Culturally and Linguistically Adapted Physical Activity Intervention for Latinas

针对拉丁裔的文化和语言适应性体育活动干预

• 批准号: 7691149
• 负责人: BESS Hya MARCUS
• 金额: $ 69.67万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-21 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7691149
• 关键词: Address; Adoption; Adult; Aftercare; Arts; Attitude; Behavior; Behavioral; Cardiovascular system; Characteristics; Clinic; Computers; Data; Diabetes Mellitus; Disadvantaged; Educational Background; Equipment; Evidence based intervention; Expert Systems; Health; Health Promotion; Health Services Accessibility; Heart Diseases; Home environment; Hypertension; Individual; Informatics; Intervention; Knowledge; Language; Latino; Life Style; Link; Mails; Maintenance; Measures; Mediating; Mediator of activation protein; Methods; Minority Groups; Modeling; National Heart, Lung, and Blood Institute; Not Hispanic or Latino; Obesity; Participant; Physical activity; Pilot Projects; Population; Populations at Risk; Prevalence; Printing; Process; Public Health; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Readiness; Relative (related person); Reporting; Research; Risk; Sampling; Self Efficacy; Socioeconomic Factors; Staging; Stroke; Target Populations; Technology; Testing; Underserved Population; Woman; Work; base; behavior change; cancer type; clinically significant; cost; effective intervention; efficacy testing; environmental change; experience; health disparity; hypercholesterolemia; hypertensive heart disease; improved; innovation; interest; intervention effect; intervention program; men; obesity risk; post intervention; programs; psychologic; psychosocial; public health relevance; sedentary; social cognitive theory; theories; treatment effect; trend; Address; Adoption; Adult; Aftercare; Arts; Attitude; Behavior; Behavioral; Cardiovascular system; Characteristics; Clinic; Computers; Data; Diabetes Mellitus; Disadvantaged; Educational Background; Equipment; Evidence based intervention; Expert Systems; Health; Health Promotion; Health Services Accessibility; Heart Diseases; Home environment; Hypertension; Individual; Informatics; Intervention; Knowledge; Language; Latino; Life Style; Link; Mails; Maintenance; Measures; Mediating; Mediator of activation protein; Methods; Minority Groups; Modeling; National Heart, Lung, and Blood Institute; Not Hispanic or Latino; Obesity; Participant; Physical activity; Pilot Projects; Population; Populations at Risk; Prevalence; Printing; Process; Public Health; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Readiness; Relative (related person); Reporting; Research; Risk; Sampling; Self Efficacy; Socioeconomic Factors; Staging; Stroke; Target Populations; Technology; Testing; Underserved Population; Woman; Work; base; behavior change; cancer type; clinically significant; cost; effective intervention; efficacy testing; environmental change; experience; health disparity; hypercholesterolemia; hypertensive heart disease; improved; innovation; interest; intervention effect; intervention program; men; obesity risk; post intervention; programs; psychologic; psychosocial; public health relevance; sedentary; social cognitive theory; theories; treatment effect; trend

DESCRIPTION (provided by applicant): In the U.S., Latinos report higher rates of inactivity and related health conditions (e.g., hypertension, hypercholesteremia, obesity, heart disease, stroke, and diabetes) than non-Hispanic whites. Furthermore, Latino women (Latinas) report higher rates of sedentary behavior than Latino men. Due to cultural factors, socioeconomic circumstances, differences in educational background, and language barriers, Latinos in general, and especially Latinas, have limited access to public health interventions that promote physically active lifestyles. To address this public health crisis, effective interventions that leverage state-of-the-art theory and methods are needed. Our research group has 20 years experience developing and evaluating individually tailored computer expert system-driven physical activity interventions (based on Social Cognitive Theory and the Transtheoretical Model). In our recent pilot study (R21NR009864), we culturally and linguistically adapted our existing tailored intervention for sedentary Latinas and conducted a small randomized trial of the modified program (N=94). Six month (post-intervention) assessments are still ongoing, but three month data have been collected on 87 participants (93 percent retention). Intervention participants increased their physical activity from a mean of 17 minutes per week (SD=25.8) at baseline to 92 minutes (SD=69.8) at three months, whereas contact control participants reported increasing their physical activity from 12 minutes per week (SD=21.8) at baseline to 64 minutes (SD=84.3) at three months. The trends in the means at 3 months lend preliminary support for the efficacy of our intervention and the high retention rates, especially for a study targeting a hard-to-reach group like Latinas, bode well for its feasibility and acceptability. For the current proposal, we will build on these encouraging results by conducting an adequately powered (N=312) randomized controlled trial to test the efficacy of the culturally and linguistically modified, individually tailored print intervention compared with a wellness contact control condition (e.g., cardiovascular health information from NHLBI in Spanish). Data will be collected at baseline, 6, and 12 months using well-established physical activity measures (7-Day PAR, Actigraphs), as well as a comprehensive set of psychosocial questionnaires. We hypothesize that at the end of treatment (month six) intervention participants will report significantly more minutes of at least moderate intensity physical activity per week than the wellness contact control participants. We will also examine the maintenance of treatment effects at 12 months, costs of delivering the tailored intervention program, and potential mediators and moderators of the intervention-physical activity relationship. In the proposed study we seek to promote physical activity among this at-risk population using a high-reach, low-cost strategy, which has great potential for adoption on a larger scale and thus high potential for reducing existing health disparities in the U.S. PUBLIC HEALTH RELEVANCE: As Latinos are the fastest growing minority group in the U.S. and report high rates of inactivity and related health conditions, we will conduct a large scale randomized controlled trial to test the efficacy of a culturally and linguistically modified, individually tailored physical activity intervention among Latinas (n=312). The proposed study seeks to promote physical activity among this at-risk population using a high-reach, low-cost strategy, which has great potential for adoption on a larger scale and thus high potential for reducing existing health disparities in the U.S.

描述（由申请人提供）：在美国，拉丁美洲人报告的无活动状况和相关健康状况（例如高血压，高胆固醇，肥胖，心脏病，中风和糖尿病）的速度高于非西班牙裔白人。此外，拉丁裔妇女（拉丁裔）报告的久坐行为率高于拉丁裔男性。由于文化因素，社会经济环境，教育背景的差异以及语言障碍，一般的拉丁美洲人，尤其是拉丁裔，对促进身体积极生活方式的公共卫生干预措施的机会有限。为了解决这一公共卫生危机，需要采取有效的干预措施来利用最先进的理论和方法。我们的研究小组拥有20年的经验，可以开发和评估单独定制的计算机专家系统驱动的体育活动干预措施（基于社会认知理论和跨理论模型）。在我们最近的试点研究（R21NR009864）中，我们在文化和语言上对久坐的拉丁裔进行了量身定制的干预措施，并对修改后的程序进行了一项小型随机试验（n = 94）。六个月（干预后）的评估仍在进行中，但已经收集了87名参与者（保留93％）的三个月数据。干预参与者将其体育活动从基线时的平均每周17分钟（SD = 25.8）提高到三个月时的92分钟（SD = 69.8），而接触对照参与者报告说，在三个月时，在基线12分钟（SD = 21.8）的体育活动从基线的12分钟（SD = 21.8）增加到了（SD = 84.3）。三个月时的平均值趋势为我们的干预效果和高保留率提供了初步支持，尤其是针对针对拉丁裔难以触及的群体的研究，对其可行性和可接受性都很好。对于当前的提案，我们将通过进行充分动力的（n = 312）随机对照试验来基于这些令人鼓舞的结果，以测试文化和语言修改的，与健康接触控制条件相比（例如，来自NHLBI的西班牙语中的心血管健康信息）的文化和语言修饰，单独定制的印刷干预措施。数据将在基线，6个和12个月的时间内使用良好的体育锻炼措施（7天PAR，Actigraphs）以及一组全面的社会心理问卷收集。我们假设在治疗结束时（第六个月）干预参与者每周至少每周至少中等强度的体育活动比健康接触对照参与者更长。我们还将检查12个月时治疗效果的维护，提供量身定制的干预计划的成本以及干预物理活动关系的潜在调解人和主持人。在拟议的研究中，我们试图使用高范围，低成本的策略来促进这一高危人群中的体育活动，该策略具有较大范围内采用的巨大潜力，因此可以降低美国公共卫生中的现有健康差异的高潜力：由于拉丁美洲人是美国增长最快的少数群体，并报告了较高的不规则和相关的健康状况，我们将进行大规模的仿制性，我们将进行大规模的仿制性，我们将在一定程度上进行大规模的测试。在拉丁裔中单独定制身体活动干预（n = 312）。拟议的研究旨在使用高度的低成本策略来促进这一高危人群中的体育活动，该战略具有较大规模的收养潜力，从而降低了美国现有健康差异的高潜力