TY - JOUR AU - Coley, Nicola AU - Andre, Laurine AU - hoevenar - blom, Marieke P AU - Ngandu, Tiia AU - Beishuizen, Cathrien AU - Barbera, Mariagnese AU - van Wanrooij, Lennard AU - Kivipelto, Miia AU - Soininen, Hilkka AU - van Gool, Willem AU - Brayne, Carol AU - Moll van Charante, Eric AU - Richard, Edo AU - Andrieu，Sandrine PY - 2022 DA - 2022/5/9 TI -预测老年人参与教练支持的电子健康干预促进生活方式改变的因素以及参与与心血管和痴呆风险变化之间的关系:一个18个月的跨国随机对照试验的二次分析JO - J Med Internet Res SP - e32006 VL - 24 IS - 5kw -老龄化KW - eHealth KW -差异KW -参与KW -预防KW -心血管KW -生活方式KW -危险因素AB -背景:数字卫生干预措施可能有助于预防与年龄有关的疾病，但目前尚不清楚老年人如何参与此类干预措施，特别是长期参与，也不清楚参与是否与该人群临床、行为或生物学结果的变化有关。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。目的:本研究旨在描述老年人对电子健康干预的参与程度，确定参与程度的相关因素，并研究参与程度与心血管和痴呆风险因素(血压、胆固醇、BMI、体育活动、饮食以及心血管和痴呆风险评分)变化之间的关系。方法:这是一项为期18个月的随机对照“老年人通过互联网咨询健康老龄化”试验的二次分析，该试验采用定制的基于互联网的干预措施，鼓励行为改变，并得到生活方式教练的远程支持，以降低荷兰、芬兰和法国线下招募的2724名年龄≥65岁的个体的心血管和认知能力下降风险。参与程度通过登录频率、设定的生活方式目标数量、输入的测量值和发送给教练的信息，以及阅读教育材料的百分比来评估。在基线期和18个月时，在亲自访问期间收集临床和生物学数据。生活方式数据是在一个基于网络的平台上自我报告的。 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. SN - 1438-8871 UR - //www.mybigtv.com/2022/5/e32006 UR - https://doi.org/10.2196/32006 UR - http://www.ncbi.nlm.nih.gov/pubmed/35385395 DO - 10.2196/32006 ID - info:doi/10.2196/32006 ER -