- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03326141
Community-based Intervention Effects on Older Adults' Physical Activity
Community-based Intervention Effects on Older Adults' Physical Activity and Falls (R01)
Study Overview
Status
Detailed Description
To fully examine the effects of these experimental components, The investigators have delineated Primary, Secondary and Exploratory Aims:
Primary Aim: Determine which experimental intervention component(s) increase PA among community-dwelling older adults post-intervention: immediately, 6 months, and 12 months. Hypothesis: Participants receiving the interpersonal set of behavior change strategies (conditions 2 and 4) will have clinically meaningful increases in PA post- intervention (at all 3 time-points), compared to participants not receiving these strategies (conditions 1 and 3).
Secondary Aim: Determine which experimental intervention component(s)decrease fall occurrence and increase quality of life (QOL) among community-dwelling older adults 12 months post-intervention. Hypotheses: Participants receiving the set of interpersonal behavior change strategies will have clinically meaningful reductions in falls and increases in QOL, 12 months post-intervention, compared to participants not receiving these strategies.
Exploratory Aim: Evaluate experimental intervention component effects on targeted psychosocial constructs (social support; readiness; self-regulation) and physical constructs (functional leg strength and balance), which are theorized as mechanisms of change--and whether these mechanisms mediate the effects of experimental intervention components on PA and falls. Hypotheses: Receiving the interpersonal behavioral change strategies, relative to not receiving these strategies, will elicit increases in targeted psychosocial constructs and increases in physical constructs, which in turn will mediate the intervention's effects on PA behavior and falls.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Minnesota
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Minneapolis, Minnesota, United States, 55408
- University of Minnesota - School of Nursing
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ≥70 years of age
- English speaking
- Low levels of PA (below recommended guidelines)
Self-reported fall risk as guided by the CDC, Steadi fall risk screener
- One or more falls in the last year
- Unsteadiness when standing or walking
- Worries about falling
Participants who self-report the following symptoms will require clearance from a primary provider (as guided by the Exercise and Screening for You Questionnaire)
- Pain, tightness or pressure in chest during PA (walking, climbing stairs, household chores, similar activities) that have not been checked and/ or treated by a healthcare provider
- Current dizziness that have not been checked and/ or treated by a healthcare provider
- Current, frequent falls that have not been checked and/ or treated by a healthcare provider
Exclusion Criteria:
- Lower extremity injury or surgery within the past 6 weeks
- Inability to walk
- Formal diagnosis of neurocognitive impairment or dementia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Otago+PAM+Health / Wellness topics
Condition 1: Otago Exercise Program adapted for delivery to small groups; a physical activity monitor such as a Fitbit (PAM); and, information about health and wellness (8) topics guided by content in the National Institute on Aging (NIA) and Centers for Disease Control and Prevention websites. |
The program has been adapted for groups and includes 5 flexibility movements (e.g., back extension and ankle, head, neck, trunk movements), 5 leg strengthening exercises (knee extensor, knee flexor, hip abductor, ankle plantar flexes, ankle dorsiflexes), 12 balance movements (knee bends, backwards walking, walking and turning, sideways walking, tandem stance, tandem walk, one leg stand, heel walking, toe walking, heel-toe walking backwards, sit to stand, stair walking), and a walking plan.
The number, intensity and duration of movements are individualized according to preference and ability and they are gradually progressed.
We will use Fitbit Charge 2 (or an equivalent).
Features essential for this research include built-in accelerometers that accurately measure steps and physical activity (PA) duration.Participants will have a brief orientation to these during baseline data collection and have the opportunity to return demonstrate.
In addition, RAs will be available to help participants troubleshoot, as needed, via telephone and in person, after intervention meetings.
Intervention meetings include discussions about the PAMs, but topics vary according to assigned study condition.
Other Names:
Information about health and wellness varies in dose, according to time spent in each condition that addresses behavior change.
Topics in condition 1 include sleep, vaccinations, supplements, fall risk factors, memory, hearing and pain guided by information for older adults available on the NIA and CDC websites.
Topics in conditions 2 and 3 include fall risk factors and sleep.
Topics in condition 4 include fall risk factors.
|
Experimental: Otago + PAM + Interpersonal strategies
Condition 2: Otago Exercise Program adapted for delivery to small groups; a PAM (e.g.,Fitbit); 5 Interpersonal behavior change strategies; and, information about health and wellness topics (1) guided by content in the National Institute on Aging (NIA) and Centers for Disease Control and Prevention websites. |
The program has been adapted for groups and includes 5 flexibility movements (e.g., back extension and ankle, head, neck, trunk movements), 5 leg strengthening exercises (knee extensor, knee flexor, hip abductor, ankle plantar flexes, ankle dorsiflexes), 12 balance movements (knee bends, backwards walking, walking and turning, sideways walking, tandem stance, tandem walk, one leg stand, heel walking, toe walking, heel-toe walking backwards, sit to stand, stair walking), and a walking plan.
The number, intensity and duration of movements are individualized according to preference and ability and they are gradually progressed.
We will use Fitbit Charge 2 (or an equivalent).
Features essential for this research include built-in accelerometers that accurately measure steps and physical activity (PA) duration.Participants will have a brief orientation to these during baseline data collection and have the opportunity to return demonstrate.
In addition, RAs will be available to help participants troubleshoot, as needed, via telephone and in person, after intervention meetings.
Intervention meetings include discussions about the PAMs, but topics vary according to assigned study condition.
Other Names:
Information about health and wellness varies in dose, according to time spent in each condition that addresses behavior change.
Topics in condition 1 include sleep, vaccinations, supplements, fall risk factors, memory, hearing and pain guided by information for older adults available on the NIA and CDC websites.
Topics in conditions 2 and 3 include fall risk factors and sleep.
Topics in condition 4 include fall risk factors.
The interpersonal content will include facilitated discussed about including PA into social routines, identifying and problem-solving social and environmental barriers to PA, social support for exercise, and friendly social comparisons about practicing PA outside the small group setting and interpreting/ sharing data.
|
Experimental: Otago, PAM, Intrapersonal strategies
Condition 3: Otago Exercise Program adapted for delivery to small groups; a PAM (e.g.,Fitbit); 5 Intrapersonal behavior change strategies; and, health and wellness topics (1) guided by content in the National Institute on Aging (NIA) and Centers for Disease Control and Prevention websites. |
The program has been adapted for groups and includes 5 flexibility movements (e.g., back extension and ankle, head, neck, trunk movements), 5 leg strengthening exercises (knee extensor, knee flexor, hip abductor, ankle plantar flexes, ankle dorsiflexes), 12 balance movements (knee bends, backwards walking, walking and turning, sideways walking, tandem stance, tandem walk, one leg stand, heel walking, toe walking, heel-toe walking backwards, sit to stand, stair walking), and a walking plan.
The number, intensity and duration of movements are individualized according to preference and ability and they are gradually progressed.
We will use Fitbit Charge 2 (or an equivalent).
Features essential for this research include built-in accelerometers that accurately measure steps and physical activity (PA) duration.Participants will have a brief orientation to these during baseline data collection and have the opportunity to return demonstrate.
In addition, RAs will be available to help participants troubleshoot, as needed, via telephone and in person, after intervention meetings.
Intervention meetings include discussions about the PAMs, but topics vary according to assigned study condition.
Other Names:
Information about health and wellness varies in dose, according to time spent in each condition that addresses behavior change.
Topics in condition 1 include sleep, vaccinations, supplements, fall risk factors, memory, hearing and pain guided by information for older adults available on the NIA and CDC websites.
Topics in conditions 2 and 3 include fall risk factors and sleep.
Topics in condition 4 include fall risk factors.
The intrapersonal content will include encouragement and guidance to identify baseline PA patterns, develop and refine personally meaningful goals and plans, identify and problem solve personal barriers to staying physically active, integrate PA into personal routines, and monitor goal outcomes
|
Experimental: Otago,PAM, Inter+Intra strategies
Condition 4: Otago Exercise Program adapted for delivery to small groups; a PAM (e.g., Fitbit); 5 Interpersonal behavior change strategies; and, 5 Intrapersonal behavior change strategies |
The program has been adapted for groups and includes 5 flexibility movements (e.g., back extension and ankle, head, neck, trunk movements), 5 leg strengthening exercises (knee extensor, knee flexor, hip abductor, ankle plantar flexes, ankle dorsiflexes), 12 balance movements (knee bends, backwards walking, walking and turning, sideways walking, tandem stance, tandem walk, one leg stand, heel walking, toe walking, heel-toe walking backwards, sit to stand, stair walking), and a walking plan.
The number, intensity and duration of movements are individualized according to preference and ability and they are gradually progressed.
We will use Fitbit Charge 2 (or an equivalent).
Features essential for this research include built-in accelerometers that accurately measure steps and physical activity (PA) duration.Participants will have a brief orientation to these during baseline data collection and have the opportunity to return demonstrate.
In addition, RAs will be available to help participants troubleshoot, as needed, via telephone and in person, after intervention meetings.
Intervention meetings include discussions about the PAMs, but topics vary according to assigned study condition.
Other Names:
The interpersonal content will include facilitated discussed about including PA into social routines, identifying and problem-solving social and environmental barriers to PA, social support for exercise, and friendly social comparisons about practicing PA outside the small group setting and interpreting/ sharing data.
The intrapersonal content will include encouragement and guidance to identify baseline PA patterns, develop and refine personally meaningful goals and plans, identify and problem solve personal barriers to staying physically active, integrate PA into personal routines, and monitor goal outcomes
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quantity of physical activity measured objectively and via self-report
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Average weekly minutes of total physical activity per week (light, moderate and vigorous intensities) as captured from PAM data (Fitbit Charge-2) and the Physical Activity Scale for the Elderly (PASE).
PASE total scores range from 0-400, with higher value representing more physical activity.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fall and Injury Rate
Time Frame: Baseline, and Post-Intervention: immediate, 6 months, and 12 months
|
Will be assessed using prospective monthly fall calendars.
|
Baseline, and Post-Intervention: immediate, 6 months, and 12 months
|
Patient Reported Outcomes Measurement Information System (PROMIS) Global Quality of life
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
This will assess Global Physical Health and Global Mental health.
Subscales for each range from 0 to 40, with 40 indicating better perceived physical and mental health, respectively
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Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Behavioral Regulation in Exercise Questionnaire (BREQ-3)
Time Frame: Baseline and Post-Intervention: immediate; 6 months, and 12 months
|
This instrument measures the extent to which participants' regulation is considered to be amotivation, external motivation, introjected regulation, Identified regulation, integrated regulation, and intrinsic regulation by calculating mean scores for items corresponding to each level of regulation, with higher mean scores indicating orientation toward that level of regulation.
Additional a multidimensional score The relative autonomy index, a single score will be derived from the subscales that gives an index of the degree to which respondents feel self-determined.
The index is obtained by applying a weighting to each subscale (-3, -2, -1, +1, +2, +3) and then summing these weighted scores.
|
Baseline and Post-Intervention: immediate; 6 months, and 12 months
|
Index of Readiness
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
This measures participants' readiness to engage in physical activity on a regular basis.
Total scores range from 0 to 9 with higher scores showing more readiness.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Self-Efficacy for Exercise Scale
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
This measures the confidence to engage in exercise at least 3 times per week in the face of common barriers.
Total scores will be calculated based on the sum scores for all items, ranging from 0 to 90, with higher scores showing higher confidence.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Index of Self-Regulation
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
This assesses re-conditioning, stimulus control and behavioral outcome monitoring related to exercise and physical activity.
Total scores will be calculated based on the sum of all items, and range from 0 to 45, with higher scores showing greater self regulation.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Chronic Illnesses Resources Survey
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months.
|
This survey assesses the extent to which a person uses multi-level resources to stay active.
Scores will be based on mean scores across all items, which range from 0 to 5, and across sub-scale items addressing resources that are personal, in the neighborhood, organizational, and in the media (all ranging from 0 to 5) with higher mean scores indicating greater influence of resources.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months.
|
Short Physical Performance Battery (SPPB)
Time Frame: Baseline, and Post-Intervention: immediate, 6 months, and 12 months
|
The SPPB is an assessment of functional strength and balance.
Total range 0-12, with higher value representing better functional strength and balance.
d)Subscales of Balance, Gait, and sit to stand all range from 0 to 4, with higher values representing more functional strength and balance.
Total SPPB score ranges from 0 to 12 with higher numbers indicating better functional balance and strength
|
Baseline, and Post-Intervention: immediate, 6 months, and 12 months
|
Life Space Assessment
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months.
|
This survey assesses the extent to which a person moves and is mobile in their home, outside their home, in their neighborhood, in their city and outside their city.
It is scored by assigning a value to each of the 5 levels and then summing the 5 scores.
The level scores are obtained by multiplying the level number (1-5) by a value for independence (2:"no assistance," 1.5:"use of equipment only," 1:"use of another person and/or equipment") times a value for frequency of movement (1:less than once a week, 2:1-3 times each week, 3: 4 - 6 times each week, and 4: daily) (Fig. 2).
The instrument scores range from 0 ("totally bed-bound") to 120 ("traveled out of town every day without assistance").
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months.
|
Modified Group Cohesion Questionnaire
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months.
|
This questionnaire assesses the extent to which a person believes their physical activity group.
In particular, these constructs are assessed: -attractions to the group-social; attractions to the group-task; group integration-social; group integration task.
Mean scores for each construct will be calculated, which range from 0 to 9, with higher scores indicating greater cohesion.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months.
|
Brief Pain Inventory
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Location and intensity of pain, as well as the extent to which interferes with daily physical, social and emotional function.
Pain severity score is calculated by summing items 2-5 and then dividing by 4, with higher scores indicating more pain.
Pain interference scores are obtained by summing items 8a, b, c, d, f, g and then dividing those totals by 7, with scores, indicating that pain confers more interference with function.
|
Baseline and Post-Intervention: immediate, 6 months, and 12 months
|
Fall risk inducing medications
Time Frame: Baseline and Post-Intervention: immediate, 6 months, and
|
Measured through medication inventory and classification of fall risk inducing medications.
|
Baseline and Post-Intervention: immediate, 6 months, and
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Siobhan K McMahon, PhD, University of Minnesota
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 1607S90922
- 1R01NR016705-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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