Physical Activity in Underserved Populations: Using Epidemiologic Assessments to Inform Sustainable Intervention

服务不足人群的体育活动：利用流行病学评估为可持续干预措施提供信息

• 批准号: 10317073
• 负责人: Kelly Ylitalo
• 金额: $ 12.63万
• 依托单位: BAYLOR UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10317073
• 关键词: Accelerometer; Address; Adherence; Aging; American; Award; Behavior; Behavior Therapy; Behavioral; Cardiovascular Physiology; Chronic Disease; Communities; Community Health; Community Health Aides; Country; Data; Data Collection; Development; Devices; Disease; Epidemiology; Ethnic Origin; Ethnic group; Evaluation; Exercise; Family health status; Federally Qualified Health Center; Focus Groups; Frequencies; Geography; Goals; Health; Health Care Costs; Health Promotion; Health Technology; Health behavior; Hispanic; Intervention; K-Series Research Career Programs; Knowledge; Latina; Latina Population; Leisures; Life; Longitudinal Studies; Longitudinal cohort study; Low income; Measurement; Mentored Research Scientist Development Award; Mentors; Mexican; Michigan; Monitor; Nature; Not Hispanic or Latino; Occupations; Participant; Patient Self-Report; Patients; Physical activity; Physical activity scale; Population; Prevalence; Problem Solving; Program Development; Program Evaluation; Race; Reporting; Research Personnel; Sampling; Self Administration; Self Management; Site; Social support; Socioeconomic Status; Source; Study of Women' s Health Across the Nation; Texas; Text Messaging; Time; Training; Translating; Transportation; Uncertainty; Underserved Population; Universities; Weight Gain; Woman; barrier to care; base; behavioral construct; behavioral health; black women; cohort; college; combat; cost; cost effective; disability; ethnic minority; health care availability; high school; improved; innovation; instrument; interest; mHealth; minority communities; participant retention; peer support; physical inactivity; prevent; productivity loss; recruit; skills; social; social culture; study population; text messaging intervention; theories; therapy development; tool; treatment adherence; underserved community

ABSTRACT Physical activity (PA), including regular exercise, prevents weight gain, delays functional limitations, and improves cardiovascular function, yet one in three Americans is inactive. PA measurement and promotion in underserved populations, such as low-income race/ethnic minority communities, is especially challenging. Inadequate cultural adaptation contributes to substantial measurement error between self-administered and continuously-monitored (e.g., device-based) PA assessments. Identification of the determinants of PA, within the context of sociocultural and geographic norms, is a central component of developing sustainable and cost- effective PA promotion strategies. Emerging evidence suggests that culturally-adapted PA promotion strategies, such as those that use community health workers, can provide cultural interpretation and adaptation of measurement and intervention, sensitivity to sociocultural norms, and increase treatment adherence and social support of intervention activities. However, these interventions are difficult to scale. Mobile health (mHealth) technology, including text messaging, has shown great promise for behavioral interventions and disease self- management, but common concerns include the impersonalized nature of texts and uncertainty regarding effective frequency and content. Culturally-adapted health coaching and social support provided by community health workers, combined with frequent contact via text messaging, may be an effective, scalable PA promotion tool, but the feasibility is not well understood among underserved communities. This career development award will provide me with training in health behavior theories, PA measurement strategies, and peer support and mHealth intervention development and evaluation. We propose to conduct an analysis of PA in the longitudinal Study of Women’s Health Across the Nation, a diverse sample of women that have been followed for 20 years, and recruit a sample of 60 Mexican-heritage Latina women from a federally-qualified health center to compare self-administered and device-based PA data among multiple race/ethnic groups (Aim 1). Then, we will develop (Aim 2) and pilot (Aim 3) a PA behavioral intervention using community health workers and mHealth tools to increase social support and PA among Latina participants. The goal of this Mentored Research Scientist Development Award (K01) is to prepare Dr. Kelly Ylitalo to become an independent investigator with expertise in innovative PA promotion throughout the lifecourse, with a specific emphasis on culturally-adapted measurement and intervention, to support the long-term goal of preventing or delaying functional limitations and aging-related disability in priority populations.

抽象的 体育锻炼（PA），包括定期运动，可以防止体重增加，延迟功能 局限性并改善了心血管功能，但三分之一的美国人不活跃。 PA 服务不足的人群（例如低收入种族/族裔）的测量和促进 少数民族社区特别具有挑战性。文化适应不足有助于 自我管理和持续监控之间的实质测量误差（例如， 基于设备的）PA评估。识别PA的决定者， 社会文化和地理规范是发展可持续和成本 - 有效的PA促进策略。新兴的证据表明，文化适应的PA 促进策略，例如使用社区卫生工作者的促进策略，可以提供文化 对测量和干预的解释和适应，对社会文化的敏感性 规范，增加治疗依从性和对干预活动的社会支持。然而， 这些干预措施很难扩展。移动健康（MHealth）技术，包括文本 消息传递对行为干预和疾病自我表现出了巨大的希望 管理，但普遍的关注包括文本的非人格性质和不确定性 关于有效的频率和内容。适应文化的健康教练和社会 社区卫生工作者提供的支持，结合经常通过文本联系 消息传递可能是一个有效的可扩展PA促销工具，但可行性不好 在服务不足的社区中理解。该职业发展奖将提供 我对健康行为理论，PA测量策略和同伴支持的培训以及 MHealth干预开发和评估。我们建议对PA进行分析 全国妇女健康的纵向研究，妇女的潜水员样本 遵循了20年，并招募了60个墨西哥裔拉丁裔的样本 来自联邦资格健康中心的妇女比较自我管理和基于设备的妇女 PA在多个种族/族裔群体中数据（AIM 1）。然后，我们将开发（AIM 2）和飞行员 （目标3）使用社区卫生工作者和MHealth工具的PA行为干预措施 在拉丁裔参与者中增加社会支持和PA。这项指导研究的目标 科学家发展奖（K01）是准备凯利·伊利塔罗（Kelly Ylitalo）博士成为独立 在整个生命过程中具有创新PA促进专业知识的研究者，具体 强调具有文化适应的测量和干预措施，以支持长期目标 在优先人群中预防或延迟功能局限性和与衰老相关的残疾。