Computer-Based Physical Activity Advice for Ethnic Minority Aging Adults

描述（由申请人提供）：尽管定期体力活动 (PA) 的好处已得到公认，但中年和老年少数族裔成年人是美国人口中最缺乏运动的群体，这使得他们患多种慢性疾病和病症的风险增加，包括某些形式的癌症和体重增加。由于成本、人员、服务提供和语言/文化障碍，低收入少数民族社区几乎没有可用的干预措施。基于计算机的咨询项目是根据文化量身定制的，需要最少的阅读和计算机知识，并且可以在值得信赖和经常使用的社区场所提供，为向服务不足的群体提供健康促进建议和支持提供了一种有前景但目前尚未充分探索的替代方案。其中一个很有前途的自动化工具是体现对话代理（ECA），这是一种基于计算机的创新通信媒介，可以最大限度地利用视觉和听觉对话元素，同时允许个性化的消息内容和用户友好的界面。这项 R-21 探索性赠款的目的是在文化上适应和试点测试基于理论、实证支持的 ECA-PA 计划，以供老年人、低收入拉丁裔成年人使用，他们代表了美国增长最快的族裔群体。计划交付将在值得信赖、经常使用的社区老年人中心进行。在第一年，我们将使用参与式定性和定量研究方法，在文化和语言上调整 ECA-PA 计划，并针对目标人群进行预测试。在第二年，我们将进行一项为期 4 个月的实验性试点研究，以测试 ECA-PA 计划在促进目标群体中初始 PA 增加（通过适合年龄和语言的问卷、日志和加速度测量记录）的可行性和初步功效。总共 60 名 55 岁及以上的拉丁裔成年人将被随机分配到 ECA-PA 组或标准护理对照组。我们将额外跟踪那些分配给 ECA-PA 计划的人员 4 个月，以确定该计划的初步行为维持效果。作为本研究的一部分，我们将探索潜在重要的理论和经验支持的基线调节因素（例如，健康素养、计算机态度、文化适应、性别）和与 PA 变化相关的中介因素（例如，PA 自我效能的变化、与具体会话代理的工作联盟）。可行性研究产生的效果大小、过程和结果信息将为更大规模的试验提供信息，该试验旨在评估适应文化的 ECA 计划的效用和成本效益，作为在快速增长但久坐和服务不足的美国人口中推广 PA 的一种手段。

DESCRIPTION (provided by applicant): Despite the recognized benefits of regular physical activity (PA), mid-life and older ethnic minority adults are the most inactive segment of the U.S. population, putting them at increased risk for a number of chronic diseases and conditions including some forms of cancer and weight gain. Few interventions are available in low-income, ethnic minority communities due to cost, personnel, service delivery, and language/cultural barriers. Computer-based counseling programs that are culturally tailored, require minimal amounts of reading and computer literacy, and could be made available in trusted and regularly used community venues offer a promising though currently under-explored alternative for delivering health promotion advice and support to underserved groups. One such promising automated tool is the embodied conversational agent (ECA), an innovative computer-based communication medium that maximizes both visual and aural conversation elements while allowing for individualized message content and a user-friendly interface. The objective of this R-21 exploratory grant is to culturally adapt and pilot-test a theoretically-based, empirically supported ECA-PA program for use with older, low-income Latino adults, who represent the fastest-growing ethnic group in the U.S. Program delivery will occur at a trusted, frequently used community senior center. During Year 01, we will use participatory qualitative and quantitative research methods to culturally and linguistically adapt and pre-test the ECA-PA program with the target population. In Year 02, we will conduct an experimental 4-month pilot study to test the feasibility and preliminary efficacy of the ECA-PA program in promoting initial PA increases (documented via age- and language-appropriate questionnaires, logs, and accelerometry) in the target group. A total of 60 Latino adults ages 55 and over will be randomized to either the ECA-PA arm or a standard care control arm. We will follow those assigned to the ECA-PA program for an additional 4 months to ascertain preliminary behavioral maintenance effects of the program. As part of this study we will explore potentially important theoretically and empirically supported baseline moderators (e.g., health literacy, computer attitudes, acculturation, gender) and mediators associated with PA change (e.g., changes in PA self-efficacy, working alliance with the embodied conversational agent). The effect-size, process, and outcomes information generated by the feasibility study wlll inform a larger-scale trial aimed at evaluating the utility and cost-effectiveness of culturally adapted ECA programs as a means of promoting PA among a fast-growing though sedentary and under-served segment of the U.S. population.