A Multilevel Physical Activity Intervention Among Chinese Rural Older Adults (Stay Active While Aging): A Study Protocol for a Clustered Randomized Controlled Trial

Li, Nanyan; Wang, Yufei; Deng, Qian; Hu, Julinling; Zhou, Jiming

doi:10.3389/fpubh.2022.760457

Cited by 3 publications

(5 citation statements)

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“…The study protocol has been published previously. 14 The study received approval from the Sichuan University Medical Ethical Review Board (K2019073).…”

Section: Methodsmentioning

confidence: 99%

“…We used data from the Stay Active While Aging (SAWA) study, which was a cluster randomized trial of PA intervention conducted in China. The study protocol has been published previously 14 . The study received approval from the Sichuan University Medical Ethical Review Board (K2019073).…”

Section: Methodsmentioning

confidence: 99%

“…The intervention group received an 8‐week multilevel PA intervention previously described in detail, 14 while the control did not. The intervention strategies based on the socio‐ecological model have been condensed into three levels: individual, interpersonal, and community 16 .…”

Section: Methodsmentioning

confidence: 99%

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Effect of physical activity intervention on cognitive function in China: A cluster randomized trial

Deng

Yang

et al. 2023

Alzheimer's & Dementia

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INTRODUCTIONCurrent randomized trial evidence on the effect of physical activity (PA) intervention on cognitive function is scarce and mainly found in well‐educated populations, limiting its generalizability. Furthermore, the modification effect of education levels remains understudied. We conducted a cluster randomized trial to evaluate the effects of PA intervention on cognitive function in a general older population, and whether education modifies such effects.METHODSEight villages were randomized to the intervention (four villages, n = 240) or the control (four villages, n = 271). The intervention group received an 8‐week multilevel PA intervention based on a socio‐ecological model, while the control did not. The intervention has been condensed to three levels with activities occurring at the individual (telephone counseling, printed material, and training sessions), interpersonal (peer group), and community levels (group sharing and coaching). The primary outcome was changes in global cognition (overall cognitive function) measured by the Telephone Interview for Cognitive Status (TICS‐10) at 12‐month follow‐up. Repeated measurements were modeled using the linear mixed model, which assumed that the missing values were missing at random.RESULTSThe mean age was 70.94 years (standard deviation 5.71) and 55.6% were women. Compared to the control, the orientation improved from baseline at 12‐month follow‐up (0.24 points [95% confidence interval (CI), 0.03 to 0.46 points; P = 0.03]). Stratified analysis showed that the global cognition and orientation improved at 12‐month follow‐up among illiterate participants in the intervention (for global cognition, mean difference, 0.57 points [95% CI, 0.03 to 1.10], P = 0.04; for orientation, mean difference, 0.31 points [95% CI, 0.04 to 0.58], P = 0.03).DISCUSSIONThese results confirm the improvements in orientation in older adults, as well as in global cognition and orientation in the illiterate at 12‐month follow‐up.

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“…The study protocol has been published previously. 14 The study received approval from the Sichuan University Medical Ethical Review Board (K2019073).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Effect of physical activity intervention on cognitive function in China: A cluster randomized trial

Deng

Yang

et al. 2023

Alzheimer's & Dementia

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“…The second step adjusted the clustering effect. The sample size of 378 for the total was inflated by the design effect calculated previously . Assuming a 20% attrition rate, the final estimated sample size was 454 participants for 2 groups.…”

Section: Methodsmentioning

confidence: 99%

“…Written or thumbprint informed consent was obtained from each participant before study commencement. The study protocol has been published previously 9 and was approved by the Sichuan University Medical Ethical Review Board. This study followed the Consolidated Standards of Reporting Trials ( CONSORT ) reporting guideline.…”

Section: Methodsmentioning

confidence: 99%

Physical Activity Intervention for Leisure-Time Activity Levels Among Older Adults

Li,

Ye,

Deng

et al. 2023

JAMA Netw Open

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ImportanceCurrent randomized trial evidence of the effects of physical activity interventions in older adults is mainly from developed countries, with little reliable evidence from low- and middle-income countries, such as China, where race, culture, and lifestyles differ substantially from those in Western populations.ObjectiveTo evaluate the effects of a multilevel intervention for increasing leisure-time activity levels in Chinese older adults.Design, Setting, and ParticipantsThis cluster randomized trial was conducted from May 2021 to May 2023, including an 8-week intervention period and a follow-up period of 24 months. Eight villages in China were randomly assigned to the intervention (4 villages) or the control (4 villages) group. Potentially eligible participants were 60 years or older. A total of 511 older adults from the selected 8 villages were enrolled.InterventionsThe intervention group received an 8-week socioecological model–based intervention, comprising individual, interpersonal, and community-level components, whereas the control group did not.Main Outcome and MeasureThe primary outcome was the change in leisure-time activity at 8 weeks, measured by the Physical Activity Scale for the Elderly (PASE). Possible PASE scores for leisure-time activity range from 0 to 502, with higher scores indicating higher activity levels.ResultsA total of 511 older adults from 8 villages were recruited and randomly allocated to the intervention (240 participants, 4 villages) or control (271 participants, 4 villages) groups. The mean (SD) age was 70.95 (5.72) years, and 284 (55.6%) were female participants. Seven serious adverse events (unrelated deaths) were reported. Participants in the intervention group increased leisure-time activity more than those in the control group, with a mean difference in PASE scores of 13.74 points (95% CI, 8.58-18.91 points) between the groups at 8 weeks (P &lt; .001). Significant differences in leisure-time activity were also found over 24 months (mean difference in scores at 4 weeks, 11.66 points; 95% CI, 6.41-16.90 points; P &lt; .001; at 6 months, 12.35 points; 95% CI, 7.19-17.50 points; P &lt; .001; at 12 months, 11.55 points; 95% CI, 6.32-16.78 points; P &lt; .001; and at 24 months, 14.51 points; 95% CI, 9.28-19.75 points; P &lt; .001).Conclusions and RelevanceIn this cluster randomized trial, the multilevel intervention was effective in promoting leisure-time activity over 24 months of follow-up in older adults from China. This finding suggests that implementation of such interventions could be an important step in addressing physical inactivity in older adults in low- and middle-income countries.Trial RegistrationChinese Clinical Trial Registry Identifier: ChiCTR2100045653

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Longer-term effect of physical activity intervention on sleep quality: a secondary analysis of cluster randomized controlled trial

Li,

Ye,

Liu

et al. 2024

Sleep

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Abstracts Study Objectives To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers. Methods This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months. Results The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point. Conclusion The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.

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A Multilevel Physical Activity Intervention Among Chinese Rural Older Adults (Stay Active While Aging): A Study Protocol for a Clustered Randomized Controlled Trial

Cited by 3 publications

References 45 publications

Effect of physical activity intervention on cognitive function in China: A cluster randomized trial

Effect of physical activity intervention on cognitive function in China: A cluster randomized trial

Physical Activity Intervention for Leisure-Time Activity Levels Among Older Adults

Longer-term effect of physical activity intervention on sleep quality: a secondary analysis of cluster randomized controlled trial

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