Cargando…

Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial

BACKGROUND: The lack of health care coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially among low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high p...

Descripción completa

Detalles Bibliográficos
Autores principales: Thiamwong, Ladda, Xie, Rui, Park, Joon-Hyuk, Lighthall, Nichole, Loerzel, Victoria, Stout, Jeffrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582821/
https://www.ncbi.nlm.nih.gov/pubmed/37788049
http://dx.doi.org/10.2196/51899
_version_ 1785122418842402816
author Thiamwong, Ladda
Xie, Rui
Park, Joon-Hyuk
Lighthall, Nichole
Loerzel, Victoria
Stout, Jeffrey
author_facet Thiamwong, Ladda
Xie, Rui
Park, Joon-Hyuk
Lighthall, Nichole
Loerzel, Victoria
Stout, Jeffrey
author_sort Thiamwong, Ladda
collection PubMed
description BACKGROUND: The lack of health care coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially among low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high perceived barrier to care. Existing fall prevention intervention technologies do not enable participants and practitioners to interact and collaborate, even with technologies that bring viable strategies to maintain independence, prevent disability, and increase access to quality care. Research is also limited on the use of technology to enhance motivation and help individuals align their perception with physiological fall risk. We developed a novel, 8-week Physio-Feedback Exercise Program (PEER), which includes (1) technology-based physio-feedback using a real-time portable innovative technology—the BTrackS Balance Tracking System, which is reliable and affordable, allows for home testing, and provides feedback and tracks balance progression; (2) cognitive reframing using the fall risk appraisal matrix; and (3) peer-led exercises focusing on balance, strength training, and incorporating exercises into daily activities. OBJECTIVE: This study consists of 3 aims. Aim 1 is to examine the effects of the technology-based PEER intervention on fall risk, dynamic balance, and accelerometer-based physical activity (PA). Aim 2 is to examine the effects of the PEER intervention on fall risk appraisal shifting and negative self-perceptions of aging. Aim 3 is to explore participants’ experiences with the PEER intervention and potential barriers to accessing and adopting the technology-based PEER intervention to inform future research. METHODS: This is an intention-to-treat, single-blinded, parallel, 2-arm clustered randomized controlled trial study. We will collect data from 340 low-income older adults at baseline (T1) and measure outcomes after program completion (T2) and follow-up at 3 months (T3) and 6 months (T4). Participants will be enrolled if they meet all the following inclusion criteria: aged ≥60 years, cognitively intact, and able to stand without assistance. Exclusion criteria were as follows: a medical condition precluding exercise or PA, currently receiving treatment from a rehabilitation facility, plan to move within 1 year, hospitalized >3 times in the past 12 months, and does not speak English or Spanish. RESULTS: As of August 2023, the enrollment of participants is ongoing. CONCLUSIONS: This study addresses the public health problem by optimizing a customized, technology-driven approach that can operate in low-resource environments with unlimited users to prevent falls and reduce health disparities in low-income older adults. The PEER is a novel intervention that combines concepts of physio-feedback, cognitive reframing, and peer-led exercise by motivating a shift in self-estimation of fall risk to align with physiological fall risk to improve balance, PA, and negative aging self-perception. TRIAL REGISTRATION: ClinicalTrials.gov NCT05778604; https://www.clinicaltrials.gov/ct2/show/study/NCT05778604 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51899
format Online
Article
Text
id pubmed-10582821
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher JMIR Publications
record_format MEDLINE/PubMed
spelling pubmed-105828212023-10-19 Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial Thiamwong, Ladda Xie, Rui Park, Joon-Hyuk Lighthall, Nichole Loerzel, Victoria Stout, Jeffrey JMIR Res Protoc Protocol BACKGROUND: The lack of health care coverage, low education, low motivation, and inconvenience remain barriers to participating in fall prevention programs, especially among low-income older adults. Low-income status also contributes to negative aging self-perceptions and is associated with a high perceived barrier to care. Existing fall prevention intervention technologies do not enable participants and practitioners to interact and collaborate, even with technologies that bring viable strategies to maintain independence, prevent disability, and increase access to quality care. Research is also limited on the use of technology to enhance motivation and help individuals align their perception with physiological fall risk. We developed a novel, 8-week Physio-Feedback Exercise Program (PEER), which includes (1) technology-based physio-feedback using a real-time portable innovative technology—the BTrackS Balance Tracking System, which is reliable and affordable, allows for home testing, and provides feedback and tracks balance progression; (2) cognitive reframing using the fall risk appraisal matrix; and (3) peer-led exercises focusing on balance, strength training, and incorporating exercises into daily activities. OBJECTIVE: This study consists of 3 aims. Aim 1 is to examine the effects of the technology-based PEER intervention on fall risk, dynamic balance, and accelerometer-based physical activity (PA). Aim 2 is to examine the effects of the PEER intervention on fall risk appraisal shifting and negative self-perceptions of aging. Aim 3 is to explore participants’ experiences with the PEER intervention and potential barriers to accessing and adopting the technology-based PEER intervention to inform future research. METHODS: This is an intention-to-treat, single-blinded, parallel, 2-arm clustered randomized controlled trial study. We will collect data from 340 low-income older adults at baseline (T1) and measure outcomes after program completion (T2) and follow-up at 3 months (T3) and 6 months (T4). Participants will be enrolled if they meet all the following inclusion criteria: aged ≥60 years, cognitively intact, and able to stand without assistance. Exclusion criteria were as follows: a medical condition precluding exercise or PA, currently receiving treatment from a rehabilitation facility, plan to move within 1 year, hospitalized >3 times in the past 12 months, and does not speak English or Spanish. RESULTS: As of August 2023, the enrollment of participants is ongoing. CONCLUSIONS: This study addresses the public health problem by optimizing a customized, technology-driven approach that can operate in low-resource environments with unlimited users to prevent falls and reduce health disparities in low-income older adults. The PEER is a novel intervention that combines concepts of physio-feedback, cognitive reframing, and peer-led exercise by motivating a shift in self-estimation of fall risk to align with physiological fall risk to improve balance, PA, and negative aging self-perception. TRIAL REGISTRATION: ClinicalTrials.gov NCT05778604; https://www.clinicaltrials.gov/ct2/show/study/NCT05778604 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51899 JMIR Publications 2023-10-03 /pmc/articles/PMC10582821/ /pubmed/37788049 http://dx.doi.org/10.2196/51899 Text en ©Ladda Thiamwong, Rui Xie, Joon-Hyuk Park, Nichole Lighthall, Victoria Loerzel, Jeffrey Stout. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 03.10.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.
spellingShingle Protocol
Thiamwong, Ladda
Xie, Rui
Park, Joon-Hyuk
Lighthall, Nichole
Loerzel, Victoria
Stout, Jeffrey
Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial
title Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial
title_full Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial
title_fullStr Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial
title_full_unstemmed Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial
title_short Optimizing a Technology-Based Body and Mind Intervention to Prevent Falls and Reduce Health Disparities in Low-Income Populations: Protocol for a Clustered Randomized Controlled Trial
title_sort optimizing a technology-based body and mind intervention to prevent falls and reduce health disparities in low-income populations: protocol for a clustered randomized controlled trial
topic Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582821/
https://www.ncbi.nlm.nih.gov/pubmed/37788049
http://dx.doi.org/10.2196/51899
work_keys_str_mv AT thiamwongladda optimizingatechnologybasedbodyandmindinterventiontopreventfallsandreducehealthdisparitiesinlowincomepopulationsprotocolforaclusteredrandomizedcontrolledtrial
AT xierui optimizingatechnologybasedbodyandmindinterventiontopreventfallsandreducehealthdisparitiesinlowincomepopulationsprotocolforaclusteredrandomizedcontrolledtrial
AT parkjoonhyuk optimizingatechnologybasedbodyandmindinterventiontopreventfallsandreducehealthdisparitiesinlowincomepopulationsprotocolforaclusteredrandomizedcontrolledtrial
AT lighthallnichole optimizingatechnologybasedbodyandmindinterventiontopreventfallsandreducehealthdisparitiesinlowincomepopulationsprotocolforaclusteredrandomizedcontrolledtrial
AT loerzelvictoria optimizingatechnologybasedbodyandmindinterventiontopreventfallsandreducehealthdisparitiesinlowincomepopulationsprotocolforaclusteredrandomizedcontrolledtrial
AT stoutjeffrey optimizingatechnologybasedbodyandmindinterventiontopreventfallsandreducehealthdisparitiesinlowincomepopulationsprotocolforaclusteredrandomizedcontrolledtrial