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

摘要 癌症是美国拉丁美洲人死亡的主要原因，而从事身体活动的生活方式 是降低癌症风险的最重要的可改变行为之一;很少有拉丁裔人实现健康- 提高国家PA指南推荐的身体活动（PA）水平，特别是肌肉- 加强活动（MSA）。例如，44%的拉丁美洲人符合国家有氧PA指南， 只有17%的人符合有氧运动和MSA的全部指南。虽然有氧MVPA的好处很好， 为了预防癌症和慢性病，参加定期的MSA可能是进一步改善癌症和慢性病的关键。 降低癌症风险，因为坚持MSA指南与19%至31%的癌症降低相关 死亡风险，独立于有氧PA。有必要采取干预措施，促进在拉丁美洲的MSA。 然而，只有少数几个MSA干预措施包括拉丁美洲人在他们的样本，没有我们的 知识，专门为这一群体设计，或解决影响拉丁美洲人的社会文化因素， 肌肉强化行为（例如，认为MSA是男人的; MSA在他们的文化中是一个回避的话题 和社交圈;相信女人只应该做某些类型的MSA）。此外，现有的干预措施 通常涉及亲自锻炼计划，由于诸如以下障碍， 缺乏交通工具或害怕移民执法。我们的研究团队此前已经开发并 测试有氧中度到剧烈PA（MVPA）干预拉丁美洲人，克服障碍，在人 计划和解决PA相关的社会文化因素。这些理论驱动的，个性化的干预措施 在印刷品和互联网上， 随机对照试验。因此，我们的网络干预（Pasos Hacia la Salud）特别提供了 一个理想的平台，促进肌肉加强PA在这个高危人群。为了解决以下方面的差距， 关于肌肉强化PA的文献，我们最近对19名拉丁美洲人进行了定性访谈， 以理论为基础的肌肉强化PA的障碍和促进因素，然后开发MSA干预材料 并进一步完善文化的适当性，相关性，并在拉丁美洲的呼吁。拟议 研究，我们将把新开发的MSA推广材料纳入我们现有的 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 测试新适应的基于网络的有氧运动加MSA干预拉丁美洲人的初步疗效。五十 拉丁裔成年人（即，年龄18-65岁）将随机分配至：1）原始Pasos有氧MVPA 干预臂，或2）Pasos有氧MVPA加MSA干预臂。我们的研究旨在1）评估 有氧运动和肌肉强化干预对提高MSA的初步疗效; 2）探索 潜在的调解人和主持人的MSA。这种互动和高度传播的方法可以实现 在高危人群中显著改善健康状况。

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.