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Published in: Trials 1/2018

Open Access 01-12-2018 | Study protocol

A community-based physical activity intervention to prevent mobility-related disability for retired older people (REtirement in ACTion (REACT)): study protocol for a randomised controlled trial

Authors: Afroditi Stathi, Janet Withall, Colin J. Greaves, Janice L. Thompson, Gordon Taylor, Antonieta Medina-Lara, Colin Green, James Bilzon, Selena Gray, Heidi Johansen-Berg, Claire E. Sexton, Max J. Western, Jolanthe L. de Koning, Jessica C. Bollen, Sarah J. Moorlock, Naiara Demnitz, Poppy Seager, Jack M. Guralnik, W. Jack Rejeski, Ken R. Fox

Published in: Trials | Issue 1/2018

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Abstract

Background

The REtirement in ACTion (REACT) study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial (RCT) with an internal pilot phase. It aims to test the effectiveness and cost-effectiveness of a community, group-based physical activity intervention for reducing, or reversing, the progression of functional limitations in older people who are at high risk of mobility-related disability.

Methods/design

A sample of 768 sedentary, community-dwelling, older people aged 65 years and over with functional limitations, but who are still ambulatory (scores between 4 and 9 out of 12 in the Short Physical Performance Battery test (SPPB)) will be randomised to receive either the REACT intervention, delivered over a period of 12 months by trained facilitators, or a minimal control intervention. The REACT study incorporates comprehensive process and economic evaluation and a nested sub-study which will test the hypothesis that the REACT intervention will slow the rate of brain atrophy and of decline in cognitive function assessed using magnetic resonance imaging (MRI). Outcome data will be collected at baseline, 6, 12 and 24 months for the main study, with MRI sub-study data collected at baseline, 6 and 12 months.
The primary outcome analysis (SPPB score at 24 months) will be undertaken blinded to group allocation. Primary comparative analyses will be on an intention-to-treat (ITT) basis with due emphasis placed on confidence intervals.

Discussion

REACT represents the first large-scale, pragmatic, community-based trial in the UK to target the non-disabled but high-risk segment of the older population with an intervention to reduce mobility-related disability. A programme that can successfully engage this population in sufficient activity to improve strength, aerobic capacity, coordination and balance would have a major impact on sustaining health and independence.
REACT is also the first study of its kind to conduct a full economic and comprehensive process evaluation alongside the RCT. If effective and cost-effective, the REACT intervention has strong potential to be implemented widely in the UK and elsewhere.

Trial registration

ISRCTN, ID:ISRCTN45627165. Retrospectively registered on 13 June 2016.
Trial sponsor: University of Bath. Protocol Version 1.5.
Appendix
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Literature
1.
go back to reference Gale CR, Cooper C, Aihie SA. Prevalence of frailty and disability: findings from the English Longitudinal Study of Ageing. Age Ageing. 2015;44:162–5.CrossRefPubMed Gale CR, Cooper C, Aihie SA. Prevalence of frailty and disability: findings from the English Longitudinal Study of Ageing. Age Ageing. 2015;44:162–5.CrossRefPubMed
2.
go back to reference Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–62.CrossRefPubMed Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–62.CrossRefPubMed
4.
go back to reference Stathi A, Western M, de Koning J, Perkin O, Withall J. Implementing Physical Activity Programmes for Community-Dwelling Older People with Early Signs of Physical Frailty. In: Nyman S. et al. (eds) The Palgrave Handbook of Ageing and Physical Activity Promotion. Cham: Palgrave Macmillan; 2018. p. 401–422. Stathi A, Western M, de Koning J, Perkin O, Withall J. Implementing Physical Activity Programmes for Community-Dwelling Older People with Early Signs of Physical Frailty. In: Nyman S. et al. (eds) The Palgrave Handbook of Ageing and Physical Activity Promotion. Cham: Palgrave Macmillan; 2018. p. 401–422.
5.
go back to reference Cooper R, Kuh D, Cooper C, Gale CR, Lawlor DA, Matthews F, Hardy R, the FaHST. Objective measures of physical capability and subsequent health: a systematic review. Age Ageing. 2011;40:14–23.CrossRefPubMed Cooper R, Kuh D, Cooper C, Gale CR, Lawlor DA, Matthews F, Hardy R, the FaHST. Objective measures of physical capability and subsequent health: a systematic review. Age Ageing. 2011;40:14–23.CrossRefPubMed
6.
go back to reference Simmonds B, Fox K, Davis M, Ku P-W, Gray S, Hillsdon M, et al. Objectively Assessed Physical Activity and Subsequent Health Service Use of UK Adults Aged 70 and Over: A Four to Five Year Follow Up Study. PLoS ONE. 2014;9:5. Simmonds B, Fox K, Davis M, Ku P-W, Gray S, Hillsdon M, et al. Objectively Assessed Physical Activity and Subsequent Health Service Use of UK Adults Aged 70 and Over: A Four to Five Year Follow Up Study. PLoS ONE. 2014;9:5.
7.
go back to reference Giné-Garriga M, Roqué-Fíguls M, Coll-Planas L, Sitja-Rabert M, Salvà A. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95:753–69.CrossRefPubMed Giné-Garriga M, Roqué-Fíguls M, Coll-Planas L, Sitja-Rabert M, Salvà A. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95:753–69.CrossRefPubMed
8.
go back to reference Pahor M, Guralnik JM, Ambrosius WT, Blair S, Bonds DE, Church TS, Espeland MA, Fielding RA, Gill TM, Groessl EJ. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA. 2014;311:2387–96.CrossRefPubMedPubMedCentral Pahor M, Guralnik JM, Ambrosius WT, Blair S, Bonds DE, Church TS, Espeland MA, Fielding RA, Gill TM, Groessl EJ. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA. 2014;311:2387–96.CrossRefPubMedPubMedCentral
9.
go back to reference Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337.
10.
go back to reference HSE: Health Survey for England. (Health Do ed., vol. 1); 2011. HSE: Health Survey for England. (Health Do ed., vol. 1); 2011.
11.
go back to reference Marmot MG, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M, Geddes I. Fair society, healthy lives: the Marmot ReviewSource: SCIE Social Care Online - 01 January 2010. London: Marmot Review; 2010. Marmot MG, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M, Geddes I. Fair society, healthy lives: the Marmot ReviewSource: SCIE Social Care Online - 01 January 2010. London: Marmot Review; 2010.
12.
go back to reference Centers for Disease Control and Prevention. Health Disparities and Inequalities Report. Morb Mortal Wkly Rep. 2011;60:1–116. Centers for Disease Control and Prevention. Health Disparities and Inequalities Report. Morb Mortal Wkly Rep. 2011;60:1–116.
13.
go back to reference Vasunilashorn S, Coppin AK, Patel KV, Lauretani F, Ferrucci L, Bandinelli S, Guralnik JM. Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI Study. J Gerontol Series A. 2009;64A:223–9.CrossRef Vasunilashorn S, Coppin AK, Patel KV, Lauretani F, Ferrucci L, Bandinelli S, Guralnik JM. Use of the Short Physical Performance Battery Score to predict loss of ability to walk 400 meters: analysis from the InCHIANTI Study. J Gerontol Series A. 2009;64A:223–9.CrossRef
15.
go back to reference Taves DR. Minimization: a new method of assigning patients to treatment and control groups. Clin Pharmacol Ther. 1974;15:443–53.CrossRefPubMed Taves DR. Minimization: a new method of assigning patients to treatment and control groups. Clin Pharmacol Ther. 1974;15:443–53.CrossRefPubMed
16.
go back to reference Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31:103–15.CrossRefPubMed Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31:103–15.CrossRefPubMed
17.
go back to reference Nelson ME, Layne JE, Bernstein MJ, Nuernberger A, Castaneda C, et al. The effects of multidimensional home-based exercise on functional performance in elderly people. J Gerontol. 2004;59:M154–60.CrossRef Nelson ME, Layne JE, Bernstein MJ, Nuernberger A, Castaneda C, et al. The effects of multidimensional home-based exercise on functional performance in elderly people. J Gerontol. 2004;59:M154–60.CrossRef
18.
go back to reference Ryan RM, Deci EL. A Self-Determination Theory approach to psychotherapy: the motivational basis for effective change. Can Psychol. 2008;49:186–93.CrossRef Ryan RM, Deci EL. A Self-Determination Theory approach to psychotherapy: the motivational basis for effective change. Can Psychol. 2008;49:186–93.CrossRef
19.
go back to reference Marcus BH, Forsyth LH. Motivating people to be physically active. Champaign: Human Kinetics; 2008. Marcus BH, Forsyth LH. Motivating people to be physically active. Champaign: Human Kinetics; 2008.
20.
go back to reference Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, Schwarz P. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health. 2011;11:119.CrossRefPubMedPubMedCentral Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, Schwarz P. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health. 2011;11:119.CrossRefPubMedPubMedCentral
21.
go back to reference Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004;23:443–51.CrossRefPubMed Bellg AJ, Borrelli B, Resnick B, Hecht J, Minicucci DS, Ory M. Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004;23:443–51.CrossRefPubMed
22.
go back to reference Deci EL, Ryan RM. Handbook of self-determination research. Rochester: The University of Rochester Press; 2002. Deci EL, Ryan RM. Handbook of self-determination research. Rochester: The University of Rochester Press; 2002.
23.
go back to reference Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13:623–49.CrossRef Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13:623–49.CrossRef
24.
go back to reference Greaves C, Poltawski L, Garside R, Briscoe S. Understanding the challenge of weight loss maintenance: a systematic review and synthesis of qualitative research on weight loss maintenance. Health Psychol Rev. 2017;11:145–63.CrossRefPubMed Greaves C, Poltawski L, Garside R, Briscoe S. Understanding the challenge of weight loss maintenance: a systematic review and synthesis of qualitative research on weight loss maintenance. Health Psychol Rev. 2017;11:145–63.CrossRefPubMed
25.
go back to reference Perera S, Studenski S, Chandler JM, Guralnik JM. Magnitude and patterns of decline in health and function in 1 year affect subsequent 5-year survival. J Gerontol Ser A Biol Med Sci. 2005;60:894–900.CrossRef Perera S, Studenski S, Chandler JM, Guralnik JM. Magnitude and patterns of decline in health and function in 1 year affect subsequent 5-year survival. J Gerontol Ser A Biol Med Sci. 2005;60:894–900.CrossRef
26.
go back to reference Curtis L, Burns A. Unit costs of health and social care 2016. Personal Social Services Research Unit, University of Kent, Canterbury; 2016. Curtis L, Burns A. Unit costs of health and social care 2016. Personal Social Services Research Unit, University of Kent, Canterbury; 2016.
28.
go back to reference Brazier J. Valuing health states for use in cost-effectiveness analysis. PharmacoEconomics. 2008;26:769–79.CrossRefPubMed Brazier J. Valuing health states for use in cost-effectiveness analysis. PharmacoEconomics. 2008;26:769–79.CrossRefPubMed
29.
go back to reference van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, Lloyd A, Scalone L, Kind P, Pickard AS. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. 2012;15:708–15.CrossRefPubMed van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, Lloyd A, Scalone L, Kind P, Pickard AS. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. 2012;15:708–15.CrossRefPubMed
30.
go back to reference Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford University Press; 2015. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford University Press; 2015.
32.
go back to reference Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, Augustovski F, Briggs AH, Mauskopf J, Loder E. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement. Cost Eff Resour Alloc. 2013;11:6.CrossRefPubMedPubMedCentral Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, Augustovski F, Briggs AH, Mauskopf J, Loder E. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement. Cost Eff Resour Alloc. 2013;11:6.CrossRefPubMedPubMedCentral
33.
go back to reference Black WC. The CE plane: a graphic representation of cost-effectiveness. Med Decis Mak. 1990;10:212–4.CrossRef Black WC. The CE plane: a graphic representation of cost-effectiveness. Med Decis Mak. 1990;10:212–4.CrossRef
34.
go back to reference Fenwick E, Marshall DA, Levy AR, Nichol G. Using and interpreting cost-effectiveness acceptability curves: an example using data from a trial of management strategies for atrial fibrillation. BMC Health Serv Res. 2006;6:52.CrossRefPubMedPubMedCentral Fenwick E, Marshall DA, Levy AR, Nichol G. Using and interpreting cost-effectiveness acceptability curves: an example using data from a trial of management strategies for atrial fibrillation. BMC Health Serv Res. 2006;6:52.CrossRefPubMedPubMedCentral
35.
go back to reference Faria R, Gomes M, Epstein D, White IR. A guide to handling missing data in cost-effectiveness analysis conducted within randomised controlled trials. PharmacoEconomics. 2014;32:1157–70.CrossRefPubMedPubMedCentral Faria R, Gomes M, Epstein D, White IR. A guide to handling missing data in cost-effectiveness analysis conducted within randomised controlled trials. PharmacoEconomics. 2014;32:1157–70.CrossRefPubMedPubMedCentral
36.
go back to reference Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, Moore L, O’Cathain A, Tinati T, Wight D. Process evaluation of complex interventions: Medical Research Council guidance. Br Med J. 2015;350:h1258.CrossRef Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, Moore L, O’Cathain A, Tinati T, Wight D. Process evaluation of complex interventions: Medical Research Council guidance. Br Med J. 2015;350:h1258.CrossRef
37.
go back to reference Dreyfus SE. The five-stage model of adult skill acquisition. Bull Sci Technol Soc. 2004;24:177–82.CrossRef Dreyfus SE. The five-stage model of adult skill acquisition. Bull Sci Technol Soc. 2004;24:177–82.CrossRef
38.
go back to reference Lubitz J, Cai L, Kramarow E, Lentzner H. Health, life expectancy, and health care spending among the elderly. N Engl J Med. 2003;349:1048–55.CrossRefPubMed Lubitz J, Cai L, Kramarow E, Lentzner H. Health, life expectancy, and health care spending among the elderly. N Engl J Med. 2003;349:1048–55.CrossRefPubMed
Metadata
Title
A community-based physical activity intervention to prevent mobility-related disability for retired older people (REtirement in ACTion (REACT)): study protocol for a randomised controlled trial
Authors
Afroditi Stathi
Janet Withall
Colin J. Greaves
Janice L. Thompson
Gordon Taylor
Antonieta Medina-Lara
Colin Green
James Bilzon
Selena Gray
Heidi Johansen-Berg
Claire E. Sexton
Max J. Western
Jolanthe L. de Koning
Jessica C. Bollen
Sarah J. Moorlock
Naiara Demnitz
Poppy Seager
Jack M. Guralnik
W. Jack Rejeski
Ken R. Fox
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-018-2603-x

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