Virtual Advisors for Physical Activity Promotion in Underserved Communities

描述（由申请人提供）：老龄化拉丁裔社区体育活动促进虚拟顾问背景：老龄化拉丁裔成年人不成比例地患有许多慢性疾病（例如，糖尿病、肥胖症）通过增加身体活动（PA）如步行而改善。由于语言，教育，计算机和健康素养的障碍，老年拉丁美洲成年人往往不能很容易地获得典型的健康促进计划提供的人或在线在美国社区。非专业健康顾问（西班牙语中的“促进者”）为拉丁裔社区提供了一个全国公认的、文化上量身定制的、具有成本效益的健康行为改变模式。然而，与所有“人类”交付的健康计划一样，它们对参与者的时间表施加了限制，并且即使有仔细的干预保真度程序，顾问之间的计划交付中的一些可变性也是不可避免的。基于计算机的文化定制的身体活动顾问程序可以潜在地减少人对人的调度和保真度约束，并扩展程序范围。在最近完成的一项为期4个月的实验中，一个基于计算机的双语虚拟顾问与触摸屏互动（不需要键盘或鼠标）被安置在社区中心，并编程为定制PA的建议，以满足低收入，老龄化的拉丁美洲成年人的需求和偏好。与健康教育对照组相比，虚拟顾问计划成功地提高了参与者的定期步行水平。目的：主要研究目的是进行一项比较有效性试验，评估基于社区的虚拟顾问PA计划相对于成熟的外行顾问计划在更广泛的老年拉丁美洲成年人人群中的12个月影响。第二个目的是确定虚拟与外行顾问计划的比较成本效益。产品设计：这项为期12个月的随机试验将招募居住在16个社区中心附近的55岁及以上的非活动拉丁美洲成年人（n=265/组;共530人）。主要结果是每周步行分钟数，其他感兴趣的结果包括BMI、久坐行为、功能表现和健康相关生活质量。其他领域的调查是评估理论基础和经验支持的调解人和调解人的干预成功，并确定潜在的普遍性的干预措施。影响：这项研究旨在证明，一个基于计算机的虚拟顾问量身定制的老年拉丁美洲成年人的需求，可以提供一个有效的和潜在的成本效益替代外行顾问在社区环境中经常光顾的人口。这些方案在一系列社区环境中使用的潜在延伸范围（例如，诊所、药房、图书馆）为积极影响目前的健康差距提供了巨大的希望。

DESCRIPTION (provided by applicant): Virtual Advisors for Physical Activity Promotion in Aging Latino Communities BACKGROUND: Aging Latino adults suffer disproportionately from a number of chronic conditions (e.g., diabetes, obesity) improved by increased physical activities (PA) such as walking. Due to language, education, computer, and health literacy barriers, older Latino adults often cannot readily access typical health promotion programs offered in-person or online in U.S. communities. Lay health advisors ("promoters" in Spanish) offer a nationally recognized, culturally tailored and cost-efficient health behavior change model for Latino communities. However, as with all "human" delivered health programs, they impose constraints on participant schedules, and, even with careful intervention fidelity procedures in place, some variability in program delivery across advisors is inevitable. Computer-based culturally tailored physical activity advisor programs can potentially reduce human- to-human scheduling and fidelity constraints and extend program reach. In a recently completed 4- month experiment, a computer-based bilingual Virtual Advisor with touch-screen interactivity (no keyboard or mouse needed) was housed in a community center and programmed to tailor PA advice to the needs and preferences of low-income, aging Latino adults. The Virtual Advisor program successfully increased regular walking levels in participants compared to a health education control. OBJECTIVE: The primary study aim is to conduct a comparative effectiveness trial evaluating the 12- month impacts of the community-based Virtual Advisor PA program relative to a proven Lay Advisor program in a broader population of aging Latino adults. The secondary aim is to determine the comparative cost effectiveness of the Virtual vs. Lay Advisor programs. DESIGN: The 12-month randomized trial will enroll inactive Latino adults ages 55 years and older living near 16 neighborhood community centers (n=265/arm; 530 total). The primary outcome is minutes of walking per week, and additional outcomes of interest include BMI, sedentary behavior, functional performance, and health- related quality of life. Additional areas of investigation are to evaluate theoretically based and empirically supported moderators and mediators of intervention success and determine the potential generalizability of the interventions. IMPACT: The study seeks to demonstrate that a computer-based Virtual Advisor tailored to the needs of aging Latino adults can provide an effective and potentially cost-efficien alternative to Lay Advisors in community settings frequented by this population. The potential extended reach of such programs for use in a range of community settings (e.g., clinics, pharmacies, libraries) provides substantial promise for positively impacting the current health disparities gap.