Improving Safety and Access for Physical Activity

描述（由申请人提供）：定期进行中等强度和剧烈强度的体力活动（PA）与肥胖呈负相关，然而，很少有成年人能够成功地将足够的PA纳入日常生活。少数民族和低收入成年人的肥胖率最高，常规PA水平最低。增加对巴勒斯坦权力机构安全和方便场所的环境支持是巴勒斯坦权力机构干预措施的一项新兴公共卫生战略。Wilson（PI）及其同事通过焦点小组的初步数据显示，低收入少数民族成年人希望增加PA的安全场所（没有犯罪的区域，流浪狗的遏制，增加警察巡逻）和获得PA（人行道/小径和扩大PA的机会）在他们的社区。此外，我们的初步研究结果表明，非裔美国人有心理障碍PA，包括缺乏自我激励，文化的身体形象问题，并缺乏时间，由于家庭义务。目前的建议是创新的，因为它专门测试的干预措施，包括巡逻步行和社会营销元素，以增加PA在低收入的非洲裔美国人的有效性。三个社区将随机接受三种方案之一：警察巡逻步行方案加社会营销干预，警察巡逻步行仅干预或无步行干预（仅一般健康教育; N=390; 130/组）。为期24个月的干预措施将侧重于提高安全性（培训社区领导人担任步行队长，雇用休班警察巡逻步行计划，并包含流浪狗），增加PA的访问（标记步行路线），并将包括量身定制的社会营销活动，以增加PA（在一个干预社区）。我们将在基线、6个月、12个月、18个月和24个月收集PA数据（7天加速计估计值、4周PA病史）、身体组成、血压、心理社会指标以及对PA安全性和可及性的环境支持的看法。主要假设是，到12个月时，与仅巡逻步行干预或无干预相比，巡逻步行+社会营销干预将导致中度和剧烈PA的更大增加，并且这些影响将在18个月和24个月评估时保持不变。

DESCRIPTION (provided by applicant): Regular moderate and vigorous intensity physical activity (PA) is inversely related with obesity, however, few adults are successful in incorporating sufficient PA into their daily lives. Minority and lower-income adults have among the highest obesity rates and lowest levels of regular PA. Increasing environmental supports for safe and convenient places for PA is an emerging public health strategy for PA interventions. Preliminary data by Wilson (PI) and colleagues has revealed through focus groups that low-income minority adults would like to increase the safe places for PA (areas free from crime, containment of stray dogs, increased police patrol) and access to PA (sidewalks/trails and expand opportunities for PA) in their community. In addition, the results of our preliminary studies suggest that African Americans had psychosocial barriers to PA that included lack of self-motivation, cultural body image issues, and lack of time due to family obligations. The present proposal is innovative in that it specifically tests the efficacy of an intervention that includes both patrolled-walking and social marketing elements to increase PA in low-income African Americans. Three communities will be randomized to receive one of three programs: a police patrolled-walking program plus social marketing intervention, a police patrolled-walking only intervention, or no walking intervention (general health education only; N=390; 130/group). The 24- month intervention will focus on increasing safety (training community leaders to serve as walking captains, hiring off-duty police officers to patrol the walking program, and containing stray dogs), increasing access for PA (marking a walking route), and will include a tailored social marketing campaign for increasing PA (in one intervention community). We will collect data for PA (7-day accelerometer estimates, 4-week PA history), body composition, blood pressure, psychosocial measures, and perceptions of environmental supports for safety and access for PA at baseline, 6-, 12-, 18-, and 24-months. The primary hypotheses are that the patrolled-walking plus social marketing intervention will result in greater increases in moderate and vigorous PA as compared to a patrolled walking only intervention or no-intervention by 12-months and that these effects will be maintained at 18-month and 24-month assessments.