Multilevel Intervention for Physical Activity in Retirement Communities (MIPARC)
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| ClinicalTrials.gov Identifier: NCT01155011 |
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Recruitment Status :
Completed
First Posted : July 1, 2010
Results First Posted : July 31, 2017
Last Update Posted : August 31, 2017
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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.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Physical Activity Blood Pressure Physical Functioning Quality of Life Sedentary | Behavioral: Physical Activity Behavioral: Group educational sessions Behavioral: Phone counseling call Behavioral: Peer Mentoring Behavioral: Policy Change Behavioral: Support Behavioral: Tailored environmental resources Behavioral: Health check phone call Behavioral: Pedometer | Not Applicable |
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.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 307 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Triple (Participant, Investigator, Outcomes Assessor) |
| Primary Purpose: | Prevention |
| Official Title: | MIPARC - Multilevel Intervention for Physical Activity in Retirement Communities |
| Study Start Date : | January 2011 |
| Actual Primary Completion Date : | July 2014 |
| Actual Study Completion Date : | July 2014 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: MIPARC intervention
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. |
Behavioral: Physical Activity
MIPARC will focus on 3 physical activity goals:
Behavioral: Group educational sessions Every three weeks, participants will be required to attend a group education session, where researchers will teach behavior change strategies and allow participants to share their experiences and offer support to each other. The group sessions will follow a common format including: a group exercise (e.g. quiz), group discussion of use of behavior change strategies (e.g. overcoming barriers), and will end with a behavior change strategy instruction and goal setting component. Behavioral: Phone counseling call To support a tailored intervention delivery, participants will receive 4 individual phone calls (in weeks 2, 5, 8, and 11) from a trained health counselor. The phone call will follow the following format:
Behavioral: Peer Mentoring Three peer mentors at each CCRC will be trained in intervention content and delivery, measurement support, and advocacy. The peer mentors will lead a group session once every three weeks for the 6 month intervention period and once a month for the following 6 months. The peer mentors will formulate their own ideas for these sessions but we will suggest they include group walks, group activities and trips to active locations, etc. The peers will help study staff to answer questions from participants and assist with study compliance and retention. They will also receive advocacy training from a non-profit advocacy organization to conduct walk audits of their CCRC and help mobilize participants to make changes to their community that will increase or improve the opportunities for physical activity. Behavioral: Policy Change In order to increase the sustainability of the project, MIPARC will focus on addressing on-site policies and neighborhood factors that are barriers to physical activity. Peers and staff will conduct site inspections to identify these barriers (e.g. lack of facilities, limited opening hours, unsafe sidewalks, etc.) which will be prioritized and presented to CCRC management and community officials. Behavioral: Support A binder of professionally prepared materials will be provided at the beginning of the intervention and are referred to by researchers in the group sessions and phone counseling calls. The materials provide important information to encourage knowledge, self efficacy and realistic expectations. Behavioral: Tailored environmental resources Participants will be provided with a set of printed materials relating to the residential and neighborhood environment of their CCRC. A list of step counts for key indoor routes will be provided as well as safe walking route maps for the site an local neighborhood. |
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Active Comparator: Health Education Control
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.
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Behavioral: Group educational sessions
Lectures will be delivered every three weeks to match the MIPARC intervention schedule. Sessions will include topics such as medications, foot care and nutrition. Physical activity will not e discussed in these sessions but participants will receive informational pamphlets on the benefits of physical activity. Behavioral: Health check phone call For the first 3 months, control participants will also receive a health check phone call to match the individual attention paid to participants in the MIPARC sites. Behavioral: Pedometer Participants will also keep the pedometer they wear during the baseline measurement week to satisfy any curiosity about the devices and the step entry criteria. They will be given instructions on its use but will not be taught the benefits of self-monitoring. |
- Daily Minutes of Physical Activity [ Time Frame: Baseline ]Measured by 7 day accelerometry with a 760 cpm cutpoint.
- Daily Minutes of Physical Activity [ Time Frame: 6 months ]Measured by 7 day accelerometry in adults, ≥65, with a 760 CPM cutpoint.
- Minutes of Light to Moderate Physical Activity [ Time Frame: 12 months ]Measured by 7 day accelerometry in adults, ≥65, using a 760 CPM cutpoint.
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| Ages Eligible for Study: | 65 Years and older (Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | Yes |
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
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01155011
| United States, California | |
| University of California, San Diego | |
| La Jolla, California, United States, 92093 | |
| Principal Investigator: | Jacqueline Kerr, PhD | University of California, San Diego |
Other Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Jacqueline Kerr, Assistant Professor, Department of Family and Preventive Medicine, University of California, San Diego |
| ClinicalTrials.gov Identifier: | NCT01155011 |
| Other Study ID Numbers: |
3134795 1R01HL098425 ( U.S. NIH Grant/Contract ) |
| First Posted: | July 1, 2010 Key Record Dates |
| Results First Posted: | July 31, 2017 |
| Last Update Posted: | August 31, 2017 |
| Last Verified: | August 2017 |
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Older adults physical activity sedentary retirement communities |
advocacy built environment peer mentoring walkability |