WalkIT: Neighborhood walkability and moderation of adaptive walking interventions

WalkIT：社区步行能力和适应性步行干预措施的调节

• 批准号: 9354546
• 负责人: Marc A Adams
• 金额: $ 3.11万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9354546
• 关键词: Accelerometer; Adherence; Adoption; Adult; Behavior; Behavioral Medicine; Chronic Disease; Complex; Educational Materials; Ensure; Environment; Environmental Risk Factor; Exercise; Exhibits; Fostering; Frequencies; Future; Goals; Guidelines; Health; Incentives; Individual; Intervention; Life; Longevity; Maintenance; Malignant Neoplasms; Measures; Medicine; Meta-Analysis; Modeling; Neighborhoods; Obesity; Outcome; Participant; Patient Self-Report; Performance; Physical activity; Public Health; Quality of life; Randomized; Recruitment Activity; Risk Factors; Sampling; Science; Socioeconomic Status; Study models; Technology; Testing; Text; Time; Transportation; Walking; Woman; Work; anxiety symptoms; arm; base; behavior change; bone health; built environment; cardiorespiratory fitness; cardiovascular disorder risk; collaborative environment; cost; depressive symptoms; design; disorder prevention; improved; intervention effect; meetings; men; moderate-to-vigorous physical activity; novel; physical inactivity; theories; therapy design; walkability; walking intervention

 DESCRIPTION (provided by applicant): Exercise is medicine. Known benefits of moderate-to-vigorous physical activity (MVPA) include improvements to cardiorespiratory fitness, obesity, bone health, cardiovascular disease risk factors, some cancers, and depression and anxiety symptoms. Nevertheless, <8% of US adults as measured by accelerometry meet MVPA guidelines. The majority of existing interventions to increase MVPA have been relatively static (with educational materials or components such as goals to engage in MVPA not changing over time) and at the individual level. Technological and theoretical advances make adaptive interventions (AIs) for MVPA feasible for individuals. Unlike static interventions, AIs have time-varying components that respond uniquely to an individual's performance and changing needs. AIs have potential to reduce treatment mismatch, increase adherence, enhance potency, and personalize behavioral medicine. Micro-incentives (MIs) that are "smaller, sooner incentives" for goal attainment are possible with technology and hypothesized to result in greater MVPA than "larger, later incentives". Combined MIs and AIs have the potential to enhance adoption of MVPA. Additionally, multilevel ecological models posit that physical activity is sensitive to the design of built environments. One core hypothesis derived from ecological models is that low walkable neighborhoods constrain physical activity adoption and maintenance, even in the context of individual-level interventions to increase such behavior. High walkable neighborhoods are hypothesized to provide a supportive environment for PA adoption and maintenance, enhancing the effect of individual-level interventions. Few studies have tested a priori the premise that individual-level interventions result in greater adoption and maintenance of MVPA when conducted in neighborhood environments supportive (vs. unsupportive) of physical activity. Based on our pilot work, we will develop novel adaptive (AI) and micro-incentive (MI) interventions and test them against static (SI) and delayed-incentive interventions (DI) in a 4-arm, randomized factorial trial to increase MVPA among 480 inactive men and women (18-60 years). Using GIS-measured neighborhood walkability and socioeconomic status, we will recruit participants from four neighborhood types: "high walkable/high SES," "high walkable/low SES," "low walkable/high SES," and "low walkable/low SES." The factorial design and sampling approach will allow us to test, within a multilevel framework, synergistic or antagonistic interaction effects of interventions and neighborhood factors on MVPA adoption and maintenance. Primary aims of this proposal are to (1) test main and interaction effects for AIs and MIs on MVPA minutes/day by 12 months, (2) investigate whether AIs and MIs foster persistence of MVPA at 18 and 24 months, and (3) determine whether AIs and MIs (compared to SIs and DIs) conducted in high walkable (vs. low walkable) neighborhoods result in greater adoption by 12 months and maintenance of MVPA at 18 and 24 months. Results will inform future hypotheses of ecological models and studies for MVPA adoption and maintenance to improve public health.

 描述（由申请人提供）：运动是医学。中度至剧烈体力活动（MVPA）的已知益处包括改善心肺功能，肥胖，骨骼健康，心血管疾病风险因素，某些癌症以及抑郁和焦虑症状。尽管如此，通过加速度计测量，<8%的美国成年人符合MVPA指南。大多数现有的增加MVPA的干预措施相对静态（教育材料或组成部分，如参与MVPA的目标不会随着时间的推移而变化），并在个人层面上。技术和理论的进步使MVPA的适应性干预（AI）对个人来说是可行的。与静态干预不同，人工智能具有随时间变化的组件，可以对个人的表现和不断变化的需求做出独特的反应。人工智能有可能减少治疗不匹配，增加依从性，提高效力，并个性化行为医学。微激励（MI），是“小，更快的激励措施”的目标实现是可能的技术和假设，导致更大的MVPA比“大，后来的激励措施”。MI和AI的组合有可能提高MVPA的采用率。此外，多层次生态模型表明，身体活动是敏感的建筑环境的设计。从生态模型中得出的一个核心假设是，低步行社区限制了身体活动的采用和维持，即使在个人层面的干预措施，以增加这种行为的背景下。高步行街区的假设提供了一个支持性的环境PA采用和维护，提高个人层面的干预措施的效果。很少有研究已经测试了先验的前提下，个人层面的干预措施，导致更多的采用和维护MVPA时，进行邻里环境支持（与不支持）的身体活动。基于我们的试点工作，我们将开发新的适应性（AI）和微激励（MI）干预措施，并在一项4臂随机析因试验中对静态（SI）和延迟激励干预（DI）进行测试，以增加480名非活动男性和女性（18-60岁）的MVPA。使用GIS测量的社区步行能力和社会经济状况，我们将从四个社区类型中招募参与者：“高步行/高SES”，“高步行/低SES”，“低步行/高SES”和“低步行/低SES”。因子设计和抽样方法将使我们能够在多层次框架内测试干预措施和邻里因素对MVPA采用和维持的协同或拮抗相互作用效应。本提案的主要目的是（1）在12个月时测试AI和MI对MVPA分钟/天的主要和相互作用效应，（2）研究AI和MI是否促进MVPA在18和24个月时的持续性，及（3）确定认可机构及管理机构是否（与SI和DI相比）在可步行的高处进行（与低步行）社区导致12个月的更多采用，并在18和24个月维持MVPA。结果将告知未来的生态模型和MVPA采用和维护，以改善公众健康的研究假设。