Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 2, 2022
Date Accepted: May 24, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and Implementation of a Peer-Led Diet and Exercise Intervention in Older Urban Dwelling Veterans with Dysmobility
ABSTRACT
Background:
The majority of older Veterans do not meet the minimum healthy diet or physical activity recommendations, despite known benefits. Identifying ways to increase adherence to programs that improve dietary quality and physical activity may reduce the risk of disability in older Veterans. Peer-based interventions may be one method to facilitate lasting behavioral change since peers often share a common culture and knowledge about the problems their community experiences.
Objective:
This study will develop, pilot, and evaluate a theory-driven 12-week peer-led nutrition and exercise intervention that targets older Veterans with dysmobility and assess its feasibility in two diverse urban areas with underrepresented populations.
Methods:
Community dwelling Veterans age 65+ years with self-reported dysmobility (defined as difficulty in at least one of the following: walking quickly across a street, walking one mile, ascending one flight of stairs, rising from a chair without the use of arms, or a fear of falling) from two VA Geriatric Research, Education, and Clinic Centers (Baltimore, MD and San Antonio, TX) will be eligible to participate. First, this study will use validated mixed methods via online surveys (N=50/site), to assess potential physical, social/environmental, and behavioral/lifestyle barriers that affect physical activity and dietary quality (Phase 1). Next, we will use the knowledge gained from these assessments and via feedback from a focus group (N=10/site) to adapt established VA diet and exercise program materials to develop peer-led intervention materials and train peer leaders (N=3/site). Finally, we will determine the feasibility and acceptability of the intervention, to assess reach (recruitment, retention), adoption (satisfaction, perceived utility, attendance, engagement) and implementation (fidelity of intervention); as well as the estimated magnitude and potential impact on selected outcomes (i.e., diet quality and mobility) in 20 older Veterans with dysmobility (N=10/site).
Results:
The study was funded on January 1, 2022, with a projected data collection period of June 1, 2022, through December 31, 2023.
Conclusions:
This study offers an innovative approach to identify strategies that increase long-term adherence to lifestyle modification programs that improve dietary quality and physical activity in older Veterans with dysmobility. Clinical Trial: ClinicalTrials.gov NCT04994938; https://clinicaltrials.gov/ct2/show/NCT04994938
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