Computer-Based Physical Activity Advice for Ethnic Minority Aging Adults

描述（由申请人提供）：尽管定期体育活动（PA）的公认益处，中年和老年少数民族成年人是美国人口中最不活跃的部分，使他们面临许多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干预措施。以计算机为基础的咨询方案是文化定制的，需要最低量的阅读和计算机知识，并可以在值得信赖和经常使用的社区场所提供，提供了一个有前途的，但目前尚未开发的替代方案，提供健康促进咨询和支持服务不足的群体。一个这样的有前途的自动化工具是体现会话代理（ECA），一种创新的基于计算机的通信介质，最大限度地提高了视觉和听觉会话元素，同时允许个性化的消息内容和用户友好的界面。这个R-21探索性补助金的目的是文化适应和试点测试一个以理论为基础的，经验支持的ECA-PA计划，用于老年人，低收入的拉丁美洲成年人，他们代表了美国增长最快的种族群体。在01年期间，我们将使用参与性定性和定量研究方法，在文化和语言上适应和预先测试ECA-PA计划与目标人群。在02年，我们将进行一项为期4个月的试验性研究，以测试ECA-PA计划在促进目标群体初始PA增加方面的可行性和初步疗效（通过年龄和语言适当的问卷，日志和加速度计记录）。共有60名55岁及以上的拉丁美洲成年人将被随机分配到ECA-PA组或标准护理对照组。我们将对分配到ECA-PA计划的人进行额外4个月的随访，以确定该计划的初步行为维持效果。作为本研究的一部分，我们将探索潜在的重要理论和经验支持的基线调节剂（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（例如，PA自我效能的变化，与具体会话代理的工作联盟）。由可行性研究产生的效应大小、过程和结果信息将为一项更大规模的试验提供信息，该试验旨在评估文化适应性ECA计划的效用和成本效益，作为在美国人口中快速增长但久坐不动和服务不足的部分中促进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.