Increasing aerobic and muscle-strengthening physical activity in Latinas via interactive web-based technology

摘要 癌症是美国从事体力活动的拉美裔人的主要死亡原因 是降低癌症风险的最重要的可改变行为之一；很少有拉丁人实现健康- 提高国家体力活动(PA)指南建议的体力活动水平，特别是肌肉 加强活动(MSA)。例如，44%的拉丁裔符合国家有氧运动指南，但 只有17%的人同时符合有氧和MSA的完整指南。虽然有氧MVPA的好处很好 为预防癌症和慢性病而设立的定期MSA可能是进一步 降低癌症风险，因为遵守MSA指南与降低19%至31%的癌症有关 死亡风险，独立于需氧PA。有必要采取干预措施，在拉丁语中推广MSA。 然而，只有少数几个MSA干预措施在他们的样本中包括拉丁裔，而没有一个是我们的 知识，是专门为这一群体设计的，或者解决了影响拉丁裔的社会文化因素 肌肉强化行为(例如，认为MSA是针对男性的；MSA在他们的文化中是一个回避的话题 和社交圈；认为女性应该只做某些类型的MSA)。此外，现有的干预措施 经常参与面对面的锻炼计划，许多拉丁裔人可能由于以下障碍而无法参加 缺乏交通工具或对移民执法的恐惧。我们的研究团队之前已经开发出了 为拉丁裔测试有氧中强度PA(MVPA)干预，克服面对面障碍 方案，并解决与巴勒斯坦权力机构有关的社会文化因素。这些理论驱动的、个性化的干预措施 在印刷和基于互联网的拉丁裔女性中增加有氧MVPA方面取得了成功 随机对照试验。因此，我们的网络干预(Pasos Hacia La Salud)尤其提供了 这是在高危人群中推广强肌PA的理想平台。要解决以下问题 关于肌肉强化PA的文献，我们最近对19名拉丁裔进行了定性采访，以确定 以理论为基础的肌肉增强PA的障碍和促进剂，然后开发了MSA干预材料 并正在进一步提炼拉丁语的文化适当性、相关性和吸引力。在建议的 研究，我们将把新开发的MSA推广材料整合到我们现有的Pasos Hacia la中 Salud(Pasos)基于网络的有氧MVPA干预，并进行为期12周的完全在线随机试点试验 测试新调整的基于网络的有氧加MSA干预对拉丁裔的初步效果。五十 拉丁裔成年人(即18-65岁)将被随机分配到：1)原始的帕索斯有氧MVPA 干预臂，或2)帕索斯有氧MVPA加MSA干预臂。我们的研究旨在1)评估 有氧健肌干预提高MSA的初步效果及2)探讨 MSA的潜在调解人和主持人。这种互动性和高度可传播性的方法可以实现 高危人群的健康状况显著改善。

ABSTRACT Cancer is the leading cause of death among Latinos in the U.S. While engaging in a physically active lifestyle is one of the most important modifiable behaviors for reducing cancer risk; few Latinas achieve health- enhancing levels of physical activity (PA) recommended by the National PA Guidelines, particularly for muscle- strengthening activities (MSA). For instance, 44% of Latinas meet the national guidelines for aerobic PA but only 17% meet the full guidelines for both aerobic and MSA. While the benefits of aerobic MVPA are well established for cancer and chronic disease prevention, participating in regular MSA may be key to further reducing cancer risk, as adherence to MSA guidelines has been associated with a 19% to 31% lower cancer mortality risk, independent of aerobic PA. There is a need for interventions promoting MSA in Latinas. However, only a select few MSA interventions have included Latinas in their sample, and none to our knowledge, were designed exclusively for this group or addressed socio-cultural factors influencing Latinas' muscle-strengthening behaviors (e.g., perception that MSA is for men; MSA is an avoided topic in their culture and social circles; belief that women should only do certain types of MSA). Moreover, existing interventions often involved in-person exercise programs, which can be inaccessible to many Latinas due to barriers such as lack of transportation or fear of immigration enforcement. Our research team has previously developed and tested aerobic moderate-to-vigorous PA (MVPA) interventions for Latinas that overcome barriers to in-person programs and address PA-related socio-cultural factors. These theory-driven, individually tailored interventions have shown success at increasing aerobic MVPA among Latina women in both print and Internet-based randomized controlled trials. Thus, our web-based intervention (Pasos Hacia la Salud), in particular, provides an ideal platform for promoting muscle-strengthening PA in this at-risk population. To address the gap in literature on muscle-strengthening PA, we recently conducted qualitative interviews with 19 Latinas to identify theory-based barriers and facilitators of muscle-strengthening PA, then developed MSA intervention materials and are further refining for cultural appropriateness, relevance, and appeal in Latinas. In the proposed research, we will incorporate the newly developed MSA promotion materials into our existing Pasos Hacia la Salud (Pasos) web-based aerobic MVPA intervention and conduct a 12-week fully online randomized pilot trial testing the preliminary efficacy of the newly adapted web-based aerobic plus MSA intervention for Latinas. Fifty Latina adults (i.e., aged 18-65 years) will be randomized to either the: 1) original Pasos aerobic MVPA intervention arm, or 2) a Pasos aerobic MVPA plus MSA intervention arm. Our study aims to 1) Assess the preliminary efficacy of the aerobic and muscle-strengthening intervention for increasing MSA, and 2) Explore potential mediators and moderators of MSA. This interactive and highly disseminable approach can achieve significant health improvements in an at-risk population.