Reducing Health Disparity in AA Women: Physical Activity Adherence

减少 AA 女性的健康差距：坚持体育活动

• 批准号: 8514421
• 负责人: JoEllen Wilbur
• 金额: $ 42.99万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-07-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8514421
• 关键词: Adherence; Adopted; Adoption; Aerobic; African American; Anxiety; Behavior; Behavioral; Body Composition; Cardiovascular Diseases; Cardiovascular system; Clinical; Clinical Trials; Clinical Trials Design; Collaborations; Communities; Community Health Centers; Community Healthcare; Complement; Computers; Data; Diabetes Mellitus; Disease; Dropout; Educational workshop; Effectiveness; Elements; Exercise; Family; Frequencies; Goals; Health; Health Services; Household; Income; Individual; Insulin-Dependent Diabetes Mellitus; Intervention; Learning; Life Style; Link; Low income; Maintenance; Measures; Modeling; Monitor; Myocardial Infarction; Obesity; Occupational; Occupations; Outcome; Outcome Study; Participant; Persons; Phase; Physical activity; Plague; Process; Public Health; Race; Radial; Randomized; Recording of previous events; Recruitment Activity; Regimen; Reporting; Research; Research Personnel; Residential Mobility; Risk; Schedule; Self Efficacy; Social support; Socioeconomic Status; Source; Stroke; Symptoms; System; Telephone; Testing; Training; Translating; Visit; Voice; Walking; Woman; Work; abstracting; aged; base; cardiovascular disorder risk; caucasian American; clinical practice; cost effective; cost effectiveness; depressive symptoms; design; effective intervention; efficacy testing; ethnic minority population; expectation; experience; fitness; health care delivery; health disparity; improved; innovation; meetings; middle age; motivational enhancement therapy; preference; primary outcome; programs; psychological outcomes; sedentary; service intervention; social; success; therapy design; waist circumference

Abstract Despite the known benefits, most individuals do not achieve the recommended levels of physical activity (PA). Overall, African American women have the lowest PA levels, which contributes to substantial disparities in cardiovascular health, diabetes, and depressive symptoms. There is a pressing need to examine ways to promote PA in African American women that are appealing, applicable to clinical practice, and cost-effective. The purpose of this clinical trial is to test the efficacy of our reframed Women's Walking Program (WWP), consisting of a lifestyle PA prescription and "group visit" delivery model, with or without tailored telephone contacts between group visits for increasing adherence to PA and improving health outcomes. Two telephone contact strategies will be compared against a no-telephone control condition: a person-administered contact strategy using brief motivational interviewing and an automated contact strategy using a telephone computer- linked system. Group visits and telephone contacts are designed to increase adherence to lifestyle PA with an emphasis on accumulation of 3,000 steps daily over baseline. The aims of this study are (1) to compare the initial (adoption 24 weeks) and longer-term (maintenance 2nd 24 weeks) effectiveness of the WWP plus person-administered telephone contacts, WWP plus automated telephone contacts, and the WWP without telephone contacts on (a) increasing adherence to lifestyle PA, (b) improving health outcomes (aerobic fitness, body composition, depressive symptoms), (c) improving self-efficacy and outcome expectations; and (2) to compare cost-effectiveness of the three telephone treatment conditions in relation to adherence to lifestyle PA and health outcomes. The study is a randomized cluster Latin Squares clinical trial with random assignment of the order of administering the three treatment conditions to six community health care centers. These six centers are similar with respect to race, socioeconomic status, and residential mobility. African American women (n = 288) aged 40 to 65 years, who are sedentary with no major signs or symptoms of cardiovascular disease and no history of myocardial infarction, stroke, or insulin-dependent diabetes will be recruited within a 3-mile radius of the community health care centers. Data will be collected at baseline, and at 24 weeks and 48 weeks using multiple measures of PA; aerobic fitness testing; BMI; waist circumference; depressive symptoms; self-efficacy for overcoming barriers; and outcome expectations. We anticipate that (a) adherence to lifestyle PA and therefore health outcomes will improve and self-efficacy and outcome expectations will be higher in the WWP complemented with telephone contacts compared to the WWP without telephone contacts and (b) the WWP plus automated telephone contact will be more cost-effective than WWP plus person-administered telephone contacts. This study will contribute to identifying a reimbursable, practical way of delivering a behavioral change intervention in clinical settings that will increase adherence to PA and be attractive and appealing to African American women.

摘要 尽管已知的好处，大多数人没有达到推荐的身体活动水平（PA）。 总的来说，非洲裔美国妇女的PA水平最低，这导致了在性别方面的巨大差异。 心血管健康、糖尿病和抑郁症状。迫切需要研究如何 促进PA在非洲裔美国妇女是有吸引力的，适用于临床实践，并具有成本效益。 这项临床试验的目的是测试我们重新设计的女性步行计划（WWP）的有效性， 包括生活方式PA处方和“团体访问”交付模式，有或没有定制的电话 小组访问之间的联系，以增加遵守PA和改善健康结果。两个电话 联系策略将与无电话控制条件进行比较：个人管理的联系 策略使用简短的动机访谈和自动联系策略使用电话计算机- 链接系统小组访问和电话联系旨在增加对PA生活方式的坚持， 强调每天超过基线3，000步的累积。本研究的目的是（1）比较 WWP plus的初始（采用24周）和长期（维持第2个24周）有效性 个人管理的电话联系，WWP加上自动电话联系，以及WWP没有 电话联系（a）增加对PA生活方式的坚持，（B）改善健康结果（有氧健身， 身体成分，抑郁症状），（c）提高自我效能和结果预期;以及（2） 比较三种电话治疗条件与坚持生活方式PA的成本效益 和健康结果。本研究是一项随机分组拉丁广场临床试验，随机分配 对六个社区卫生保健中心实施三种治疗条件的顺序。这六 中心在种族、社会经济地位和居住流动性方面相似。非裔美国人 女性（n = 288），年龄40 - 65岁，久坐不动，无心血管疾病的主要体征或症状 疾病和无心肌梗死、中风或胰岛素依赖型糖尿病史的患者将在 3-社区卫生服务中心的半径。将在基线、24周和48周时收集数据 周使用多种措施的PA;有氧健身测试;体重指数;腰围;抑郁症状; 克服障碍的自我效能;以及结果预期。我们预计（a）坚持生活方式 PA和因此健康结果将改善，自我效能和结果期望将更高， 与没有电话联系的WWP相比，补充有电话联系的WWP，以及（B） WWP加自动电话联系将比WWP加人工管理更具成本效益 电话联系。这项研究将有助于确定一种可偿还的、切实可行的方式， 临床环境中的行为改变干预，将增加对PA的依从性，并具有吸引力， 吸引了非裔美国女性

项目成果

Effectiveness, efficiency, duration, and costs of recruiting for an African American women's lifestyle physical activity program.

• DOI: 10.1002/nur.21550
• 发表时间: 2013-10
• 期刊: RESEARCH IN NURSING & HEALTH
• 影响因子: 2
• 作者: Wilbur, JoEllen;Buchholz, Susan W.;Ingram, Diana M.;Braun, Lynne T.;Johnson, Tricia J.;Fogg, Louis;Miller, Arlene M.;Volgman, Annabelle S.;McDevitt, Judith
• 通讯作者: McDevitt, Judith

Retention of African American Women in a Lifestyle Physical Activity Program.

在生活方式体育锻炼计划中保留非裔美国妇女。

• DOI: 10.1177/0193945915609902
• 发表时间: 2016-03
• 期刊: Western journal of nursing research
• 影响因子: 1.8
• 作者: Buchholz SW;Wilbur J;Schoeny ME;Fogg L;Ingram DM;Miller A;Braun L
• 通讯作者: Braun L

Cardiovascular Risk in Midlife African American Women Participating in a Lifestyle Physical Activity Program.

• DOI: 10.1097/jcn.0000000000000266
• 发表时间: 2016-07
• 期刊: The Journal of cardiovascular nursing
• 作者: Braun LT;Wilbur J;Buchholz SW;Schoeny ME;Miller AM;Fogg L;Volgman AS;McDevitt J
• 通讯作者: McDevitt J

The Cost of Increasing Physical Activity and Maintaining Weight for Midlife Sedentary African American Women.

中年久坐的非洲裔美国女性增加体力活动和保持体重的成本。

• DOI: 10.1016/j.jval.2015.10.009
• 发表时间: 2016
• 期刊: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
• 作者: Johnson,TriciaJ;ESchoeny,Michael;Fogg,Louis;Wilbur,JoEllen
• 通讯作者: Wilbur,JoEllen

Women's Lifestyle Physical Activity Program for African American Women: Fidelity Plan and Outcomes.

非裔美国女性的女性生活方式体育活动计划：忠诚计划和成果。

• DOI: 10.1123/jpah.2015-0701
• 发表时间: 2016
• 期刊: Journal of physical activity & health
• 影响因子: 3.1
• 作者: Wilbur,JoEllen;Schoeny,MichaelE;Buchholz,SusanW;Fogg,Louis;Miller,ArleneMichaels;Braun,LynnedT;Halloway,Shannon;Dancy,BarbaraL
• 通讯作者: Dancy,BarbaraL