Suchergebnisse

Purpose Identify the effects of engagement with different intervention delivery channels on physical activity (PA), and the participant subgroups engaging with the different channels, among Women's Health Initiative Strong and Healthy ( WHISH) PA trial participants. Design Secondary analysis of data from WHISH, a pragmatic trial that used passive randomized consent. Setting United States (remote intervention in all 50 states). Sample 18,080 U.S. women, aged 68-99 years, assigned to the WHISH PA intervention arm. Measures 6 dichotomous variables operationalized engagement: Engagement with Targeted Inserts, Email (opened), Email (clicked links), Website (logging in), Website (tracking), Interactive Voice Response (IVR). PA was measured using the CHAMPS PA questionnaire. Analysis Linear regressions evaluated effects of engagement on PA. Conditional Inference Trees identified subgroups of participants engaging with different channels based on demographic and psychosocial variables. Results Engagement with each channel, except IVR, was associated with significantly more hours/week of PA (square root coefficients .29 - .13, P values <.001). Consistently across channels, features that identified subgroups of participants with higher engagement included younger age, and higher levels of PA and physical function. Subgroups with the highest engagement differed from those with the lowest in most participant characteristics. Conclusions For equitable population-level impact via large-scale remotely-delivered PA programs, it may be necessary to identify strategies to engage and target harder to reach subgroups more precisely. Clinical Trial Registration The WHISH trial is registered at ClinicalTrials.gov (No. NCT02425345).

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journals of Gerontology Series a-Biological Sciences and Medical Sciences following peer review. The definitive publisher-authenticated version Laddu, D., Parimi, N., Cauley, J. A., Cawthon, P. M., Ensrud, K. E., Orwoll, E., . . . Osteoporotic Fractures Men Mr, O. S. (2018). The Association Between Trajectories of Physical Activity and All-Cause and Cause-Specific Mortality. Journals of Gerontology Series a-Biological Sciences and Medical Sciences, 73(12), 1708-1713. doi:10.1093/gerona/gly037 is available online at: indigo.uic.edu. ; Background: The benefits of physical activity (PA) for health have primarily been evaluated during midlife. Whether patterns of change in late-life PA associate with overall and cause-specific mortality remains unclear. Methods: We examined the association between PA trajectories and subsequent mortality among 3,767 men aged ≥ 65 years. Men self-reported PA using the Physical Activity Scale for the Elderly scale (PASE) at up to 4 time points from 2000 through 2009 (Year 7); mortality was assessed over an average of 7.1 years after the Year 7 contact. Group-based trajectory modeling identified patterns of PA change. Cox proportional hazards models described associations between patterns of change in PA, Year 7 PA, and subsequent mortality risk. Results: Three discrete PA patterns were identified, all with declining PA. Compared to low-activity declining men, moderate (HR = 0.78; 95% CI: 0.70, 0.88) and high-activity (HR = 0.69, 95% CI: 0.57, 0.83) declining groups were associated with lower risk of all-cause mortality. Among models with a single time-point, the last time point (Year 7 PA score) was a strong predictor of mortality with HR = 0.85 (95% CI: 0.78, 0.93) per SD increase in PASE score. PA patterns were not a risk factor for mortality after adjustment for the Year 7 PA score. Conclusions: Recent PA levels are a stronger indicator of subsequent mortality risk than PA patterns reported over the prior 7 years or prior PA level, suggesting that current PA rather than history of PA is the most relevant parameter in clinical settings. ; The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA); the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); the National Center for Advancing Translational Sciences (NCATS); and NIH Roadmap for Medical Research (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128). This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.