Promoting Physical Activity and Healthy Eating in Latinas via Interactive Web-Based Technology

项目摘要/摘要 缺乏体力活动和饮食质量差，包括水果和蔬菜摄入量低，糖分高- 含糖饮料与糖尿病、超重/肥胖和许多慢性健康有关 条件。对于美国的拉丁裔女性来说，不成比例的低体力活动(PA)水平和不健康 饮食习惯导致糖尿病和超重/肥胖的高患病率和不断上升的患病率，以及心脏 疾病、高血压和中风。缩小这些差距需要文化上适当的干预措施， 促进PA的多元健康行为和健康饮食。大多数针对以下目标的生活方式干预 拉丁裔的这些行为是通过面对面的方式实现的，而面对面的方式可能不是 拉丁裔由于共同障碍(例如，缺乏时间、对移民执法的恐惧以及缺乏 运输)，并且可能需要昂贵的资源来实施。基于互联网的干预可以克服 这是面对面方法的障碍，具有广泛传播的潜力。拉美裔美国人现在报告的互联网使用率更高 比白人和黑人成年人(95%的拉丁裔人使用互联网)更多，而且比非拉丁裔更有可能使用他们的 移动设备访问健康信息。虽然大多数拉丁裔报告了不止一个可修改的风险因素 导致心脏代谢性疾病(缺乏运动、饮食质量差)没有基于互联网的干预 已经开发了在文化上量身定做的产品，以满足拉丁裔的饮食和PA需求。我们的 研究团队已经开发和测试了一种文化和语言适应的、理论驱动的互联网- 基于在拉丁裔妇女中推广PA的干预措施，Pasos Hacia la Salud通过以下方式显示出成功 在12个月内增加并维持这一人群的PA增长。我们队PA中的拉丁裔参与者 研究也表示有兴趣了解更多关于饮食质量的知识。因此，我们将扩大我们的互联网- 以PA为基础的干预措施，包括在拉丁语中促进健康饮食，作为更全面的方法 减少拉丁裔的心脏代谢性疾病。然后我们将测试改编后的网络的初步效果- 在为期12周的试验性随机对照试验中，基于对拉丁裔的多重行为改变干预。参与者(N=70)将是 随机分为：1)PA和饮食干预组，或2)等待名单对照组。拟议研究的目标是 帮助拉丁美洲人达到国家PA和F&V和SSB消费的饮食指南。这项工作充分利用了 我们现有的基础设施(基于Web的平台)、教学培训以及独特和互补的专业知识 指导团队和合作者在开发以技术为基础的创新和个人定制方面的 高危人群的PA和饮食干预。拟议的项目将提供PI(贝尼特斯博士)培训 关于这一领域的营养研究和新方法(干预绘图进程、营养评价 干预和多行为临床试验)。本研究提出了一种新颖、低成本、高覆盖的 减少拉美人心脏代谢性疾病负担的方法，并将为PI提供技能 开发和进行文化定制的多种行为(营养和体力活动)临床试验。

Project Summary/Abstract Physical inactivity and poor diet quality, including low fruit and vegetable consumption and high sugar- sweetened beverages, have been linked with diabetes, overweight/obesity and numerous chronic health conditions. For Latina women in the U.S., the disproportionately low physical activity (PA) levels and unhealthy dietary habits contribute to the high and rising prevalence of diabetes and overweight/obesity, as well as heart disease, hypertension, and stroke. Reducing these disparities requires culturally appropriate interventions that promote multiple health behaviors of PA and healthy eating. The majority of lifestyle interventions that target these behaviors in Latinos have been implemented using face-to-face approaches, which may not be accessible to Latinas due to common barriers (e.g., lack of time, fear of immigration enforcement, and lack of transportation) and can require costly resources to implement. Internet-based interventions can overcome barriers of face-to-face approaches and have potential for wide reach. Latinos now report higher Internet usage than White and Black adults (95% Latinos use Internet) and are more likely than non-Latinos to use their mobile devices to access health information. While most Latinas report more than one modifiable risk factor contributing to cardiometabolic disease (physical inactivity, poor diet quality) no Internet-based interventions have yet been developed that are culturally tailored to address both diet and PA needs of Latinas. Our research team has already developed and tested a culturally and linguistically adapted, theory-driven, Internet- based intervention promoting PA in Latina women, Pasos Hacia la Salud, that has shown success by increasing and maintaining PA gains in this population over 12 months. Latina participants in our team’s PA studies have also expressed interest in learning more about dietary quality. Thus, we will expand our Internet- based PA intervention to include promotion of healthy eating in Latinas as a more comprehensive approach to reducing cardiometabolic disease in Latinas. We will then test the preliminary efficacy of the adapted web- based multiple behavior change intervention for Latinas in a 12-week pilot RCT. Participants (N=70) will be randomized to: 1) PA and dietary intervention arm, or 2) wait-list control arm. The goal of the proposed study is to help Latinas meet national PA and dietary guidelines for F&V and SSB consumption. This work leverages our existing infrastructure (web-based platform), didactic training, and the unique and complementary expertise of the mentorship team and collaborators in developing innovative technology-based and individually tailored PA and diet interventions in at-risk populations. The proposed project will provide the PI (Dr. Benitez) training on nutrition research and new methodologies in this area (Intervention Mapping process, evaluation of nutrition interventions, and multiple behavior clinical trials). This study proposes a novel, low-cost and high reach approach to reduce the burden of cardiometabolic disease in Latinas and will provide the PI with skills for developing and conducting culturally tailored multiple behavior (nutrition and physical activity) clinical trials.