Promoting Physical Activity in Latinas via Interactive Web-based Technology

描述（由申请人提供）：在美国，拉丁裔妇女（拉丁裔）报告的不活动率高于非西班牙裔白色和男性同行，因此不成比例地承受着相关健康状况的负担（例如，癌症、高血压、心脏病、中风、糖尿病）。文化因素，社会经济环境，语言和教育障碍限制了拉丁美洲人获得促进身体活动生活方式的公共卫生干预措施。为了解决这一公共卫生危机，需要利用最先进的理论和方法进行有效的干预，以达到这一风险人群。我们的研究小组拥有超过20年的经验，通过各种渠道和设置开发和评估个性化，计算机专家系统驱动的身体活动干预（基于社会认知理论和跨理论模型）。在我们最近的试点（R21 NR 009864）中，我们在文化和语言上调整了我们为久坐的拉丁裔人量身定制的干预措施，并对修改后的计划进行了一项小型随机试验（N=93）。共有81名参与者完成了为期6个月的研究（87%的保留率），并增加了他们的身体活动，从平均每周17分钟（SD=25.76）基线至147分钟（SD=241.55），而接触对照组参与者的体力活动从每周12分钟增加到每周12分钟。（SD=21.99）至6个月时的97分钟（SD=118.49）。这些观察到的改善，在我们的干预组的身体活动，沿着高保留率，参与者报告的愿望，互联网提供的程序，并形成工作开发我们的程序在互联网格式借给支持测试互联网干预量身定制的拉丁美洲人的需求。因此，对于当前的应用程序，我们将建立在我们以前的工作，进行充分的动力（N=200）随机对照试验，以测试我们的文化和语言修改，个性化定制的身体活动干预通过互联网提供相对于互联网健康接触控制条件（包括由NHLBI为拉丁美洲人开发的心血管健康信息）的有效性。将在基线、6个月（治疗后）和12个月（维持）时使用完善的体力活动测量（7天PAR，Actigraphs）以及一套全面的心理社会问卷收集数据。我们假设，在治疗结束时（第六个月），干预参与者每周报告的中等强度体力活动的分钟数明显多于健康接触控制参与者。我们还将研究12个月时治疗效果的维持、干预-体力活动关系的潜在中介者和调节者，以及提供量身定制的互联网计划的成本。在这项拟议的研究中，我们寻求使用高覆盖率，低成本，基于技术的策略在服务不足的人群中促进体育活动，该策略具有更大规模采用的巨大潜力，因此很有可能减少美国的健康差距。

DESCRIPTION (provided by applicant): In the U.S., Latino women (Latinas) report higher rates of inactivity than their non-Hispanic White and male counterparts and thus are disproportionately burdened by related health conditions (e.g., cancer, hypertension, heart disease, stroke, diabetes). Cultural factors, socioeconomic circumstances, language and educational barriers limit Latinas access to public health interventions that promote physically active lifestyles. To address this public health crisis, effective interventions that leverage state-of-the-art theory and methods are needed to reach this at-risk population. Our research group has over 20 years experience developing and evaluating individually-tailored, computer expert system-driven, physical activity interventions (based on Social Cognitive Theory and the Transtheoretical Model) through various channels and settings. In our recent pilot (R21NR009864), we culturally and linguistically adapted our tailored intervention for sedentary Latinas and conducted a small randomized trial of the modified program (N=93). A total of 81 participants completed the 6- month study (87 percent retention) and increased their physical activity from a mean of 17 minutes per week (SD=25.76) at baseline to 147 minutes (SD=241.55) at six months whereas contact control participants increased their physical activity from 12 minutes per week (SD=21.99) at baseline to 97 minutes (SD=118.49) at six months. These observed improvements in physical activity in our intervention group, along with high retention rates, participant-reported desire for an Internet-delivered program, and formative work developing our program in an Internet format lend support for testing an Internet intervention tailored to the needs of Latinas. Therefore, for the current application, we will build on our previous work by conducting an adequately powered (N=200) randomized controlled trial to test the efficacy of our culturally and linguistically modified, individually tailored physical activity intervention delivered via the Internet relative to an Internet wellness contact control condition (including cardiovascular health information developed for Latinos by the NHLBI). Data will be collected at baseline, 6 months (post-treatment), and 12 months (maintenance) using well- established physical activity measures (7-Day PAR, Actigraphs), as well as a comprehensive set of psychosocial questionnaires. We hypothesize that at end of treatment (month six) intervention participants will report significantly more minutes of moderate intensity physical activity per week than the wellness contact control participants. We will also examine the maintenance of treatment effects at 12 months, potential mediators and moderators of the intervention-physical activity relationship, and the costs of delivering the tailored Internet program. In the proposed study we seek to promote physical activity among an underserved population using a high-reach, low-cost, technology-based strategy, which has great potential for adoption on a larger scale and thus high potential for reducing health disparities in the U.S.