Individually tailored physical activity intervention for Latina adolescents: Ninas Saludables

摘要 拉丁裔青少年的身体活动水平低，只有3%的人达到国家体育活动水平。 指南，并且处于与不活动相关的疾病的高终身风险中，例如肥胖，代谢综合征， 和糖尿病以健全的心理社会理论为基础的干预措施， 拉丁裔青少年需要扭转不活动的模式，建立健康的生活习惯， 差距扩大。我们的研究团队已经开发并测试了个性化定制的基于Web的 增加中度至剧烈体力活动（MVPA）的干预措施， 拉丁裔成年人。在我们最近的试点研究（R03NR014329）中，我们根据形成性 访谈，使其适合拉丁裔青少年，并在单臂试点试验（N = 21）进行了测试。经过12 24周时，保持率较高（90.5%），自我报告的MVPA从24.7（26.11）分钟/周增加到 基线至随访时的79.4（46.8）（p <0.001），表明良好的潜在疗效。在最后的面试中，女孩们 表示倾向于增加网站的音频视频部分，并纳入其他移动的- 健康技术，如短信、智能手机应用程序、社交网络和可穿戴设备。因此，这一目标 研究是进行一项随机对照试验（N = 200），对一项个体定制的、基于理论的、多因素的 技术干预，以增加拉美青少年的MVPA。为期12个月的干预措施将包括 咨询会议，教行为改变技术，一个互动的多媒体网站，个别 量身定制的内容，可穿戴跟踪器和智能手机应用程序，以加强行为改变技术，连接 到一个Instagram帐户，加强网络内容，并自动短信，以指导继续目标 设置.参与者将被随机分配接受干预或仅接受可穿戴跟踪器。活动 将在基线、6个月（主要结局）和12个月时使用成熟的MVPA进行测量 测量（加速度计和7天体力活动回忆访谈）。我们假设那些 随机接受干预的患者在6个月时MVPA的增加显著大于 那些在控制组。我们还将评估MVPA的变化是否由以下因素的变化介导： 有针对性的心理社会结构（如自我效能，社会支持），以及干预效果是否 受基线个人和环境变量（例如年龄，BMI，邻里环境）的调节。 将跟踪提供干预措施的成本（例如，工作人员时间、材料、管理费用），以评估成本和成本- 两个研究组的有效性，我们将评估接触超时结局的影响。我们还将 使用来自以下的连续数据探索干预组和对照组的日常活动轨迹： 可穿戴追踪器拟议的研究将促进一个关键的预防性健康行为，体育活动， 拉丁裔青少年使用的技术是普遍存在于这个高风险人群和高度可扩展性，奠定 为具有成本效益、影响广泛的干预措施奠定基础，这些干预措施具有很大的公共卫生影响潜力。

Abstract Latina adolescents report low levels of physical activity, with only 3% meeting national physical activity guidelines, and are at high lifetime risk for conditions related to inactivity, such as obesity, metabolic syndrome, and diabetes. Interventions grounded in sound psychosocial theory and leveraging growing technology use in Latina adolescents are needed to reverse patterns of inactivity, establish healthy lifetime habits and reduce widening disparities. Our research team has developed and tested individually tailored web-based interventions to increase moderate-to-vigorous physical activity (MVPA), which significantly increased MVPA in Latina adults. In our recent pilot study (R03NR014329), we adapted this intervention based on formative interviews to make it appropriate for Latina adolescents and tested it in a single-arm pilot trial (N=21). After 12 weeks, retention was high (90.5%) and self-reported MVPA increased from 24.7(26.11) minutes/week at baseline to 79.4(46.8) at follow up (p<0.001), suggesting good potential efficacy. In closeout interviews, girls expressed a preference to increase audio-video components of the website and to incorporate other mobile- health technologies, such as texting, smartphone apps, social networks, and wearables. Thus, the aim of this study is to conduct a randomized controlled trial (N=200) of an individually tailored, theory-based, multi- technology intervention to increase MVPA in Latina adolescents. The 12-month intervention will comprise a counseling session to teach behavior change techniques, an interactive multimedia website with individually tailored content, a wearable tracker and smartphone app to reinforce behavior change techniques, connection to an Instagram account reinforcing web content, and automated text messages to guide continued goal setting. Participants will be randomly assigned to receive the intervention or only a wearable tracker. Activity will be measured at baseline, six-months (primary outcome) and 12 months using well-established MVPA measures (accelerometers and the 7-Day Physical Activity Recall Interview). We hypothesize that those randomized to receive the intervention will show significantly greater increases in MVPA at six months than those in the control group. We will also evaluate whether changes in MVPA are mediated by changes in targeted psychosocial constructs (e.g. self-efficacy, social support), and whether intervention effects are moderated by baseline personal and environmental variables (e.g. age, BMI, neighborhood environment). Costs to deliver the intervention (e.g. staff time, materials, overhead) will be tracked to evaluate costs and cost- effectiveness of both study arms, and we will evaluate the effects of contact time out outcomes. We will also explore trajectories of daily activity in both the intervention and control groups using continuous data from wearable trackers. The proposed study will promote a critical preventive health behavior, physical activity, in Latina adolescents using technologies that are pervasive in this high risk population and highly scalable, laying the groundwork for cost-effective, broad reaching interventions with great potential for public health impact.