This application is submitted in response to NOT-AT-20-004 as a supplement to Mindful Movement for Physical Activity and Wellbeing in Older Adults: A Community Based Randomized Hybrid Effectiveness-Implementation Study (4R33AT009110). The proposed Administrative Supplement will focus on improving intervention training for YMCA facilitators to enhance fidelity of the experimental mindfulness-based intervention (MBI), and active comparison which have transitioned to remote delivery (due to COVID-19). Importantly, the supplemental aims do not affect the original scope of the awarded parent project. The long-term objective of the parent study is to optimize physical activity levels in middle to older age adults (>50 years) through mindfulness. The parent R33 has the following aims:
Aim 1 : To determine the relative effectiveness of 8 weeks of Mindful Movement versus Keys to Health & Wellbeing in a Randomized Controlled Trial (RCT, n=182) as measured by changes in the primary physical activity outcome of time spent per week in ?10 minute bouts of moderate-vigorous physical activity (MVPA) at 9 weeks.
Aim 2 : To determine the relative effectiveness of the two interventions as measured by changes in a) secondary physical activity outcomes and b) secondary self-report measures at 9, 26, and 52 weeks.
Aim 3 : To facilitate interpretation of RCT results and provide resources for translation and sustainability by collecting contextual information to inform eventual broad scale intervention implementation and creating a web-based implementation toolkit that can be used by other sites. Supplemental Aims A. To enhance facilitator adherence in delivering required intervention elements with skills that foster supportive alliances which promote participant engagement. B. To assess and monitor the additional facilitators adherence and skills required for remote delivery, by adapting the parent project?s facilitator fidelity monitoring system to document them. C. To assess and monitor participants? receipt and application of the interventions by modifying the parent project?s participant fidelity monitoring system to include new data collection of participant views of remote delivery and qualitative questions regarding barriers and facilitators to engagement. D. To examine i) participants? views of the supportive alliance and their impact on primary/secondary outcomes and ii) whether participants? perception of the alliance matches the facilitators? perception and the resulting impact on primary/secondary outcomes.
This Administrative Supplement supports additional training related activities to enhance fidelity as part of a clinical trial of mindfulness for physical activity in older adults conducted in collaboration with the YMCA. Aligned with the parent project aims, the supplemental aims will focus on the implementation of competency based training for the remote delivery of study interventions; refinement of study fidelity monitoring systems; and novel exploration of the supportive alliance between facilitators and participants.
