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1.
Artigo em Inglês | MEDLINE | ID: mdl-33585918

RESUMO

BACKGROUND: This study evaluated the association between ratings of perceived exertion (RPE) of walking and major mobility disability (MMD), as well as their transitions in response to a physical activity (PA) compared to a health education (HE) program. METHODS: Older adults (n=1633) at risk for mobility impairment were randomized to structured PA or HE programs. During a 400m walk, participants rated exertion as "light" or "hard". An MMD event was defined as the inability to walk 400m. MMD events and RPE values were assessed every 6-months for an average of 2.6 years. RESULTS: Participants rating their exertion as "hard" had a nearly 3-fold higher risk of MMD compared with those rating their exertion as "light" (HR: 2.61, 95%CI: 2.19-3.11). The association held after adjusting for disease conditions, depression, cognitive function and walking speed (HR: 2.24, 95%CI: 1.87-2.69). The PA group was 25% more likely to transition from "light" to "hard" RPE than the HE group (1.25, 1.05-1.49). Additionally, the PA group was 27% (0.73, 0.55 - 0.97) less likely to transition from a "hard" RPE to inability to walk 400m and was more likely to recover their ability to walk 400m by transitioning to a "hard" RPE (2.10, 1.39-3.17) than the HE group. CONCLUSIONS: Older adults rating "hard" effort during a standardized walk test were at increased risk of subsequent MMD. A structured PA program enabled walking recovery, but was more likely to increase transition from "light" to "hard" effort, which may reflect greater capacity to perform the test.

3.
Glob Public Health ; : 1-17, 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-33427068

RESUMO

The physical and social environment of school settings are important for health promotion among children and adolescents. Efforts to create supportive environments at the school level can benefit from including community engagement and empowerment processes to advocate for health promotion. The Our Voice model presents a unique opportunity for Latin American students to improve their school environments. The objective of this study was to engage and empower students (9-18 years) from five schools in Bogotá, Colombia to use the Our Voice model to assess and seek to improve their local school environments. This study employed Our Voice's 'citizen science by the people' method using a mobile application for data collection. The Our Voice initiative included the following four phases: (1) Design, planning and recruitment; (2) Data collection; (3) Community meetings for thematic analysis, priority setting and initial design of feasible solutions; and (4) Community meetings with decision-makers to advocate for changes. The citizen scientists identified and advocated for safer physical activity-supportive environments and healthier food and drinks availability. This study allowed children and adolescent citizen scientists to make their voices heard by policymakers and empowered them as agents of change in the process of building healthier schools.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33433559

RESUMO

BACKGROUND: National guidelines promote physical activity to prevent cardiovascular disease (CVD), yet no randomized controlled trial has tested whether physical activity reduces prevent CVD. METHODS: The Women's Health Initiative (WHI) Strong and Healthy (WHISH) pragmatic trial used a randomized consent design to assign women for whom cardiovascular outcomes were available through WHI data collection (N=18,985) or linkage to the Centers for Medicare and Medicaid Services (N30,346), to a physical activity intervention or "usual activity" comparison, stratified by ages 68-99 years (in tertiles), U.S. geographic region, and outcomes data source. Women assigned to the intervention could "opt out" after receiving initial physical activity materials. Intervention materials applied evidence-based behavioral science principles to promote current national recommendations for older Americans The intervention was adapted to participant input regarding preferences, resources, barriers and motivational drivers and was targetted for three categories of women at lower, middle or higher levels of self-reported physical functioning and physical activity. Physical activity was assessed in both arms through annual questionnaires. The primary outcome is major cardiovascular events, specifically myocardial infarction, stroke, or CVD death; primary safety outcomes are hip fracture and non-CVD death. The trial is monitored annually by an independent Data Safety and Monitoring Board. Final analyses will be based on intention-to-treat in all randomized participants, regardless of intervention engagement. RESULTS: The 49,331 randomized participants had a mean baseline age of 79.7 years; 84.3% were white, 9.2% black, 3.3% Hispanic, 1.9% Asian/Pacific Islander, 0.3% Native American, and 1% were of unknown race/ethnicity. The mean baseline RAND-36 physical function score was 71.6 (± 25.2 SD). There were no differences between Intervention (N=24,657) and Control (N=24,674) at baseline for age, race/ethnicity, current smoking (2.5%), use of blood pressure or lipid-lowering medications, body mass index, physical function, physical activity, or prior CVD (10.1%). CONCLUSION: The WHISH trial is rigorously testing whether a physical activity intervention reduces major CV events in a large, diverse cohort of older women.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33494135

RESUMO

Growing socioeconomic and structural disparities within and between nations have created unprecedented health inequities that have been felt most keenly among the world's youth. While policy approaches can help to mitigate such inequities, they are often challenging to enact in under-resourced and marginalized communities. Community-engaged participatory action research provides an alternative or complementary means for addressing the physical and social environmental contexts that can impact health inequities. The purpose of this article is to describe the application of a particular form of technology-enabled participatory action research, called the Our Voice citizen science research model, with youth. An overview of 20 Our Voice studies occurring across five continents indicates that youth and young adults from varied backgrounds and with interests in diverse issues affecting their communities can participate successfully in multiple contributory research processes, including those representing the full scientific endeavor. These activities can, in turn, lead to changes in physical and social environments of relevance to health, wellbeing, and, at times, climate stabilization. The article ends with future directions for the advancement of this type of community-engaged citizen science among young people across the socioeconomic spectrum.

6.
Int J Behav Med ; 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495978

RESUMO

BACKGROUND: Altered cortisol dynamics have been associated with increased risk for chronic health problems among midlife and older adults (≥ 45 years of age). Yet, studies investigating the impact of health behavior interventions on cortisol activity in this age group are limited. OBJECTIVE AND METHODS: The current study examined whether 48 midlife and older adults (50% family caregivers, 69% women) randomized to one of four telephone-based health behavior interventions (stress management (SM), exercise (EX), nutrition (NUT), or exercise plus nutrition (EX+NUT)) showed improvements in their perceived stress, mood, and cortisol dynamics at 4 months post-intervention. Participants collected four salivary cortisol samples (waking, 30 min after waking, 4 p.m., and bedtime) across two collection days at baseline and at 4 months post-intervention to assess for total cortisol, cortisol awakening response (CAR), and diurnal cortisol slope. RESULTS: Participants in SM showed lower levels of total cortisol and a smaller CAR compared with those in EX, NUT, or EX+NUT from baseline to 4 months post-intervention. Participants in EX showed lower levels of perceived stress, depression, and anxiety compared with those in NUT or SM. Finally, participants in NUT showed a greater diurnal decline in cortisol and lower levels of anxiety compared with those in SM. CONCLUSIONS: These findings provide support for the efficacy of telephone-based, health behavior interventions in improving different stress outcomes among chronically stressed midlife and older adults and suggest the need to test the longer-term effects of these interventions for improving health outcomes in this population.

7.
Data Brief ; 33: 106394, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33117863

RESUMO

This data article describes data from an Our Voice citizen science data collection aiming at identifying elements that facilitate or hinder physical activity among adolescents in a medium sized city in Sweden. Twenty-four adolescents from two neighborhoods with low socioeconomic status in Sweden used the Stanford Healthy Neighborhood Discovery Tool app on their phones to take photographs and record audio narratives of aspects of their neighborhood that they perceived as facilitating or hindering their physically activity. In total, 186 photos of the neighborhood elements were taken by the adolescents and thereafter the research group categorized the photos into a final set of 16 elements of which 12 described the built environment and 4 the social environment. The data collection included the combination of the following data collected using the app: photographs, geocoded data of where the photographs were taken, recorded narratives describing the photographs, positive and negative neighborhood attributes (portrayed as a happy or sad "smiley face"), and an 8-item survey. In addition, we used official statistics from the City of Västerås describing the two neighborhoods as well as the whole city. This data article is associated with the article titled "Using citizen science to understand the prerequisites for physical activity among adolescents in low socioeconomic status neighborhoods - the NESLA study" [1].

8.
Transl Behav Med ; 10(5): 1098-1109, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33044541

RESUMO

Maintaining or improving quality of life (QoL) and well-being is a universal goal across the lifespan. Being physically active has been suggested as one way to enhance QoL and well-being. In this systematic review, conducted in part for the 2018 U.S. Health and Human Services Physical Activity Guidelines for Americans Scientific Advisory Committee Report, we examined the relationship between physical activity (PA) and QoL and well-being experienced by the general population across the lifespan and by persons with psychiatric and neurologic conditions. Systematic reviews, meta-analyses, and pooled analyses from 2006 to 2018 were used for the evidence base. Strong evidence (predominantly from randomized controlled trials [RCTs]) demonstrated that, for adults aged 18-65 years and older adults (primarily 65 years and older), PA improves QoL and well-being when compared with minimal or no-treatment controls. Moderate evidence indicated that PA improves QoL and well-being in individuals with schizophrenia and Parkinson's disease, and limited evidence indicated that PA improves QoL and well-being for youth and for adults with major clinical depression or bipolar disorder. Insufficient evidence existed for individuals with dementia because of a small number of studies with mixed results. Future high-quality research designs should include RCTs involving longer interventions testing different modes and intensities of PA in diverse populations of healthy people and individuals with cognitive (e.g., dementia) and mental health conditions (e.g., schizophrenia) to precisely characterize the effects of different forms of PA on aspects of QoL and well-being.

9.
Health Place ; 65: 102387, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32889390

RESUMO

Socioeconomic status (SES) as well as adolescents' perceptions of the neighborhood's built and social environments have been shown to influence adolescents' physical activity. Twenty-four adolescents from two low SES neighborhoods in Sweden participated as citizen scientists, using the Stanford Discovery Tool app on their phones to take photographs and record audio narratives of aspects of their neighborhood that they perceived facilitate or hinder their physical activity. The most frequently reported facilitators were 'parks, playgrounds and outdoor gym' as well as 'amenities' and 'sport facilities', whereas lack of or shortcomings regarding 'bikeability and walkability', 'personal safety' and 'lighting' were the most frequently reported barriers. The results will be used to inform local politicians and policy makers about new ways to improve physical activity among residents in Sweden's low SES neighborhoods. Also, this study shows that a Swedish version of the Discovery Tool app is acceptable and can generate useful information in the context of adolescents from disadvantaged neighborhoods.

11.
JAMA Intern Med ; 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-32986075

RESUMO

Importance: Effective and practical treatments are needed to increase physical activity among those at heightened risk from inactivity. Walking represents a popular physical activity that can produce a range of desirable health effects, particularly as people age. Objective: To test the hypothesis that counseling by a computer-based virtual advisor is no worse than (ie, noninferior to) counseling by trained human advisors for increasing 12-month walking levels among inactive adults. Design, Setting, and Participants: A cluster-randomized, noninferiority parallel trial enrolled 245 adults between July 21, 2014, and July 29, 2016, with follow-up through September 15, 2017. Data analysis was performed from March 15 to December 20, 2018. The evidence-derived noninferiority margin was 30 minutes of walking per week. Participants included inactive adults aged 50 years and older, primarily of Latin American descent and capable of walking without significant limitations, from 10 community centers in Santa Clara and San Mateo counties, California. Interventions: All participants received similar evidence-based, 12-month physical activity counseling at their local community center, with the 10 centers randomized to a computerized virtual advisor program (virtual) or a previously validated peer advisor program (human). Main Outcomes and Measures: The primary outcome was change in walking minutes per week over 12 months using validated interview assessment corroborated with accelerometry. Both per-protocol and intention-to-treat analysis was performed. Results: Among the 245 participants randomized, 193 were women (78.8%) and 241 participants (98.4%) were Latino. Mean (SD) age was 62.3 (8.4) years (range, 50-87 years), 107 individuals (43.7%) had high school or less educational level, mean BMI was 32.8 (6.8), and mean years residence in the US was 47.4 (17.0) years. A total of 231 participants (94.3%) completed the study. Mean 12-month change in walking was 153.9 min/wk (95% CI, 126.3 min/wk to infinity) for the virtual cohort (n = 123) and 131.9 min/wk (95% CI, 101.4 min/wk to infinity) for the human cohort (n = 122) (difference, 22.0, with lower limit of 1-sided 95% CI, -20.6 to infinity; P = .02); this finding supports noninferiority. Improvements emerged in both arms for relevant clinical risk factors, sedentary behavior, and well-being measures. Conclusions and Relevance: The findings of this study indicate that a virtual advisor using evidence-based strategies produces significant 12-month walking increases for older, lower-income Latino adults that are no worse than the significant improvements achieved by human advisors. Changes produced by both programs are commensurate with those reported in previous investigations of these behavioral interventions and provide support for broadening the range of light-touch physical activity programs that can be offered to a diverse population. Trial Registration: ClinicalTrials.gov Identifier: NCT02111213.

12.
Health Psychol ; 39(9): 841-845, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32833485

RESUMO

The Science of Behavior Change Network (SOBC) offers a pragmatic "experimental medicine" approach for advancing mechanisms of change regarding behavior. The key promise of the SOBC is to facilitate more effective knowledge accumulation about not only whether behavior change occurs in response to an intervention, but also how and why behavior change occurs. This work is being advanced during a time of rapid evolution on scientific best practices, particularly "open science" practices, which at their core, seek to increase the trustworthiness of science. The purpose of this commentary is to facilitate a broader discussion on opportunities and challenges involved with conducting mechanistic science related to behavior change (i.e., SOBC) via open science practices. The 10 studies published in this special issue highlight the considerable complexity involved in a mechanistic science of behavior change. Conducting this type of science will require a rich, multifaceted "team science" approach that can match that level of complexity, while constantly striving toward being as straightforward or as simple as possible, no simpler. Effective open science practices, which involve the sharing of resources whenever possible, can facilitate this type of team science. Moving to this new future would benefit from careful shifts in our scientific culture and financial models toward better supporting team and open science. In addition, there is also need for continued advancements in methods and infrastructure that can support the inherent complexities involved in advancing a mechanistic science of behavior change. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Transtornos Mentais/terapia , Pesquisa Biomédica/métodos , Humanos
13.
Contemp Clin Trials ; 95: 106084, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32659437

RESUMO

Physical inactivity is a key risk factor for a range of chronic diseases and conditions, yet, approximately 50% of U.S. adults fall below recommended levels of regular aerobic physical activity (PA). This is particularly true for ethnic minority populations such as Latino adults for whom few culturally adapted programs have been developed and tested. Text messaging (SMS) represents a convenient and accessible communication channel for delivering targeted PA information and support, but has not been rigorously evaluated against standard telehealth advising programs. The objective of the On The Move randomized controlled trial is to test the effectiveness of a linguistically and culturally targeted SMS PA intervention (SMS PA Advisor) versus two comparison conditions: a) a standard, staff-delivered phone PA intervention (Telephone PA Advisor) and b) an attention-control arm consisting of a culturally targeted SMS intervention to promote a healthy diet (SMS Nutrition Advisor). The study sample (N = 350) consists of generally healthy, insufficiently active Latino adults ages 35 years and older living in five northern California counties. Study assessments occur at baseline, 6, and 12 months, with a subset of participants completing 18-month assessments. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of PA, assessed via validated self-report measures and supported by accelerometry, and physical function and well-being variables. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. Trial Registration: clinicaltrial.gov Identifier = NCT02385591.

14.
J Urban Health ; 97(4): 529-542, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32613496

RESUMO

The availability of parks and urban green spaces has been associated with a number of benefits, including increased physical activity, improvements in mental health, increases in social interactions, improvements to the environment, and increases in property values. The installation of temporary pop-up parks in urban areas is one way for urban communities to obtain these benefits. In this mixed-methods study, quantitative and qualitative data were gathered by researchers, the city council, a local investment company, and community residents that informed the initiation, iteration, and incremental expansion of a series of temporary, summer pop-up parks in the downtown business district of the City of Los Altos in Northern California over a 4-year period (2013-2016). Results showed that the parks were visited by a large, multigenerational group of users who engaged in leisure-time physical activity, shopped at local stores, attended programed events, and socialized with others. Direct observation and survey data gathered in year 2014 also indicated that foot traffic into businesses directly fronting on a pop-up park (n = 8) was higher during a 4-day period when the park was in place, as compared to a similar 4-day period before the park was installed. The majority of downtown business owners/managers reported no decrease in sales compared to the month before the pop-up park was installed. City sales tax data indicated increases in year-on-year sales tax revenue in the summer quarter of 2014 and 2016 compared with the year (2015) when there was no downtown pop-up park. Perspectives of community residents collected before, during, and after the installation of the pop-up parks indicated that the pop-up park created a vibrant space in an otherwise underutilized area that was enjoyed by a variety of people in a host of ways (e.g., children playing, families relaxing, people shopping and eating at downtown stores and restaurants, people of all ages attending scheduled park events). These results informed a number of discussions and meetings between key stakeholders about the pop-up parks, culminating in a temporary park that was held in a new location in 2017 that was substantially larger in size, installed for a longer time period, cost more, and had more scheduled park events. Results from this prospective investigation of the initial impacts of pop-up parks in this urban location provide insights regarding the potential benefits and viability of such temporary parks for residents and businesses alike.

15.
Health Promot Int ; 2020 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-32361761

RESUMO

Colombia's Recreovía program offers community-based free physical activity (PA) classes in parks. We evaluated built and social environmental factors influencing Recreovía local park environments, and facilitated a consensus-building and advocacy process among community members, policymakers and academic researchers aimed at improving uptake and impact of the Recreovía program. We used a mixed-methods approach, with individual and contextual PA measurements and a resident-enabled participatory approach (the Our Voice citizen science engagement model). Recreovía participants were likely to be women meeting PA recommendations, and highly satisfied with the Recreovía classes. Reported facilitators of the Recreovía included its role in enhancing social and individual well-being through PA classes. Reported barriers to usage were related to park maintenance, cleanliness and safety. The Our Voice process elicited community reflection, empowerment, advocacy and action. Our Voice facilitated the interplay among stakeholders and community members to optimize the Recreovía program as a facilitator of active living, and to make park environments more welcoming.

16.
Gerontologist ; 60(8): 1527-1537, 2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-32277697

RESUMO

BACKGROUND AND OBJECTIVES: Since the launch of Dublin City University's Age-Friendly University (AFU) Initiative in 2012, relatively little empirical research has been published on its feasibility or implementation by institutions of higher learning. This article describes how collaborative citizen science-a research method where professional researchers and community members work together across multiple stages of the research process (e.g., data collection, analysis, and/or knowledge mobilization) to investigate an issue-was used to identify barriers and supports to university age-friendliness at the University of Manitoba (UofM) in Canada. RESEARCH DESIGN AND METHODS: Ten citizen scientists each completed 1 data collection walk around the UofM campus and used a tablet application to document AFU barriers and supports via photographs and accompanying audio commentaries. The citizen scientists and university researchers then worked together in 2 analysis sessions to identify AFU priority areas and brainstorm recommendations for institutional change. These were then presented to a group of interested university stakeholders. RESULTS: The citizen scientists collected 157 photos documenting AFU barriers and supports on campus. Accessibility, signage, and transportation were identified as being the most pressing issues for the university to address to improve overall age-friendliness. DISCUSSION AND IMPLICATIONS: We suggest that academic institutions looking to complete assessments of their age-friendliness, particularly those exploring physical barriers and supports, could benefit from incorporating older citizen scientists into the process of collecting, analyzing, and mobilizing findings.

17.
Front Public Health ; 8: 64, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32211367

RESUMO

Background: Cable cars provide urban mobility benefits for vulnerable populations. However, no evaluation has assessed cable cars' impact from a health perspective. TransMiCable in Bogotá, Colombia, provides a unique opportunity to (1) assess the effects of its implementation on the environmental and social determinants of health (microenvironment pollution, transport accessibility, physical environment, employment, social capital, and leisure time), physical activity, and health outcomes (health-related quality of life, respiratory diseases, and homicides); and (2) use citizen science methods to identify, prioritize, and communicate the most salient negative and positive features impacting health and quality of life in TransMiCable's area, as well as facilitate a consensus and advocacy-building change process among community members, policymakers, and academic researchers. Methods: TrUST (In Spanish: Transformaciones Urbanas y Salud: el caso de TransMiCable en Bogotá) is a quasi-experimental study using a mixed-methods approach. The intervention group includes adults from Ciudad Bolívar, the area of influence of TransMiCable. The control group includes adults from San Cristóbal, an area of future expansion for TransMiCable. A conceptual framework was developed through group-model building. Outcomes related to environmental and social determinants of health as well as health outcomes are assessed using questionnaires (health outcomes, physical activity, and perceptions), secondary data (crime and respiratory outcomes) use of portable devices (air pollution exposure and accelerometry), mobility tracking apps (for transport trajectories), and direct observation (parks). The Stanford Healthy Neighborhood Discovery Tool is being used to capture residents' perceptions of their physical and social environments as part of the citizen science component of the investigation. Discussion: TrUST is innovative in its use of a mixed-methods, and interdisciplinary research approach, and in its systematic engagement of citizens and policymakers throughout the design and evaluation process. This study will help to understand better how to maximize health benefits and minimize unintended negative consequences of TransMiCable.

18.
Artigo em Inglês | MEDLINE | ID: mdl-32121001

RESUMO

The trajectory of aging is profoundly impacted by the physical and social environmental contexts in which we live. While "top-down" policy activities can have potentially wide impacts on such contexts, they often take time, resources, and political will, and therefore can be less accessible to underserved communities. This article describes a "bottom-up", resident-engaged method to advance local environmental and policy change, called Our Voice, that can complement policy-level strategies for improving the health, function, and well-being of older adults. Using the World Health Organization's age-friendly cities global strategy, we describe the Our Voice citizen science program of research that has specifically targeted older adults as environmental change agents to improve their own health and well-being as well as that of their communities. Results from 14 Our Voice studies that have occurred across five continents demonstrate that older adults can learn to use mobile technology to systematically capture and collectively analyze their own data. They can then successfully build consensus around high-priority issues that can be realistically changed and work effectively with local stakeholders to enact meaningful environmental and policy changes that can help to promote healthy aging. The article ends with recommended next steps for growing the resident-engaged citizen science field to advance the health and welfare of all older adults.


Assuntos
Ciência do Cidadão , Planejamento Ambiental , Envelhecimento Saudável , Projetos de Pesquisa , Humanos
19.
Transl Behav Med ; 10(1): 55-57, 2020 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-32011718

RESUMO

Despite the numerous successful behavioral interventions that have been published in the behavioral medicine field over a number of decades, surprisingly few have been translated and adapted for real-world settings using participatory research methods. The purpose of this commentary is to highlight the advances in participatory behavioral medicine reflected in the articles contained in the Diabetes special section. The articles contained in the Diabetes special section were reviewed, with a focus on the advances made with this type of research and the challenges that came to light. Numerous strengths of the large-scale translational studies were identified. The studies also highlighted important areas meriting further attention, including exploration of additional dissemination pathways, and further piloting and refinement of program components for different population segments. The articles in this special section represent major advances in implementing successful, impactful programs for diabetes prevention and control in low- and middle-income countries.

20.
J Am Geriatr Soc ; 68(4): 872-881, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32105353

RESUMO

BACKGROUND: Walking independently is basic to human functioning. The Lifestyle Interventions and Independence for Elders (LIFE) studies were developed to assess whether initiating physical activity could prevent major mobility disability (MMD) in sedentary older adults. METHODS: We review the development and selected findings of the LIFE studies from 2000 through 2019, including the planning phase, the LIFE-Pilot Study, and the LIFE Study. RESULTS: The planning phase and the LIFE-Pilot provided key information for the successful implementation of the LIFE Study. The LIFE Study, involving 1635 participants randomized at eight sites throughout the United States, showed that compared with health education, the physical activity program reduced the risk of the primary outcome of MMD (inability to walk 400 m: hazard ratio = 0.82; 95% confidence interval = 0.69-0.98; P = .03), and that the intervention was cost-effective. There were no significant effects on cognitive outcomes, cardiovascular events, or serious fall injuries. In addition, the LIFE studies provided relevant findings on a broad range of other outcomes, including health, frailty, behavioral outcomes, biomarkers, and imaging. To date, the LIFE studies have generated a legacy of 109 peer-reviewed publications, 19 ancillary studies, and 38 independently funded grants and clinical trials, and advanced the development of 59 early career scientists. Data and biological samples of the LIFE Study are now publicly available from a repository sponsored by the National Institute on Aging (https://agingresearchbiobank.nia.nih.gov). CONCLUSIONS: The LIFE studies generated a wealth of important scientific findings and accelerated research in geriatrics and gerontology, benefiting the research community, trainees, clinicians, policy makers, and the general public. J Am Geriatr Soc 68:872-881, 2020.

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