Developing a Intervention to Enhance Motivation for Physical Activities Known to Reduce Fall Risk

Study Overview
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Brief Summary
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The purpose of this pilot study is to develop an intervention, based on empirical evidence and health-related behavioral change theory, to enhance motivation for engaging in fall-reducing physical activities.

Detailed Description
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The intervention being developed, Ready Steady, combines 3 components; a) interpersonal motivation, b) intrapersonal motivation, and c) physical activity. Theoretical concepts from the wellness motivation theory are (a) translated into intervention strategies; and (b) operationalized as variables to form a basis for evaluating this intervention. The overall objective is to advance the development of Ready Steady by assessing the impact of its motivation components.

Official Title
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Enhancing Motivation for Physical Activity to Reduce the Risk of Falls Among Community-Dwelling Older Adults: A Wellness Intervention.

Conditions
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Accidental Falls, Sedentary Lifestyle

Intervention / Treatment
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* Behavioral: 1 Physical Activity
* Behavioral: Interpersonal Motivation
* Behavioral: Intrapersonal Motivation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥ 70 years, level of physical activity (strength training and aerobic) below national recommendations Exclusion Criteria: Dementia, recent injury or surgery, unable to participate in light-moderately intense exercise

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: 1 Physical Activity<br>Small groups (4-7 people) meeting in community centers weekly for 90 minutes, over the course of 8 weeks. Curricula for meetings are manualized and include introducing and practicing Otago exercises, progressed according to individual capacity and preference, as well as falls prevention. All participant receive Fitbit Ones and are asked to use them on a daily basis. | Behavioral: 1 Physical Activity<br>* Fall reducing strength (5), balance (12) and flexibility (4) exercises as well as walking. Participants were also given a Fitbit One with instructions on how to use<br>* Other names: Otago;|
| Experimental: 2 Interpersonal Motivation<br>Small groups (4-7 people) meeting in community centers weekly for 90 minutes, over the course of 8 weeks. Curricula for meetings are manualized and include introducing and practicing Otago exercises, progressed according to individual capacity and preference, as well as falls prevention. The interventionist also facilitates discussions addressing the interpersonal motivational intervention content. All participant receive Fitbit Ones and are asked to use them on a daily basis: Fitbit Ones are included in weekly discussions. | Behavioral: 1 Physical Activity<br>* Fall reducing strength (5), balance (12) and flexibility (4) exercises as well as walking. Participants were also given a Fitbit One with instructions on how to use<br>* Other names: Otago;Behavioral: Interpersonal Motivation<br>* Strategies used to support Interpersonal motivational targets include: a) discuss and model ways to provide and receive more support for physical activity, b) identify environmental barriers to being physically active, c) problem-solve environmental and social barriers to being physically active, d) use and create new resources that support physical activity behavior<br>|
| Experimental: 3.Intrapersonal Motivation<br>Small groups (4-7 people) meeting in community centers weekly for 90 minutes, over the course of 8 weeks. Curricula for meetings are manualized and include introducing and practicing Otago exercises, progressed according to individual capacity and preference, as well as falls prevention. The interventionist also facilitates discussions addressing the intrapersonal motivational intervention content. All participant receive Fitbit Ones and are asked to use them on a daily basis: Fitbit Ones are included in weekly discussions. | Behavioral: 1 Physical Activity<br>* Fall reducing strength (5), balance (12) and flexibility (4) exercises as well as walking. Participants were also given a Fitbit One with instructions on how to use<br>* Other names: Otago;Behavioral: Intrapersonal Motivation<br>* Strategies used to support intrapersonal motivation included a) use of the goal attainment scale, b) facilitating the formation of action plans, c) identify and problem solve personal barriers to being active, d) identify satisfying aspects of being active, e) self-evaluate physical activity patterns and progress.<br>|
| Experimental: 4.Full Intervention<br>Small groups (4-7 people) meeting in community centers weekly for 90 minutes, over the course of 8 weeks. Curricula for meetings are manualized and include introducing and practicing Otago exercises, progressed according to individual capacity and preference, as well as falls prevention. The interventionist also facilitates discussions addressing the intrapersonal and interpersonal motivational intervention content. All participant receive Fitbit Ones and are asked to use them on a daily basis: Fitbit Ones are included in weekly discussions. | Behavioral: 1 Physical Activity<br>* Fall reducing strength (5), balance (12) and flexibility (4) exercises as well as walking. Participants were also given a Fitbit One with instructions on how to use<br>* Other names: Otago;Behavioral: Interpersonal Motivation<br>* Strategies used to support Interpersonal motivational targets include: a) discuss and model ways to provide and receive more support for physical activity, b) identify environmental barriers to being physically active, c) problem-solve environmental and social barriers to being physically active, d) use and create new resources that support physical activity behavior<br>Behavioral: Intrapersonal Motivation<br>* Strategies used to support intrapersonal motivation included a) use of the goal attainment scale, b) facilitating the formation of action plans, c) identify and problem solve personal barriers to being active, d) identify satisfying aspects of being active, e) self-evaluate physical activity patterns and progress.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in self-reported physical activity behavior | Community Healthy Activities Model Program for Seniors (CHAMPS) Questionnaire | Baseline; 1 week post; 6 months post | 
| Change in objectively measured physical activity behavior | Accelerometers built in to Fitbit Ones | Baseline; 1 week post; 6 months post | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in functional strength and balance | Short Physical Performance Battery | Baseline; 1 week post; 6 months post | 
| Change in functional strength and balance | Timed Up and Go | Baseline; 1 week post; 6 months post | 
| Change in the number of community resources used for physical activity | Number of community resources identified and used: 2 item survey | Baseline; 1 week post; 6 months post | 
| Change in social support for fall-reducing physical activities | Social support for exercise: Survey | Baseline; 1 week post; 6 months post | 
| Change in readiness | Index of Readiness | Baseline; 1 week post; 6 months post | 
| Change in self-regulation | Index of Self-Regulation | Baseline; 1 week post; 6 months post | 
| Change in self-reported lower extremity function | Neuro-QOL SF v1.0 - LEx Fnct (Mobility) | Baseline; 1 week post; 6 months post | 
| Change in self-reported ability to participate in social activities | PROMIS SF v2.0 - Ability to Participate Social 4a | Baseline; 1 week post; 6 months post |