@文章{信息:doi/10.2196/32006，作者=“Coley, Nicola和Andre, Laurine和hoevenar - blom, Marieke P和Ngandu, Tiia和Beishuizen, Cathrien和Barbera, Mariagnese和van Wanrooij, Lennard和Kivipelto, Miia和Soininen, Hilkka和van Gool, Willem和Brayne, Carol和Moll van Charante, Eric和Richard, Edo和Andrieu, Sandrine”，标题=“使用教练支持的电子健康干预促进生活方式改变的老年人参与的因素以及参与与心血管和痴呆风险变化之间的关系:18个月跨国随机控制试验的二次分析”，期刊=“J Med Internet Res”，年=“2022”，月=“5”，日=“9”，量=“24”，数=“5”，页=“e32006”，关键词=“衰老;电子健康;差距;参与;预防;心血管疾病;生活方式;背景:数字健康干预可能有助于预防与年龄相关的疾病，但对于老年人如何参与此类干预，特别是在长期内，以及参与是否与该人群临床、行为或生物学结果的变化相关，我们知之甚少。老年人对数字卫生干预措施的参与程度可能存在差异，并与健康不平等有关。 Objective: This study aimed to describe older adults' engagement with an eHealth intervention, identify factors associated with engagement, and examine associations between engagement and changes in cardiovascular and dementia risk factors (blood pressure, cholesterol, BMI, physical activity, diet, and cardiovascular and dementia risk scores). Methods: This was a secondary analysis of the 18-month randomized controlled Healthy Ageing Through Internet Counselling in the Elderly trial of a tailored internet-based intervention encouraging behavior changes, with remote support from a lifestyle coach, to reduce cardiovascular and cognitive decline risk in 2724 individuals aged ≥65 years, recruited offline in the Netherlands, Finland, and France. Engagement was assessed via log-in frequency, number of lifestyle goals set, measurements entered and messages sent to coaches, and percentage of education materials read. Clinical and biological data were collected during in-person visits at baseline and 18 months. Lifestyle data were self-reported on a web-based platform. Results: Of the 1389 intervention group participants, 1194 (85.96{\%}) sent at least one message. They logged in a median of 29 times, and set a median of 1 goal. Higher engagement was associated with significantly greater improvement in biological and behavioral risk factors, with evidence of a dose-response effect. Compared with the control group, the adjusted mean difference (95{\%} CI) in 18-month change in the primary outcome, a composite z-score comprising blood pressure, BMI, and cholesterol, was −0.08 (−0.12 to −0.03), −0.04 (−0.08 to 0.00), and 0.00 (−0.08 to 0.08) in the high, moderate, and low engagement groups, respectively. Low engagers showed no improvement in any outcome measures compared with the control group. Participants not using a computer regularly before the study engaged much less with the intervention than those using a computer up to 7 (adjusted odds ratio 5.39, 95{\%} CI 2.66-10.95) or ≥7 hours per week (adjusted odds ratio 6.58, 95{\%} CI 3.21-13.49). Those already working on or with short-term plans for lifestyle improvement at baseline, and with better cognition, engaged more. Conclusions: Greater engagement with an eHealth lifestyle intervention was associated with greater improvement in risk factors in older adults. However, those with limited computer experience, who tended to have a lower level of education, or who had poorer cognition engaged less. Additional support or forms of intervention delivery for such individuals could help minimize potential health inequalities associated with the use of digital health interventions in older people. ", issn="1438-8871", doi="10.2196/32006", url="//www.mybigtv.com/2022/5/e32006", url="https://doi.org/10.2196/32006", url="http://www.ncbi.nlm.nih.gov/pubmed/35385395" }