were collected from the original researchers, target group, and HCPs, and information was used to decide whether and how specified intervention elements needed to be adapted. In phase two, a one-group pre-test post-test pilot study was conducted (n = 25 community-dwelling elderly), to elicit further improvements to the prototype intervention. The evaluation included participant questionnaires and measurements at baseline (T0) and follow-up (T1), registration forms, interviews, and focus group discussions (T1). Qualitative data for both phases were analysed using an inductive approach. Outcome measures included physical functioning, strength, body composition, and dietary intake. Change in outcomes was assessed using Wilcoxon signed-rank tests.ResultsThe most important adaptations to the original intervention were the design of HCP training and extending the original protein supplementation with a broader nutrition programme aimed at increasing protein intake, facilitated by a dietician. Although the prototype intervention was appreciated by participants and professionals, and perceived applicable for implementation, the pilot study process evaluation resulted in further adaptations, mostly concerning recruitment, training session guidance, and the nutrition programme. Pilot study outcome measures showed significant improvements in muscle strength and functioning, but no change in lean body mass.ConclusionThe combined nutrition and exercise intervention was successfully adapted to the real-life setting and seems to have included the most important effective intervention elements. After adaptation of the intervention using insights from the pilot study, a larger, controlled trial should be conducted to assess cost-effectiveness.Trial registrationTrial registration number: ClinicalTrials.gov NL51834.081.14 (April 22, 2015).

【 授权许可】

CC BY   
© The Author(s). 2017