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 百分之五十七的非裔美国女性患有心脏代谢疾病。 肥胖，57% 患有心血管疾病，12% 患有糖尿病。 体力活动是预防和管理这些心脏代谢疾病的既定机制。 这项研究的目的是测试根据文化定制、基于理论的智能手机提供的物理治疗的功效 活动干预，以增加身体活动，促进坚持国家有氧身体活动 指南，并在 12 个月内改善非裔美国女性的心脏代谢疾病危险因素。 两组随机试验，240 次久坐（即每周 < 60 分钟的中等至剧烈强度体力活动） 活动）肥胖的非裔美国女性（即 BMI >30 kg/m2）将被分配接受 Smart 步行，一种根据文化量身定制、基于社会认知理论的身体活动促进干预措施（n=120），或 仅使用 Fitbit 的比较组（n=120）将接受针对文化量身定制的 Smart Walk 干预组。 通过 Smart Walk 智能手机应用程序提供身体活动干预、虚拟身体活动指导、 Smart Walk 应用程序上提供的功能包括：1) 个人资料页面，2) 文化页面。 相关多媒体（即文字和视频）体育活动推广模块，3）留言/讨论板， 4) 身体活动自我监测/跟踪功能，与 Fitbit 活动监视器集成 参与者将主动跟踪他们每天、每周和每月的活动。 参与并促进讨论区参与者之间的小组对话，并提供 通过电话或基于商业应用程序的视频进行个性化、一对一的身体活动指导 电话会议软件根据参与者的偏好，Smart Walk 参与者也会收到三个。 在为期 4 个月的积极干预期间，每周都会发送体育活动促进短信。 仅使用 Fitbit 的手臂对比手臂将收到 Fitbit 活动监测器，并鼓励使用商业产品 我们率先加入了智能步行干预小组。 将在体力活动和心脏代谢危险因素方面表现出更显着的改善 与仅使用 Fitbit 的对照组相比，主要结果包括自我报告和加速度计。 次要结果包括心脏代谢的传统危险因素。 疾病（即体重指数、血压、血脂、葡萄糖耐受不良、胰岛素抵抗）以及更多新奇的疾病 和预后危险因素，包括心肺健康、主动脉脉搏波速度、促炎性 我们还将探索 TNF-α、IL-6 的生物标志物以及 IL-10 和 IL-15 的抗炎生物标志物。 干预效果的中介变量和调节变量，并确定每个参与者的总社会成本 提供智能步行干预和两个研究组的成本效益，以提高 分钟/周的中度至剧烈体力活动。