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研究生: 方怡堯
Fang, I-Yao
論文名稱: 生態學模式與多元性運動訓練介入對社區高齡者功能性體適能與休閒時間身體活動量之影響
The influence of ecological-based multi-component exercise training programs on functional fitness and leisure-time physical activity among older adults
指導教授: 張少熙
Chang, Shao-Hsi
學位類別: 博士
Doctor
系所名稱: 體育學系
Department of Physical Education
論文出版年: 2015
畢業學年度: 103
語文別: 中文
論文頁數: 118
中文關鍵詞: 高齡者運動方案身體活動量運動介入
英文關鍵詞: Senior exercise programs, physical activity, exercise intervention
論文種類: 學術論文
相關次數: 點閱:208下載:18
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  • 臺灣人口老化嚴重,65歲以上人口快速成長且比例急速攀升。為此,以運動促進高齡者健康的公共衛生方案顯得極其需要。雖然臺灣老年人口參與運動比例高、時間足夠,但運動強度不足、運動種類單調。其次,臺灣高齡者運動方案逐漸普及,但課程內容缺乏持續性及專業性。本研究目的旨在探究透過生態學模式 (個人、人際及社區層次) 促進多元性運動訓練 (柔軟度、阻力、有氧及平衡運動) 對社區高齡者在功能性體適能與休閒時間身體活動量之影響。本研究以臺北市衛生局103年社區悠活站-健康促進與輔導方案之參與者為研究對象,以準實驗設計法將參與者分為三組。實驗組1 (24人) 接受生態學模式為主的多元性運動訓練介入;實驗組2 (25人) 接受多元性運動訓練;控制組 (25人) 維持低強度身體活動。為了探究方案效益,所有受試者在第0週、第13週及第25週參與功能性體適能測驗,並填答休閒時間身體活動量表。資料分析在考驗水準α<.05下進行描述性統計、獨立樣本t檢定、卡方檢定及二因子重覆量數變異數檢定。研究結果發現: (一) 低強度的休閒時間身體活動量無法改善社區高齡者的功能性體適能; (二) 從事多元性運動訓練,不論是否透過生態學模式介入,皆可有效提升功能性體適能與休閒時間身體活動量; (三) 透過生態學模式促進多元性運動訓練,對功能性體適能及休閒時間身體活動量的提升及維持效益優於僅從事多元性運動訓練。結論:多元性運動訓練,尤其是透過生態學模式進行,可有效提升並維持社區高齡者的功能性體適能及休閒時間身體活動量,是值得推行的公共衛生政策。

    Taiwan is an aging society, with the amount and proportion of older citizens aged 65 and over increasing rapidly in recent years. Because of such population trend, a public health intervention that focuses on using exercise to promote health among older adults has become imperative. Although studies have shown that many Taiwanese older adults do spend quite amount of time participating in physical activities, the intensity and variety of such participation is often limited. Furthermore, although there are increasing numbers of exercise programs available to seniors, oftentimes programs are not designed by professionals or for sustained participation among the older generation. The purpose of this study is to examine the impacts of multi-component exercise training (MET) programs (i.e., flexibility exercise, resistance exercise, aerobic training, and balance training, etc.) among older adults, with a focus on whether adapting an ecological approach that delivers interventions at different levels (i.e., individuals, organizations, and communities) can affect seniors' functional fitness and leisure-time physical activity participation. The subjects were recruited from the “Recreation Hubs—Health promotion and consultation project” initiated by the Department of Health in Taipei, Taiwan in 2014. Using a quasi-experimental design, participants were selected into three study groups. The Experimental Group 1 (24 participants) received the ecological-based MET intervention, while the Experimental Group 2 (25 participants) received the MET and the Control Group (25 participants) received no interventions and continued participating in low-intensity physical activities. To evaluate the impacts, data were collected from all participants using the Senior Functional Fitness Test (SFT) and Leisure Time Physical Activity (LTPA) scale one week before the project started (0 week), one week after the project ended (13th week), and at the 25th week. Results from the independent t-tests, chi-square tests and two-way ANOVA repeated measures (α<.05) suggested that: (1) Participation in low-intensity physical activities alone cannot lead to enhanced functional fitness among older adults; (2) Participation in MET, despite it's an ecological-based model or not, can effectively promote seniors' functional fitness and leisure time physical activity participation; (3) The ecological-based MET can maintain and promote seniors' functional fitness and their participation in leisure time physical activities more effectively than the general MET. Conclusion: MET programs, especially those based on the ecological model, can effectively maintain and promote seniors' functional fitness and leisure time physical activity participation. Because of the benefits, policy makers are encouraged to promote MET programs as an effective public health intervention for older adults.

    目次 論文通過簽名表……………………………………………………………………………………………………………………………i 學位論文授權書…………………………………………………………………………………………………………………………ii 中文摘要……………………………………………………………………………………………………………………………………iii 英文摘要………………………………………………………………………………………………………………………………………iv 謝誌………………………………………………………………………………………………………………………………………………vi 目次……………………………………………………………………………………………………………………………………………vii 表次………………………………………………………………………………………………………………………………………………ix 圖次…………………………………………………………………………………………………………………………………………………x 第壹章 緒論…………………………………………………………………………………………………………………………1 第一節 研究背景與動機……………………………………………………………………………………………………1 第二節 研究目的…………………………………………………………………………………………………………………6 第三節 研究問題…………………………………………………………………………………………………………………7 第四節 研究範圍與限制……………………………………………………………………………………………………8 第五節 研究重要性……………………………………………………………………………………………………………8 第六節 名詞操作性定義……………………………………………………………………………………………………9 第貳章 文獻探討………………………………………………………………………………………………………………11 第一節 高齡者從事多元性運動效益……………………………………………………………………………11 第二節 社區高齡者運動促進方案的重要性………………………………………………………………19 第三節 生態學模式與高齡者運動方案促進………………………………………………………………26 第四節 本章總結………………………………………………………………………………………………………………35 第參章 研究方法………………………………………………………………………………………………………………37 第一節 研究架構………………………………………………………………………………………………………………37 第二節 研究流程………………………………………………………………………………………………………………38 第三節 研究對象………………………………………………………………………………………………………………39 第四節 研究工具………………………………………………………………………………………………………………40 第五節 實驗設計………………………………………………………………………………………………………………44 第六節 實施步驟與程序…………………………………………………………………………………………………45 第七節 資料分析與處理…………………………………………………………………………………………………48 第肆章 結果與討論…………………………………………………………………………………………………………49 第一節 前測依變項之同質性檢定………………………………………………………………………………49 第二節 生態學模式及多元性運動訓練介入之功能性體適能效果………………………50 第三節 生態學模式及多元性運動訓練介入之身體活動量效果…………………………68 第四節 本章總結………………………………………………………………………………………………………………74 第伍章 結論與建議…………………………………………………………………………………………………………78 第一節 結論………………………………………………………………………………………………………………………78 第二節 建議………………………………………………………………………………………………………………………80 參考文獻 ……………………………………………………………………………………………………………………………83 附錄一 高齡者功能性體適能檢測表格………………………………………………………………………96 附錄二 休閒時間身體活動量表……………………………………………………………………………………97 附錄三 研究倫理審查核可證明……………………………………………………………………………………98 附錄四 高齡者多元性運動訓練課程實施表………………………………………………………………99 附錄五 生態學模式實施進程說明表…………………………………………………………………………101 附錄六 高齡者多元性運動摺頁…………………………………………………………………………………103 附錄七 運動目標設定與記錄表…………………………………………………………………………………107 附錄八 社區運動環境與資源資訊……………………………………………………………………………109 附錄九 各項統計分析摘要表………………………………………………………………………………………111 表次 表2-1 ACSM高齡者運動準則建議一覽表…………………………………………………………………14 表2-2 高齡者多元性運動相關研究一覽表………………………………………………………………16 表2-3 社區高齡者運動促進方案相關研究一覽表…………………………………………………23 表2-4 生態學模式演進表………………………………………………………………………………………………28 表2-5 生態學模式介入身體活動策略一覽表…………………………………………………………31 表2-6 生態學模式介入身體活動相關研究一覽表…………………………………………………33 表3-1 研究對象基本生理條件同質性檢定一覽表…………………………………………………40 表3-2 功能性體適能測驗再測信度與效度一覽表…………………………………………………41 表3-3 功能性體適能測量方法一覽表………………………………………………………………………41 表3-4 生態學模式與多元性運動訓練介入之實驗設計表……………………………………44 表3-5 依ACSM原則設計之多元性運動訓練課程一覽表………………………………………46 表3-6 生態學模介入策略表…………………………………………………………………………………………47 表4-1 前測功能性體適能測驗及身體活動量摘要表……………………………………………49 表4-2 坐姿起立測驗摘要表…………………………………………………………………………………………52 表4-3 手臂彎舉測驗摘要表…………………………………………………………………………………………55 表4-4 2分鐘踏步測驗摘要表………………………………………………………………………………………58 表4-5 坐姿體前彎測驗摘要表……………………………………………………………………………………61 表4-6 抓背測驗摘要表…………………………………………………………………………………………………64 表4-7 8英呎繞行測驗摘要表………………………………………………………………………………………67 表4-8 休閒時間身體活動量變化摘要表……………………………………………………………………70 表4-9 中、高強度身體活動量變化摘要表………………………………………………………………73 表4-10 功能性體適能測驗及休閒時間身體活動量整體結果摘要表………………77   圖次 圖2-1 四面向活躍生活生態學模式圖………………………………………………………………………30 圖3-1 研究架構圖……………………………………………………………………………………………………………37 圖3-2 研究流程圖……………………………………………………………………………………………………………38 圖3-3 功能性體適能測驗流程圖…………………………………………………………………………………43 圖4-1 不同組別與時間測驗在坐姿起立比較分析圖……………………………………………52 圖4-2 不同組別與時間測驗在手臂彎舉比較分析圖……………………………………………55 圖4-3 不同組別與時間測驗在2分鐘踏步比較分析圖…………………………………………58 圖4-4 不同組別與時間測驗在坐姿體前彎比較分析圖…………………………………………61 圖4-5 不同組別與時間測驗在抓背比較分析圖………………………………………………………64 圖4-6 不同組別與時間測驗在8英呎繞行比較分析圖…………………………………………67 圖4-7 不同組別與時間測驗在休閒時間身體活動量比較分析圖………………………70 圖4-8 不同組別與時間測驗在中、高強度身體活動量比較分析圖…………………73

    內政部 (2013) 。中華民國102年國民生活狀況意向調查報告。取自http://sowf.moi.gov.tw/stat/Survey/國民/102年國民生活狀況意向調查分析.pdf
    內政部 (2015a) 。104年第29週內政統計通報。取自http://www.moi.gov.tw/files/news_file/week10429 . pdf
    內政部 (2015b) 。民國102年簡易生命表提要分析。取自http://sowf.moi.gov.tw/stat/Life/T04-analysis.html
    方怡堯 (2015) 。高齡者運動促進篇。載於張少熙 (主編) ,高齡者全方位健康促進實施手冊。 (頁1-177)。臺北市:臺北市政府衛生局。
    方怡堯、何信弘、張少熙 (2014) 。在地老化運動促進策略之探討:以芬蘭高齡者運動促進方案為例。中華體育季刊,28(2),137-144。
    方怡堯、張少熙、何信弘 (2015) 。多元性運動訓練對社區高齡者功能性體適能之影響。體育學報,48(1),59-72。
    方進隆 (2015) 。高齡者的運動與全人健康。臺北市:華都。
    方進隆、李若屏、高鈺彥、張致瑋、卓俊辰 (2008) 。社區身體活動推廣策略與介入模式之研究。體育學報,41(3),1-14。
    王秀華、李淑芳 (2011) 。不同運動階段老年婦女其功能性體適能與健康生活品質之研究。體育學報,44 (3),333-350。
    石博文、莊媖智 (2010) 。非政府組織人員在原住民社區健康工作的困境。護理暨健康照護研究,6 (3),231-239。
    牟鍾福、陳建松 (2010) 。我國老人運動政策之研究報告書,行政院體育委員會。
    行政院主計總處 (2012) 。社會指標統計年報。取自http://www.stat.gov.tw/public/Attachment/29211553471.pdf
    行政院主計總處 (2013) 。社會指標統計年報。取自http://ebook.dgbas.gov.tw/public/Data/31211154738MKFOK1MR.pdf
    行政院經濟建設委員會 (2012) 。中華民國2012年至2060年人口推計。臺北市:作者。
    吳孟恬、陳惠姿、詹元碩 (2009) 。六週知覺動作訓練對高齡者平衡控制能力之影響。輔仁大學體育學刊,8,198-209。
    吳孟恬、詹元碩 (2011) 。不同知覺動作訓練週期對高齡者平衡控制能力之成效分析。長榮運動休閒學刊,5,21-37。
    李若屏、黃奕仁、蘇福新、方進隆 (2008) 。多元性運動訓練計畫對社區老人DHEA-S和體適能之影響。運動生理暨體能學報,8,69-79。
    李麗晶、卓俊玲 (2008) 。身體活動和老人憂鬱症。中華體育季刊,22 (2),60-69。
    林士絹 (2012) 。高齡者運動保健課程學習需求之研究─活躍老化的觀點 (未出版碩士論文)。國立嘉義大學,嘉義市。
    林清壽、王文君 (2013) 。中高齡者從事規律運動行為意向之研究。運動與健康研究,2 (2),31-48。
    林嘉志 (譯) (2012) 。ACSM運動測試與運動處方指引。臺北市:易利。 (American College of Sports Medicine,2009)。
    邱淑媞 (2011) 。高齡友善健康照護。醫療品質雜誌,5 (5),20-24。
    徐文媛 (2009) 。有品質的健康照護:台灣健保擁有五大特色。衛生報導季刊,140,28-29。
    高淑貴、周欣宜 (2008) 。 推動在地老化策略之研究─以「建立社區照顧關懷據點計畫」為例。農業推廣文彙,53,35-47。
    張少熙、方怡堯、陳少卿 (2014) 。 銀髮族愛運動。臺北市:臺北市政府衛生局。
    張少熙、何信弘、方怡堯、詹培明 (2012,12月) 。在地老化與健康促進之實施成效-以大同區健康服務中心長青健康活力站為例。以海報形式發表於2012體育運動學術團體聯合年會暨學術研討會,臺北市:國立臺灣師範大學。
    張彩秀、樓美玲、譚蓉瑩、吳昭軍、吳寶琴 (2013) 。健康促進計畫對防治社區老人憂鬱症狀之成效探討。澄清醫護管理雜誌,9 (4),29-36。
    教育部 (2013) 。樂齡運動休閒健身與保健:樂齡學習教材。臺北市:作者。
    教育部體育署 (2013) 。中華民國101年運動城市調查。臺北市: 作者。
    教育部體育署 (2014) 。中華民國102年運動城市調查。臺北市: 作者。
    章宏智、程瑞福 (2012) 。從生態觀點探討兒童規律運動行為的養成。教師專業研究期刊,3,1-13。
    許毓珈、林麗娟、汪翠瀅、黃上真、吳蕙雯 (2013) 。社區型團體運動對社區中老年人身心功能之影響。臺灣職能治療研究與實務雜誌,9 (1),16-27。
    連心瑜、高碧霞、羅美芳 (2012) 。生態系統理論於兒童肥胖防治之應用。長庚護理,23 (3),313-322。
    郭世傑、古博文、周碧瑟 (2013) 。中老年人身體活動劑量反應對全因死亡率之影響-1996至2007年縱貫性研究。運動生理暨體能學報,(17),29-39。
    郭佳慧、林惠賢、李碧玉 (2012) 。生態系統理論於社區健康評估之運用。護理雜誌,59 (2),99-105。
    陳孟鈺、林麗娟、林泰祐、羅詩文、謝閔繐、蔡岳璋、沈彥廷 (2014) 。不同運動訓練類型對中老年人骨質密度暨等速肌力之影響。體育學報,47(4),503-516。
    陳詩婷 (2013) 。台灣推動高齡友善城市刻不容緩。健康世界,326,33-38。
    陳寬政、林子瑜、邱毅潔、紀筱涵 (2009) 。人口老化、疾病擴張、與健保醫療費用。人口學刊,39,59-83。
    曾于芬、高碧霞 (2012) 。運用生態系統理論於一位學齡期氣喘兒童之護理經驗。護理雜誌,59 (1),96-103。
    曾中明 (2006) 。台灣老人福利概況及政策展望。台灣老年醫學雜誌,1 (3),112-121。
    曾雅玲、陳淑齡、林綽娟 (2004) 。由生態系統理論視角探討應用於護理實務之菸害防制架構。長庚護理,15 (1),65-72。
    黃泰諭、方進隆 (2010) 。八週太極拳訓練對老年女性下肢肌力與平衡表現之影響。體育學報,43 (1),23-36。
    廖南凱、游進達 (2012)。城市與鄉村老年人健康狀況、運動行為與健康生活品質差異之研究。亞洲高齡健康休閒及教育學刊,1 (1),26-39。
    臺北市衛生局 (2014) 。臺北高齡者健康行為調查。臺北市:作者。
    劉永琦、方怡堯、張少熙 (2012年12月) 。專責機構在運動推廣之重要性─以芬蘭高齡者運動為例。2012體育運動學術團體聯合年會暨學術研討會,臺北市:國立臺灣師範大學。
    劉宏鈺、吳明儒、吳曉君 (2012) 。社區高齡者學習與健康關係之評析:以嘉義縣長青活力站為例。台灣社區工作與社區研究學刊,2 (2),123-162。
    劉影梅 (2004) 。國際身體活動量表台灣中文版之發展與信效度驗證。未出版博士論文,國立臺灣大學,臺北市。
    潘姿玲、林淑媛 (2011) 。團體遊戲介入在改變養護機構老人衰弱之成效。護理暨健康照護研究,7 (1),45-54。
    蔡存維、郭彥宇、蔡櫻蘭 (2011) 。團體伸展訓練課程對長期照護機構高齡者功能性體適能的影響。大專體育學刊,13 (4),111-118。
    蔡英美、郭慈安、王俊明 (2012) 。老年人生活型態、運動參與程度與功能性體適能之研究。運動與健康研究,2 (1),25-49。
    衛生福利部 (2009) 。老人健康促進計畫 (2009~2012) 。臺北市:作者。
    衛生福利部 (2011) 。健康體能相關實證文獻。臺北市:作者。
    衛生福利部 (2013) 。友善關懷老人服務方案第二期計畫(核定本)。取自http://sfaa.gov.tw/u/cms/www/201312/161402180ton.pdf
    衛生福利部 (2014a)。民國102年健康行為危險因子監測系統。取自https://olap.hpa.gov.tw/search/ListHealth1.aspx?menu=1&mode=16&year=100
    衛生福利部 (2014b) 。102老人狀況調查報告。臺北市:作者
    錢桂玉、甘乃文、林雅麗 (2012) 。水中運動訓練對中老年人健康之效益。運動生理暨體能學報,14,11-21。
    羅玉岱、劉淑玲、潘輝民 (2009) 。某醫院五週整合式運動課程對中高齡民眾體適能之影響。臺灣家庭醫學雜誌,19 (4), 203-212。
    蘇子炘、陳淑慧 (2012) 。建構高齡者服務體驗量表。健康管理學刊,10 (2),126-137。
    蘇蕙芬、蔡永川 (2013) 運動介入對高齡者功能性體適能影響之研究。社會服務與休閒產業研究,2,71-88。
    蘇麗瓊、黃雅鈴 (2005) 。老人福利政策再出發推動在地老化政策。社區發展季刊,110,5-13。
    Adams, M. A., Hovell, M. F., Irvin, V., Sallis, J. F., Coleman, K. J., & Liles, S. (2006). Promoting stair use by modeling: An experimental application of the behavioral ecological model. American Journal of Health Promotion, 21 (2), 101-109.
    Adelman, R. D., Greene, M. G., Friedmann, E., Ory, M. G., & Snow, C. E. (2011). Older patient-physician discussions about exercise. Journal of Aging and Physical Activity, 19 (3), 225-238.
    Aragao, F. R., Abrantes, C. G., Gabriel, R. E., Sousa, M. F., Castelo-Branco, C., & Moreira, M. H. (2014). Effects of a 12-month multi-component exercise program on the body composition of postmenopausal women. Climacteric, 17( 2), 155-163.
    Baker, G., Gray, S. R., Wright, A., Fitzsimons, C., Nimmo, M., Lowry, R., & Mutrie, N. (2008). The effect of a pedometer-based community walking intervention. International Journal of Behavioral Nutrition and Physical Activity, 5 (1), 44.
    Baker, M. K., Atlantis, E., & Singh, M. A. F. (2007). Multi-modal exercise programs for older adults. Age and Ageing, 36 (4), 375-381.
    Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. NJ: Prentice-Hall.
    Barker, R. G. (1968). Ecological psychology. CA: Stanford University Press.
    Bird, M., Hill, K. D., Ball, M., Hetherington, S., & Williams, A. D. (2011). The long-term benefits of a multi-component exercise intervention to balance and mobility in healthy older adults. Archives Of Gerontology And Geriatrics, 52 (2), 211-216.
    Blair S. N., Kohl, H. W. , Paffenbarger, R. S., Jr, Clark, D. G., Cooper, K. H., Gibbons, L. W.(1989) . Physical fitness and all-cause mortality. A prospective study of healthy men and women. Journal of the American Medical Association, 262 (17), 2395–2401.
    Bookman, A. (2008). Innovative models of aging in place: Transforming our communities for an aging population. Community, Work & Family, 11(4), 419-438.
    Borg, G. (1982). Psychophysical bases of perceived exertion. Medicine and Science in Sport and Exercise, 14, 377-381.
    Bronfenbrenner, U. (1979). The ecology of human developmen t: Experiments by nature and design. MA: Harvard University Press.
    Campbell, A. J., Robertson, M. C., Gardner, M. M., Norton, R. N., Tilyard, M. W., & Buchner, D. M. (1997). Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. British Medical Journal, 315 (7115), 1065-1069.
    Cao, Z. B., Maeda, A., Shima, N., Kurata, H., & Nishizono, H. (2007). The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women. Journal of physiological anthropology, 26 (3), 325-332.
    Chodzko-Zajko, W. (2014), Acsm's exercise for older adults. London:Lippincott Williams & Wilkins .
    Chou, C. H., Hwang, C. L., & Wu, Y. T. (2012). Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 93 (2), 237-244.
    Cohen, D. A., Scribner, R. A., &Farley, T. A. (2000). A structural model of health behavior: A pragmatic approach to explain and influence health behaviors at the population level. Preventive Medicine, 30 (2),146-54.
    Cress, M.E., Buchner, D.M., Questad, K.A., Esselman, P.C. deLateur, B.J., & Schwartz, R.S. (1999). Exercise: effects on physical functional performance in independent older adults. The Journal of Gerontogy, 54(5), 242-248.
    Davies, C. A., Vandelanotte, C., Duncan, M. J., & Van Uffelen, J. G. Z. (2012). Associations of physical activity and screen-time on health related quality of life in adults. Preventive Medicine, 35, 46-49.
    De Negreiros, Cabral, K., Perracini, M. R., Soares, A. T., de Cristo Stein, F., Sera, C. T., Tiedemann, A., Sherrington, C., Filho, W. J., Paschoal, S. M. (2013). Effectiveness of a multifactorial falls prevention program in community-dwelling older people when compared to usual care: Study protocol for a randomised controlled trial (Prevquedas Brazil). BMC Geriatr. 13,27.
    De Vries, N., Van Ravensberg, C., Hobbelen, J., Olde Rikkert, M., Staal, J., & Nijhuis-van der Sanden, M. (2012). Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: A meta-analysis. Ageing research reviews, 11 (1), 136-149.
    Ding, D. (2013). Ecological models: Application to physical Activity. In Marc D. Gellman, J. Rick Turner (Ed), Encyclopedia of Behavioral Medicine (pp. 645-647). New York:Springer-Verlag.
    Dishman, R. K., & Buckworth, J. (1996). Increasing physical activity: A quantitative synthesis. Medicine and Science in Sports and Exercise, 28 (6), 706-719.
    Dishman, R. K., Oldenburg, B., O’Neal, H., & Shephard, R. J. (1998). Worksite physical activity interventions. American Journal of Preventive Medicine, 15 (4), 344-361.
    Elsawy, B., & Higgins, K. E. (2010). Physical activity guidelines for older adults. American family physician, 81 (1), 55-59.
    Elvik, R. (2001). Area-wide urban traffic calming schemes: A meta-analysis of safety effects. Accident Analysis & Prevention, 33 (3), 327-336.
    Fang, I. Y., Chang, S. H., Cheng, H. P., & Hsueh, M. C. (2013, Jun). A study on the analysis of older adults' exercise participation in Taiwan [Abstract]. The 20th IAGG World Congress of Gerontology and Geriatrics, Seoul, Korea. Journal of Nutrition Health & Aging vol 17, supplement 1.
    Fei, S., Norman, I. J., & While, A. E. (2013). Physical activity in older people: a systematic review. BMC Public Health, 13(1), 1-17. doi: 10.1186/1471-2458-13-449
    Fisher, E. B., Brownson, C. A., O'Toole, M. L., Shetty, G., Anwuri, V. V., Glasgow, R. E. (2005). Ecological approaches to self-management: The case of diabetes. American Journal of Public Health, 95 (9), 1523-1535.
    Flay, B. R., & Petraitis, J. (1994). The theory of triadic influence: A new theory of health behavior with implications for preventive interventions. Advances in Medical Sociology, 4, 19-44.
    Foley, A., Hillier, S., & Barnard, R. (2011). Effectiveness of once-weekly gym-based exercise programmes for older adults post discharge from day rehabilitation: A randomised controlled trial. British Journal of Sports Medicine, 45 (12), 978-986.
    Gianoudis, J., Bailey, C. A., Ebeling, P. R., Nowson, C. A., Sanders, K. M., Hill, K., & Daly, R. M. (2014). Effects of a targeted multimodal exercise program incorporating high‐speed power training on falls and fracture risk factors in older adults: A community‐based randomized controlled trial. Journal of bone and mineral research, 29(1), 182-191.
    Giles-Corti, B., Timperio, A., Bull, F.,& Pikora, T. (2005). Understanding physical activity environmental correlates: Increased specificity for ecological models. Exercise and Sport Sciences Reviews, 33 (4),175-181.
    Glanz, K., Sallis, J. F., Saelens, B. E., & Frank, L. D. (2005). Healthy nutrition environments: concepts and measures. American Journal of Health Promotion, 19 (5), 330-333.
    Glass, T. A., & McAtee, M. J. (2006). Behavioral science at the crossroads in public health: Extending horizons, envisioning the future. Social Science & Medicine,62 (7),1650-1671.
    Gothe NP, Wójcicki TR, Olson EA, Fanning J, Awick E, Chung HD, Zuniga KE, Mackenzie MJ, Motl RW., & McAuley E. (2014). Physical activity levels and patterns in older adults: the influence of a DVD-based exercise program. Journal of Behavioral Medicine.
    Gregg, E. W., Pereira, M. A., & Caspersen, C. J. (2000). Physical activity, falls, and fractures among older adults: A review of the epidemiologic evidence. Journal of the American Geriatrics Society, 48 (8), 883.
    Gschwind, Y. J., Kressig, R. W., Lacroix, A., Muehlbauer, T., Pfenninger, B., & Granacher, U. (2013). A best practice fall prevention exercise program to improve balance, strength/power, and psychosocial health in older adults: Study protocol for a randomized controlled trial. BMC Geriatr, 13(1), 105.
    Heath, G. W., Parra, D. C., Sarmiento, O. L., Andersen, L. B., Owen, N., Goenka, S., . . . Group, L. P. A. S. W. (2012). Evidence-based intervention in physical activity: lessons from around the world. The Lancet, 380(9838), 272-281.
    Hooker, S. P., William, M. D., Seavey, M., Weidmer, C. E., Harvey, D. J., Stewart, A. L., Gillis, D. E., King, A. C. (2005). The california active aging community grant program: Translating science into practice to promote physical activity in older adults. Annals of Behavioral Medicine, 29 (3), 155-165.
    Inoue, S. L., Murase, N., Shimomitsu, T., Ohya, Y., Odagiri, Y., Takamiya, T., Ishii, K., Katsumura, T., Sallis, J. F. (2009). Association of physical activity and neighborhood environment among Japanese adults. Preventive Medicine, 48 (4), 321-325.
    Institute of Medicine (2001).Health and behavior: The Interplay of biological, behavioral, and societal Influences.Washington, DC: National Academies Press.
    Jones, C. J., Rikli, R. E., & Wotipka, R. (2005). Effects of a 5-year exercise program on functional performance of older adults. Paper presented at the Medicine and science in sports and exercise.
    Jones, D. W., Peterson, E. D., Bonow, R. O., Masoudi, F. A., Fonarow, G. C., Smith, S. C. Jr, Solis, P., Girgus, M., Hinton, P. C., Leonard, A., Gibbons, R. J. (2008). Translating research into practice for healthcare providers: The American heart association's strategy for building healthier lives, free of cardiovascular diseases and stroke. Circulation,118 (6), 687-96.
    June, P. (2009). The built environment: Designing communities to promote physical activity in children. Pediatrics, 123 (6), 1591-1598.
    Karinkanta, S., Heinonen, A., Sievänen, H., Uusi-Rasi, K., Pasanen, M., Ojala, K., Kannus, P. (2007). A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: Randomized, controlled trial. Osteoporosis International, 18 (4), 453-462.
    Katzmarzyk, P. T., Dentro, K., Beals, K., Crouter, S., Joey C. Eisenmann, McKenzie, T. L., Spruijt-Metz, D. (2014). The 2014 united states report card on physical activity forchildren & youth national physical activity. Columbia, SC: National Physical Activity Plan Alliane.
    Kerr, J., Rosenberg, D. E., Nathan, A., Millstein, R. A., Carlson, J. A., Crist, K., Buchner, D. M. (2012). Applying the ecological model of behavior change to a physical activity trial in retirement communities: Description of the study protocol. Contemporary Clinical trials, 33 (6) , 1180-1188.
    Kolbe-Alexander, T. L., Lambert, E. V., & Charlton, K. E. (2006). Effectiveness of a community based low intensity exercise program for older adults. The Journal of Nutrition Health and Aging,10 (1) , 21-29.
    Kovács, E., Sztruhár, J. I., Karóczi, C., Korpos, A., & Gondos, T. (2013). Effects of a multimodal exercise program on balance, functional mobility and fall risk in older adults with cognitive impairment: a randomized controlled single-blind study. European jJournal of pPhysical aand rRehabilitation mMedicine, 49(5), 639-648.
    Kukuljan, S., Nowson, C. A., Bass, S. L., Sanders, K., Nicholson, G. C., Seibel, M. J., & Daly, R. M. (2009). Effects of a multi-component exercise program and calcium–vitamin-D3-fortified milk on bone mineral density in older men: A randomised controlled trial. Osteoporosis International, 20 (7), 1241-1251.
    Kwon, Y., Park, S., Kim, E., & Park, J. (2008). The effects of multi-component exercise training on (V)over-dot-O(2)max, muscle mass, whole bone mineral density and fall risk in community-dwelling elderly women. Japanese Journal of Physical Fitness and Sports Medicine, 57 (3) , 339-348.
    Lee L. L, Arthur A, & Avis M. (2007). Evaluating a community-based walking intervention for hypertensive older people in Taiwan: A randomized controlled trial. Preventive Medicine, 44 (2),160-166.
    Levy, S. S., Macera, C. A., Hootman, J. M., Coleman, K. J., Lopez, R., Nichols, J. F., Ainsworth, Barbara A., & Ji, M. (2012). Evaluation of a multi-component group exercise program for adults with arthritis: Fitness and exercise for people with arthritis (FEPA). Disability and Health Journal, 5(4), 305-311.
    Lewin, K., and Cartwright, D. (1951). Field Theory in Social Science. N Y: Harper.
    Li, I. C., Kuo, H. T., Lin, K. C., & Wu, Y. C. (2014). The effects of depressive symptoms on quality of life among institutionalizedolder adults in Taiwan. Perspectives in psychiatric Psychiatric Care, 50 (1), 58-64.
    Liu-Ambrose, T. Y., Khan, K. M., Eng, J. J., Lord, S. R., Lentle, B., & McKay, H. A. (2005). Both resistance and agility training reduce back pain and improve health-related quality of life in older women with low bone mass. Osteoporosis International, 16 (11), 1321-1329.
    Marcus, B. H., Dubbert, P. M., Forsyth, L. H., McKenzie, T. L., Stone, E. J., Dunn, A. L., & Blair, S. N. (2000). Physical activity behavior change: Issues in adoption and maintenance. Health Psychology, 19 (1) , 32-41.
    Matsudo, S., Matsudo, V., Andrade, D., Arau´jo, T., Andrade, E., Oliveira, L., & Braggion, G. (2004). Physical activity promotion: Experience and evaluation of the Agita Sa˜o Paulo program using the ecological Mo´bile Model. Journal of Physical Activity and Health, 1 , 81-97.
    McCormack, G. R., Giles-Corti, B., Timperio, A., Wood, G., & Villanueva, K. (2011). A cross-sectional study of the individual, social, and built environmental correlates of pedometer-based physical activity among elementary school children. International Journal of Behavioral Nutrition and Physical Activtity, 12 (8), 30.
    McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15 (4), 351-377.
    Milne, A., Culverwell, A., Guss, R., Tuppen, J., & Whelton, R. (2008). Screening for dementia in primary care: A review of the use, efficacy and quality of measures. International Psychogeriatrics, 20 (5) , 911-926.
    Moore, K., McGowan, M., Kollipara, S., & Roubideaux, Y. (2009). Community resources for promoting youth nutrition and physical activity. American Journal of Health Education, 40 (5), 298-303.
    Moos, R. H. (1980). Social-Ecological Perspectives on Health. In G. C. Stone, F. Cohen, and N. E. Adler (eds.), Health Psychology: A Handbook. (pp. 523-547) San Francisco: Jossey-Bass.
    Nakamura, Y., Tanaka, K., Yabushita, N., Sakai, T., & Shigematsu, R. (2007). Effects of exercise frequency on functional fitness in older adult women. Archives Of Gerontology And Geriatrics, 44 (2), 163-173.
    National institute on aging. (2013). Exercise & physical activity: your everyday guide from the National Institute on Aging. Bethesda, Maryland: Author.
    Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., & Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: Recommendation from the american college of sports medicine and the american heart association. Circulation, 116 (9), 1094.
    Nicholson, V. P., McKean, M. R., & Burkett, B. J. (2014). Twelve weeks of BodyBalance® training improved balance and functional task performance in middle-aged and older adults. Clinical Interventions in Aging Clin Interv Aging, 9, 1895.
    Owen, N., Humpel, N., Leslie, E., Bauman, A., & Sallis, J.F. (2004). Understanding environmental influences on walking: Review and research agenda. American Journal of Preventive Medicine, (1), 67-76.
    Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C., & King, A. C. (1995). Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association Jama, 273 (5) , 402-407.
    Pelssers, J., Delecluse, C., Opdenacker, J., Kennis, E., Van Roie, E., & Boen, F. (2013). Every step counts : effects of a structured walking intervention in a community-based senior organization. Journal of Aging and Physical Activity, 21 (2), 167-185.
    Radaelli, R., Botton, C., Wilhelm, E., Bottaro, M., Brown, L., Lacerda, F., & Pinto, R. (2014). Time course of low- and high-volume strength training on neuromuscular adaptations and muscle quality in older women. AGE, 1-12. doi: 10.1007/s11357-013-9611-2.
    Rikli, R. E., & Jones, C. J. (2001). Senior fitness manual. Champaign, IL: Human Kinetics.
    Rikli, R. E., & Jones, C. J. (2013a). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. The gerontologistGerontologist, 53 (2), 255-267.
    Rikli, R. E., & Jones, C. J. (2013b). Senior fitness test manual. Champaign, IL: Human Kinetics.
    Rosenberg, D. E., Kerr, J., Sallis, J. F., Norman, G. J., Calfas, K., & Patrick, K. (2012). Promoting walking among older adults living in retirement communities. Journal of Aging and Physical Activity, 20, 379-394.
    Saelens, B. E., Sallis, J. F., & Frank, L. D. (2003). Environmental correlates of walking and cycling: findings from the transportation, urban design, and planning literatures. Annals of Behavioral Medicine, 25 (2), 80-91.
    Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., & Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public Health, 27, 297–322.
    Sallis, J. F., Owen, N., & Fisher, E. B. (2008). Ecological models of health behavior. In K. Glanz, B. K. Rimer,& K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (4th ed.) (pp. 465–485). San Francisco: Jossey-Bass.
    Sallis, J. F.,& Glanz, K. (2009). Physical activity and food environments: Solutions to the obesity epidemic. The Milbank Quarterly, 87(1), 123–154.
    Sallis, J.F., & Owen, N. (1999). Physical Activity and Behavioral Medicine. Thousand Oaks, CA: Sage.
    Sallis, J.F., & Owen, N. (2002). Ecological models of health behavior. In K. Glanz, B.K. Rimer, & F.M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice, (3rd ed) ( pp. 462-484). San Francisco: Jossey-Bass.
    Sattelmair, J. R., Pertman, J. H., & Forman, D. E. (2009) Effects of physical activity on cardiovascular and noncardiovascular outcomes in older adults. Clinics in Geriatric Medicine, 25(4), 677-702.
    Shen‐Miller, D. S., Isacco, A., Davies, J. A., St Jean, M., & Phan, J. L. (2013). The Men's center approach: Ecological interventions for college Men's Health. Journal of Counseling & Development, 91 (4), 499-507.
    Silveira, P., Daniel, F., Casati, F., & de Bruin, E. D. (2013). Motivating and assisting physical exercise in independently living older adults: A pilot study. International journal Journal of medical Medical informaticsInformatics, 82 (5), 325-334.
    Skinner, B.F. (1953). Science and Human Behavior. New York: Macmillan.
    Sloan, R. A., Haaland, B. A., Leung, C., & Muller-Riemenschneider, F. (2013). The use of point-of-decision prompts to increase stair climbing in Singapore. International Journal of Environmental Research and Public HealthInt J Environ Res Public Health, 10 (1), 210-218.
    Solberg, P. A., Kvamme, N. H., Raastad, T., Ommundsen, Y., Tomten, S. E., Halvari, H., & Hallen, J. (2013). Effects of different types of exercise on muscle mass, strength, function and well-being in elderly. European Journal of Sport Science, 13 (1), 112-125.
    Sousa, N., Mendes, R., Abrantes, C., Sampaio, J., & Oliveira, J. (2014). Effectiveness of combined exercise training to improve functional fitness in older adults: A randomized controlled trial. Geriatrics & Gerontology International, 14(4), 892-898. doi: 10.1111/ggi.12188
    Stokols, D. (1992). Establishing and maintaining healthy environments: toward a social ecology of health promotion. American Psychologist, 47, 6–22.
    Stokols, D., Grzywacz, J. G., McMahan, S., & Phillips, K. (2003). Increasing the health promotive capacity of human environments. American Journal of Health Promotion, 18 (1), 4–13.
    Straight, C. R., Dorfman, L. R., Cottell, K.E., Krol, J. M., Lofgren, I. E., & Delmonico, M.J. (2012). Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults. Journal of physical Physical activity Activity & healthHealth, 9, 875 – 883.
    Strand, K. A., Francis, S. L., Margrett, J. A., Franke, W. D., & Peterson, M. J. (2014). Community-based exergaming program increases physical activity and perceived wellness in older adults. Journal of Aging & Physical Activity, 22(3), 364.
    Thompson, W. R., Gordon, N. F., & Pescatello, L. S. (2009). ACSM's guidelines for exercise testing and prescription (8th ed.). PA: Lippincott Williams & Wilkins.
    Toto, P. E., Raina, K. D., Holm, M. B., Schlenk, E. A., Rubinstein, E. N., & Rogers, J. C. (2012). outcomes of a multicomponent physical activity program for sedentary, community-dwelling older adults. Journal of Aging and Physical Activity, 20, 363-378.
    Warren, B. S., Maley, M., Sugarwala, L. J., Wells, M. T., & Devine, C. M. (2010). Small steps are easier together: A goal-based ecological intervention to increase walking by women in rural worksites. Preventive medicineMedicine, 50 (5–6), 230-234.
    Whitt-Glover, M.C., Bennett, G., & Sallis, J.F. (2013). Introduction to the active living research supplement: disparities in environments and policies that support active living. , Annals of Behavioral Medicine, 45, 1, S1-5.
    World Health Organization. (2007). A guide for population-based approa ches to increasing levels of physical activity. Retrieved July, 2014 from the web: http://www.who.int/dietphysicalactivity/PA-promotionguide-2007.pdf
    World Health Organization. (2010). Global recommendations on physical activity for health. retrieved July, 2014 from the web: http://www.who.int/dietphysicalactivity/factsheet_recommendations/zh/index. html。
    Zhuang, J., Huang, L., Wu, Y., & Zhang, Y. (2014). The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults. Clinical Interventions in AgingClin Interv Aging, 9, 131.

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