Walking Adherence and Health in African American Women

描述（由申请人提供）：本研究的目的是测试 为期 48 周的家庭步行干预对低收入中年人的疗效 （45-65 岁）非裔美国 (AA) 女性。干预措施的增强是通过 针对女性社区和个人量身定制的行为策略 特点（强化治疗）。具体目标是 (1) 描述 依从性增强因素的变化（社会影响、人际交往） 特征（认知、态度和动机）和健康状况结果 强化治疗 (ET) 的（心血管 [CV] 健康和症状） 以及基线时没有行为策略的标准治疗（ST）， 24、48 和 72 周； (2) 将接受 ET 的女性与接受 ET 的女性进行比较 ST 坚持增强因素、运动坚持指标（频率、 运动的持续时间和强度；遵守模式；能量消耗） 24、48 和 72 周时的健康状况； (3) 识别关系 坚持增强因素、运动坚持指标和健康 - 状态结果。 ET 将被随机分配到两个健康中心之一 在芝加哥西区，心脏病是该市发病率最高的地区之一。 受试者将包括 240 名没有重大体征或症状的久坐女性 心血管疾病；无心肌梗塞、中风或 1 型糖尿病病史； 且未服用 β 受体阻滞剂、地硫卓或维拉帕米。将招募女性 来自两个医疗中心周围的低收入社区。女性（均 治疗）将以步行处方为导向，适度 强度，每周至少 3 次每次 30 分钟的训练。 24周期间 活跃阶段，ET 接收到一个组合的行为包 社区工作人员通过研讨会提供以社区为中心的策略 针对女性环境特点量身定制，注重个性化 通过电话提供适合每位女性个人的策略 特点。在 24 周的维持阶段，ET 中的女性接受 每月或每两个月打一次电话，具体取决于他们的遵守情况。两者治疗 小组将使用心率监测器自我监控他们的表现，输入 通过语音应答系统获取锻炼日志数据，并进行三个面对面的交流 在每个阶段拜访社区工作者。 24周期间 后续阶段，两组都没有接受行为策略。身体方面 活动行为框架，源自Cox的客户端交互模型 健康行为，将指导干预。分析包括描述性 统计数据、变化分数和混合效应回归模型 纵向数据。

DESCRIPTION (provided by applicant): The purpose of this study is to test the efficacy of a 48-week home-based walking intervention for low-income midlife (45-65 years) African American (AA) women. The intervention is enhanced by behavior strategies tailored to a woman's community and personal characteristics (Enhanced treatment). The specific aims are (1) to describe the changes in adherence-enhancing factors (social influence, interpersonal characteristics-cognition, attitude and motivation) and health-status outcomes (cardiovascular [CV] health and symptoms) for both the Enhanced Treatment (ET) and a Standard Treatment (ST) without the behavioral strategies at baseline, 24, 48, and 72 weeks; (2) to compare women receiving the ET to the women in the ST on adherence-enhancing factor, exercise adherence indicators (frequency, duration, and intensity of exercise; patterns of adherence; energy expenditure) and health status at 24, 48 and 72 weeks; (3) to identify the relationships among adherence-enhancing factors, exercise adherence indicators, and health -status outcomes. The ET will be randomly assigned to one of two health centers in the Chicago Westside where heart disease is among the highest in the city. Subjects will include 240 sedentary women who have no major signs or symptoms of CV disease; no history of myocardial infarction, stroke, or Type 1 diabetes; and are not on a beta blocker, Ditiazem or Verapamil. Women will be recruited from low-income communities surrounding the two health centers. Women (both treatments) will be oriented to the walking prescription, which is moderate intensity, a minimum of three 30-minute sessions per week. During the 24-week active phase, the ET receives a combined behavioral package of community-focused strategies delivered by community workers via workshops tailored to the women's environmental characteristics, and individually-focused strategies delivered via phone tailored to each women's personal characteristics. During the 24-week maintenance phase, women in the ET receive phone calls monthly or bimonthly, depending on their adherence. Both treatment groups will self-monitor their performance with heart rate monitors, enter exercise-log data via a voice response system, and have three face-to-face visits with the community worker during each phase. During the 24-week follow-up phase, neither group receives behavior strategies. The Physical Activity Behavior Framework, derived from Cox's Interaction Model of Client Health Behavior, will guide the intervention. Analyses include descriptive statistics, change scores, and mixed-effects regression models for the longitudinal data.