Background: In response to the COVID-19 pandemic, experts in mental health science emphasized the importance of developing and evaluating approaches to support and maintain the mental health of older adults. Objective: The aim of this study was to assess whether a group-based exercise program relative to a personal exercise program (both delivered online) and waitlist control (WLC) can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. Methods: The Seniors COVID-19 Pandemic and Exercise (SCOPE) trial was a 3-arm, parallel randomized controlled trial conducted between May and September 2020 in which low active older adults (aged ≥65 years) were recruited via media outlets and social media. After baseline assessments, consented participants were randomized to one of two 12-week exercise programs (delivered online by older adult instructors) or a WLC condition. A total of 241 older adults (n=187 women) provided baseline measures (via online questionnaires), were randomized (ngroup=80, npersonal=82, ncontrol=79), and completed measures every 2 weeks for the duration of the trial. The trial’s primary outcome was psychological flourishing. Secondary outcomes included global measures of mental and physical health, life satisfaction, and depression symptoms. Results: The results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (P>.05 for all). Participants in the group condition displayed improved mental health relative to WLC participants over the first 10 weeks (effect size [ES]=0.288-0.601), and although the week 12 effect (ES=0.375) was in the same direction the difference was not statistically significant (P=.089). Participants in the personal condition displayed improved mental health, when compared with WLC participants, in the same medium ES range (ES=0.293-0.565) over the first 8 weeks, and while the effects were of a similar magnitude at weeks 10 (ES=0.455, P=.069) and 12 (ES=0.258, P=.353), they were not statistically significant. In addition, participants in the group condition displayed improvements in physical health when compared with the WLC (ES=0.079-0.496) across all 12 weeks of the study following baseline. No differences were observed between the personal exercise condition and WLC for physical health (slope P=.271). Conclusions: There were no intervention effects for the trial’s primary outcome (ie, psychological flourishing). It is possible that the high levels of psychological flourishing at baseline may have limited the extent to which those indicators could continue to improve further through intervention (ie, potential ceiling effects). However, the intervention effects for mental and physical health point to the potential capacity of low-cost and scalable at-home programs to support the mental and physical health of previously inactive adults in the COVID-19 pandemic. Trial Registration: ClinicalTrials.gov NCT04412343; https://clinicaltrials.gov/ct2/show/NCT04412343

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中文翻译：

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COVID-19 大流行期间在线提供的团体和个人锻炼计划支持低活跃老年人的心理健康：随机对照试验


背景：为了应对 COVID-19 大流行，心理健康科学专家强调了制定和评估支持和维持老年人心理健康的方法的重要性。目的：本研究的目的是评估基于团体的锻炼计划相对于个人锻炼计划（均在线提供）和候补名单控制（WLC）是否可以改善先前活动量较低的老年人在早期阶段的心理健康。 COVID-19 大流行。方法：老年人 COVID-19 流行病与运动 (SCOPE) 试验是一项 3 臂、平行随机对照试验，于 2020 年 5 月至 9 月期间进行，通过媒体和社交媒体招募低活跃老年人（年龄≥65 岁） 。基线评估后，同意的参与者被随机分配到两个为期 12 周的锻炼计划（由老年教练在线提供）或 WLC 条件之一。共有 241 名老年人（n=187 名女性）提供了基线测量（通过在线问卷），并进行了随机分组（ngroup=80，nperson=82，ncontrol=79），并在试验期间每两周完成一次测量。该试验的主要结果是心理健康。次要结果包括心理和身体健康、生活满意度和抑郁症状的整体衡量标准。结果：潜在生长模型的结果显示，对繁荣、生活满意度或抑郁症状没有干预效果（全部 P>0.05）。在前 10 周内，与 WLC 参与者相比，该组参与者的心理健康状况有所改善（效应大小 [ES]=0.288-0.601），尽管第 12 周的效应 (ES=0.375) 方向相同，但差异并不明显。具有统计学意义（P=.089）。 与 WLC 参与者相比，个人状况良好的参与者在前 8 周内表现出相同的中等 ES 范围 (ES=0.293-0.565)，并且在第 10 周时的影响程度相似 (ES= 0.455，P=.069）和12（ES=0.258，P=.353），它们没有统计学意义。此外，在基线后的所有 12 周研究中，与 WLC (ES=0.079-0.496) 相比，该组参与者的身体健康状况有所改善。在身体健康方面，个人运动条件和 WLC 之间没有观察到差异（斜率 P=.271）。结论：对于试验的主要结果（即心理繁荣）没有干预作用。基线时的高水平心理繁荣可能限制了这些指标通过干预进一步改善的程度（即潜在的上限效应）。然而，对心理和身体健康的干预效果表明，低成本且可扩展的家庭计划具有潜在能力，可以支持在 COVID-19 大流行中以前不活动的成年人的心理和身体健康。试验注册：ClinicalTrials.gov NCT04412343； https://临床试验。政府/ct2/show/NCT04412343


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