Multilevel Intervention for Physical Activity in Retirement Communities (MIPARC)

University of California San Diego

Status: Completed

Conditions: Sedentary; Physical Activity; Quality of Life; Physical Functioning; Blood Pressure

Treatments: Behavioral: Physical Activity; Behavioral: Pedometer; Behavioral: Tailored environmental resources; Behavioral: Support; Behavioral: Group educational sessions; Behavioral: Phone counseling call; Behavioral: Peer Mentoring; Behavioral: Health check phone call; Behavioral: Policy Change

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01155011

3134795

1R01HL098425 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this study was to assess whether a 6-month multilevel physical activity intervention can significantly increase physical activity levels in sedentary adults, 65 and older, living in Continuing Care Retirement Communities (CCRCs).

Sedentary residents (N=307) in 11 CCRCs received the multilevel MIPARC intervention or a control health education program for 6 months. A group randomized control design was employed with site as the unit of randomization. The intervention was delivered through group sessions, phone calls, printed materials, tailored signage and mapping and targeted peer led advocacy efforts.

Full description

Objective monitoring of physical activity suggests that fewer than 3% of adults over age 60 meet current physical activity guidelines. Ecological models posit that behavioral interventions are most effective when they operate on multiple levels. The MIPARC study intervenes on four levels: individual (pedometer-based self monitoring, educational materials and monthly counseling calls), interpersonal (monthly group sessions and peer mentoring), environment (walking signage prompts, tailored walking maps, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for change and peer led advocacy)to increase the activity levels of residents. The study promotes walking as the primary means to increase light to moderate PA, with a secondary focus on strength and flexibility and decreased sedentary behavior.

As most Continuing Care Retirement Communities have management structures that provide the opportunity to improve the social and built environments for physical activity and walking, this study also aims to train participants on how to advocate for improvements in the environment that would improve walkability.

Enrollment: 307 patients

Sex: All

Ages: 65+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Over the age of 65
• Able to walk 20 meters independently (without human assistance, can use cane/walker)
• Able to speak and read in English
• No cognitive, vision or hearing impairments that would prevent provision of informed consent, comprehension of instructions, completion of surveys and participation in phone conversations
• Able to complete the Timed Up and Go Test to assess falls risk within 30 seconds
• Live within the selected retirement community (facility-dwelling) Able to hold brief conversation over the telephone.
• Will be in San Diego for the duration of the study
• Provision of consent to participate
• Willing to wear a pedometer, accelerometer and GPS device
• Willing to complete all surveys and attend weekly meetings
• No history of falls in previous that resulted in an injury or hospitalization in the past 12 months
• Physician clearance to participate

Exclusion criteria

• Inability to give informed, voluntary consent
• Inability to complete assessments
• Lack of written physician consent to participate in unsupervised light-to-moderate intensity walking
• Inability to speak and read English

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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307 participants in 2 patient groups

MIPARC intervention

Experimental group

Description:

Eleven Continuing Care Retirement Communities were randomized to either the MIPARC intervention or an attention-control condition. The intervention focused on increasing light to moderate PA. The MIPARC study intervenes on four levels: individual (pedometer self monitoring, educational materials and monthly counseling calls, support), interpersonal (monthly group educational sessions and peer mentoring), environment (walking signage prompts, tailored environmental resources, step counts)and policies (review of on-site activity opportunities and walkability, recommendations for policy change and peer led advocacy)to increase the activity levels of residents. For the first 3 months, intervention participants will engage in either a group educational session, phone counseling call, or a peer led session, on a rotating basis.

Treatment:

Behavioral: Group educational sessions

Behavioral: Policy Change

Behavioral: Support

Behavioral: Group educational sessions

Behavioral: Phone counseling call

Behavioral: Physical Activity

Behavioral: Peer Mentoring

Behavioral: Tailored environmental resources

Health Education Control

Active Comparator group

Description:

The control group received an active health education intervention. The education curriculum will involve both lectures and mailed materials. The lectures were delivered to match the MIPARC intervention schedule. Sessions included information on general health and healthy aging. Physical activity was not discussed in these sessions but participants received information on the benefits of PA. Control participants also received health check phone calls to match the individual attention paid to participants in the MIPARC intervention sites.

Treatment:

Behavioral: Group educational sessions

Behavioral: Pedometer

Behavioral: Health check phone call

Behavioral: Group educational sessions