Smart Walk: A culturally tailored smartphone-delivered physical activity intervention to reduce cardiometabolic disease risk among African American women

Smart Walk：一种根据文化定制的智能手机提供的身体活动干预措施，以降低非裔美国女性的心脏代谢疾病风险

• 批准号: 10639951
• 负责人: Rodney Joseph
• 金额: $ 70.46万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10639951
• 关键词: Accelerometer; Accountability; Address; Adherence; Adult; Aerobic; African American; Age; Anti-Inflammatory Agents; Aorta; Behavior; Biological; Biological Markers; Blood Pressure; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Cardiovascular system; Cellular Phone; Characteristics; Communities; Comparison arm; Computer Vision Systems; Computer software; Control Groups; Data; Devices; Diabetes Mellitus; Diagnosis; Diastolic blood pressure; Discrimination; Dose; Effectiveness of Interventions; Ethnic Origin; Feedback; Glucose Intolerance; Guidelines; Heart Diseases; Hispanic; Home; Inflammatory; Insulin Resistance; Interleukin-10; Interleukin-15; Interleukin-6; Intervention; Link; Lipids; Measures; Mediation; Mediator; Monitor; Multimedia; National Heart, Lung, and Blood Institute; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Participant; Patient Self-Report; Physical activity; Physiologic pulse; Population; Prevalence; Protocols documentation; Public Health; Race; Randomized; Reduce health disparities; Research; Research Personnel; Risk Factors; Serum; Site; Social support; Structural Racism; Structure; Surveys; TNF gene; Technology; Teleconferences; Telephone; Testing; Text; Text Messaging; Walking; Weight maintenance regimen; Woman; Work; actigraphy; aged; arm; burden of illness; cardiometabolic risk; cardiometabolism; cardiorespiratory fitness; cardiovascular fitness; clinically relevant; comparison control; comparison group; cost comparison; cost effectiveness; design; disorder risk; eHealth; efficacy testing; efficacy trial; exercise intervention; experience; fasting glucose; fitbit; follow-up; group intervention; health disparity; improved; intervention effect; intervention participants; mHealth; moderate-to-vigorous physical activity; mortality; novel; outcome prediction; participant retention; physical inactivity; post intervention; pragmatic trial; preference; prevent; primary outcome; prognostic; racism; randomized trial; response; secondary outcome; sedentary; smartphone application; social cognitive theory; social culture; societal costs; theories; two-arm trial; vigorous intensity; virtual; walkability; walking intervention

Abstract/Project Summary African American women experience a high burden of cardiometabolic disease conditions. Fifty-seven percent are obese, 57% have cardiovascular disease, and 12% have diagnosed diabetes. Engaging in regular aerobic physical activity is an established mechanism to prevent and manage these cardiometabolic diseases. The purpose of this study is test the efficacy of a culturally tailored, theory-based smartphone-delivered physical activity intervention to increase physical activity, promote adherence to national aerobic physical activity guidelines, and improve cardiometabolic disease risk factors among African American women. In a 12-month, two arm randomized trial, 240 sedentary (i.e., < 60 minutes/week of moderate-to-vigorous intensity physical activity) African American women with obesity (i.e., BMI >30 kg/m2) will be assigned to receive either Smart Walk, a culturally tailored, Social Cognitive Theory-based physical activity promotion intervention (n=120), or a Fitbit-only comparison arm (n=120). The Smart Walk intervention group will receive a culturally tailored physical activity intervention delivered via the Smart Walk smartphone app, virtual physical activity coaching, and text messages. Features available on the Smart Walk app include: 1) personal profile pages, 2) culturally relevant multi-media (i.e., text and video) physical activity promotion modules, 3) message/discussion boards, and 4) physical activity self-monitoring/tracking feature that integrates with Fitbit activity monitors for participants to track their daily, weekly, and monthly activity. Virtual physical activity coaches will actively engage and facilitate group-based dialogue among participants on the discussion boards and provide individualized, one-on-one physical activity coaching via telephone or commercially available app-based video teleconferencing software, based on participant preference. Smart Walk participants also receive three physical activity promotion text messages each week for the duration of the active 4-month intervention. The Fitbit-only arm comparison arm will receive a Fitbit activity monitor and be encouraged to use the commercially available device to increase physical activity. We hypothesize participants in the Smart Walk intervention group will demonstrate significantly greater improvements in physical activity and cardiometabolic risk factors when compared to the Fitbit-only comparison group. Primary outcomes include self-reported and accelerometer- measured changes in physical activity. Secondary outcomes include traditional risk factors for cardiometabolic disease (i.e., BMI, blood pressure, serum lipid profiles, glucose intolerance, insulin resistance) and more novel and prognostic risk factors, including cardiorespiratory fitness, aortic pulse wave velocity, pro-inflammatory biomarkers of TNF-α, IL-6, and anti-inflammatory biomarkers of IL-10 and IL-15. We will also explore mediators and moderators of intervention effectiveness and determine the total societal cost per participant of delivering the Smart Walk intervention and the cost-effectiveness of the two study groups to increase minutes/week of moderate-to-vigorous physical activity.

摘要/项目摘要 非洲裔美国妇女经历了心脏代谢疾病状况的高燃烧。五十七个百分比 肥胖，有57％的人患有心血管疾病，而12％的糖尿病患有诊断性糖尿病。进行常规有氧运动 体育活动是预防和管理这些心脏代谢疾病的既定机制。这 这项研究的目的是测试以文化量身定制的，基于理论的智能手机提供的物理的有效性 活动干预以增加体育锻炼，促进遵守国家有氧运动 指南，改善非裔美国妇女的心脏代谢疾病危险因素。在12个月中 两次手臂随机试验，240久经久坐（即，<60分钟/周的中度至vigotive themententy物理 活动）肥胖症的非洲裔美国妇女（即BMI> 30 kg/m2）将被分配接受任何一个智能 步行是一种以文化量身定制的社会认知理论促进干预措施（n = 120）或 仅FITBIT比较组（n = 120）。智能步行干预小组将获得一个文化量身定制的 通过智能步行智能手机应用程序，虚拟体育活动教练提供的体育活动干预， 和短信。 Smart Walk应用程序上可用的功能包括：1）个人资料页面，2）文化上 相关的多媒体（即文本和视频）体育活动促销模块，3）消息/讨论板， 4）体育活动自我监控/跟踪功能，与Fitbit活动监测器集成 参与者跟踪他们的每日，每周和每月的活动。虚拟体育锻炼教练将积极 参与者在讨论委员会中参与并促进基于小组的对话，并提供 通过电话或基于商业应用的视频进行个性化的，一对一的体育活动教练 基于参与偏好的电信软件。聪明的步行参与者也会收到三个 在活动4个月干预期间，体育活动促进文本消息每周延长。这 仅Fitbit的手臂比较臂将接收Fitbit活动监视器，并鼓励商业使用 可用的设备以增加体育锻炼。我们假设参加智能步行干预小组的参与者 当当体育锻炼和心脏代谢危险因素方面将显着改善 与仅Fitbit比较组相比。主要结果包括自我报告和加速度计 - 测量了体育锻炼的变化。次要结果包括心脏代谢的传统风险因素 疾病（即BMI，血压，血清脂质曲线，葡萄糖耐药，胰岛素抵抗）和更多新颖 和预后危险因素，包括心肺适应性，主动脉脉搏波速度，促炎 IL-10和IL-15的TNF-α，IL-6和抗炎生物标志物的生物标志物。我们还将探索 干预效率的调解人和主持人，并确定参与的总社会成本 提供智能步行干预和两个研究小组的成本效益以增加 中度到剧烈的体育活动的分钟/周。