ENLACE: A Promotora-Led Physical Activity Intervention Trial for Latinas in Texas

ENLACE：Promotora 主导的德克萨斯州拉丁裔体育活动干预试验

• 批准号: 8909331
• 负责人: DEBORAH PARRA-MEDINA
• 金额: $ 3.43万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-15 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8909331
• 关键词: Achievement; Address; Adult; Age; Area; Attention; Attitude; Behavior Therapy; Behavioral; Body mass index; Chronic Disease; Church; Communities; Control Groups; Counseling; County; Disadvantaged; Effectiveness; Environment; Environmental Risk Factor; Equilibrium; Failure; First Aid; Funding; Future; Gender; Generic Drugs; Goals; Guidelines; Health; Health Promotion; Health education; Hispanics; Home environment; Individual; Institutionalization; Intervention; Intervention Trial; Joints; Knowledge; Latina; Latino; Life; Link; Literature; Low income; Maintenance; Malignant Neoplasms; Measurement; Measures; Mediator of activation protein; Methods; Mexican Americans; Minority; Modeling; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Newsletter; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Outcome; Participant; Phase; Physical Fitness; Physical activity; Population; Psyche structure; Randomized; Randomized Controlled Trials; Recommendation; Recreation; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Research Project Grants; Resources; Risk; Role; Safety; Self Efficacy; Services; Site; Social Network; Social support; South Texas; Telephone; Testing; Texas; Weight Gain; Woman; Work; base; behavior change; comparative efficacy; cost; design; experience; health disparity; improved; meetings; member; men; mortality; obesity risk; outreach; post intervention; prevent; primary outcome; programs; racial and ethnic; research study; secondary outcome; skills; social; socioeconomics; success; weight maintenance

DESCRIPTION (provided by applicant): Latinos experience a disproportionate burden of hypokinetic-related chronic diseases, threatening the future health of the nation's fastest-growing population. Physical inactivity has been linked to increased risk of obesity, type 2 diabetes, and various cancers. Latinos are more likely than non-Hispanic whites to fail to meet physical activity (PA) recommendations, and Latino women are less physically active than Latino men. The goal of the proposed ENLACE research project is to design, implement and evaluate a promotora-led PA intervention that takes a comprehensive, multi- level, community-based approach to promoting moderate-to-vigorous physical activity (MVPA) among a particularly underserved segment of Latinas. The intervention approach, based on the social ecological model, focuses on individual attitudes and skills, socio-cultural factors and environmental influences to behavior change. The proposed group- randomized controlled trial builds on formative and pilot research (funded by a National Heart, Lung and Blood Institute R21, HL087765) by a team of academic investigators and community partners with extensive experience working together to conduct behavioral interventions and outreach with Latino and disadvantaged populations. Eight community resource centers (CRCs) in four predominantly Latino counties in South Texas' Lower Rio Grande Valley will be randomly assigned to either the Enlace PA Intervention (4 CRCs) or an attention-control condition (4 CRCs). We will recruit 704 Latinas ages 18-64 who do not meet national PA guidelines from colonias (unincorporated, impoverished, underserved Latino settlements) in the CRC service areas. Participants from CRCs randomized to the Enlace PA Intervention (N = 352; 88 women per CRC) will receive 16 weekly promotora-led group sessions followed by 24 weeks of a maintenance intervention (monthly promotora-delivered newsletters and telephone counseling). The group sessions' behavioral goal is for Latinas to engage in 30 minutes per day of MVPA on 5 or more days per week. The attention- control group (N = 352; 88 women per CRC) will receive 16 weekly promotora-led group sessions on home safety/first aid and monthly generic health education materials and informational telephone calls during the maintenance intervention period. The primary outcome is minutes per week of MVPA (measured with accelerometers). Secondary outcomes are physical fitness and weight maintenance. We also will evaluate self-efficacy, social support, decisional balance, and collective efficacy as mediators of MVPA changes. Standardized measurement of primary and secondary outcomes will occur at baseline, immediate (16 weeks) and delayed post-intervention (40 weeks). We hypothesize that Latinas in the ENLACE PA Intervention will significantly increase their MVPA levels as a result of addressing their specific individual, socio-cultural and environmental barriers and enhancing their social support and collective efficacy, compared to attention-control Latinas.

描述（由申请人提供）：拉丁美洲人承受着与运动机能减退相关的慢性疾病的不成比例的负担，威胁着​​美国增长最快的人口的未来健康。缺乏身体活动与肥胖、2 型糖尿病和各种癌症的风险增加有关。拉丁裔比非西班牙裔白人更有可能达不到体力活动 (PA) 建议，而拉丁裔女性的体力活动少于拉丁裔男性。拟议的 ENLACE 研究项目的目标是设计、实施和评估以 promotora 为主导的 PA 干预措施，该干预措施采用全面、多层次、基于社区的方法，在服务特别不足的人群中促进中度至剧烈身体活动 (MVPA)拉丁裔的一部分。干预方法基于社会生态模型，重点关注个人态度和技能、社会文化因素以及环境对行为改变的影响。拟议的分组随机对照试验以形成性和试点研究（由国家心肺和血液研究所 R21，HL087765 资助）为基础，由具有丰富经验的学术研究人员和社区合作伙伴组成的团队共同对拉丁裔进行行为干预和推广和弱势群体。位于德克萨斯州南部下里奥格兰德河谷的四个以拉丁裔为主的县的八个社区资源中心 (CRC) 将被随机分配到 Enlace PA 干预（4 个 CRC）或注意力控制条件（4 个 CRC）。我们将从 CRC 服务区的殖民地（非法人、贫困、服务不足的拉丁裔定居点）招募 704 名年龄在 18-64 岁之间、不符合国家 PA 准则的拉丁裔美国人。随机接受 Enlace PA 干预的 CRC 参与者（N = 352；每个 CRC 88 名女性）将每周接受 16 次由 promotora 主导的小组会议，随后接受 24 周的维持干预（promotora 每月发送的时事通讯和电话咨询）。小组会议的行为目标是拉丁裔每周 5 天或更多天每天参与 30 分钟 MVPA。注意力对照组（N = 352；每个 CRC 88 名女性）将在维持干预期间接受 16 次由 promotora 主导的每周一次的关于家庭安全/急救的小组会议，以及每月的通用健康教育材料和信息电话。主要结果是每周 MVPA 的分钟数（用加速度计测量）。次要结果是身体健康和体重维持。我们还将评估自我效能、社会支持、决策平衡和集体效能作为 MVPA 变化的中介因素。主要和次要结果的标准化测量将在基线、干预后立即（16 周）和延迟干预后（40 周）进行。我们假设，与注意力控制的拉丁裔相比，ENLACE PA 干预中的拉丁裔将显着提高他们的 MVPA 水平，因为他们解决了特定的个人、社会文化和环境障碍，并增强了他们的社会支持和集体效能。