Improving Safety and Access for Physical Activity

描述(申请人提供)：定期、中等强度和剧烈的体力活动(PA)与肥胖呈负相关，然而，很少有成年人能成功地将足够的PA融入他们的日常生活中。少数族裔和低收入成年人的肥胖率最高，而正常PA水平最低。增加对PA安全和便利场所的环境支持是PA干预的一项新兴公共卫生战略。威尔逊(PI)及其同事的初步数据通过焦点小组揭示，低收入少数族裔成年人希望在他们的社区增加PA的安全场所(无犯罪区域、遏制流浪狗、增加警察巡逻)和进入PA(人行道/小径，并扩大PA的机会)。此外，我们的初步研究结果表明，非裔美国人对PA存在心理社会障碍，包括缺乏自我激励、文化身体形象问题以及由于家庭义务而缺乏时间。本提案的创新之处在于，它具体测试了包括巡逻行走和社会营销元素的干预措施的有效性，以增加低收入非裔美国人的PA。三个社区将随机接受三个计划中的一个：警察巡逻步行计划加社会营销干预，警察巡逻步行干预，或不步行干预(仅限一般健康教育；N=390；130个/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，聘请休班警察巡逻步行项目，以及遏制流浪狗)，增加PA的准入(标记步行路线)，并将包括为增加PA量身定做的社会营销活动(在一个干预社区)。我们将收集PA(7天加速度计估计，4周PA病史)、身体成分、血压、心理社会测量以及对PA在基线、6个月、12个月、18个月和24个月时安全和准入的环境支持的感知的数据。基本假设是，在12个月后，巡逻步行加社会营销干预将导致中度和剧烈PA比仅巡逻步行干预或不干预更大，这些影响将维持在18个月和24个月的评估中。

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.