Promoting Physical Activity in Latinas via Interactive Web-based Technology

摘要 在美国，拉丁裔妇女报告的不活动率高于非西班牙裔白色和男性同行， 并且不成比例地受到相关健康状况的影响（例如，癌症，高血压，心脏病， 中风、糖尿病）。为了解决这一公共卫生危机，基于证据的干预措施，利用最先进的 需要技术、理论和方法来增加这一高危人群的身体活动（PA）。 最近，我们的团队进行了一项随机对照试验（N=205），以测试为期6个月的文化治疗的有效性。 在拉丁美洲人中进行适应性强、量身定制的、基于互联网的西班牙语PA干预（Pasos Hacia La Salud，R 01 CA 159954）与健康接触控制互联网组。每周增加分钟数 中度到剧烈的体力活动（MVPA）在干预组中显著高于 对照组在6个月和12个月时（p <0.01），但仍未达到国家推荐的水平 身体活动指南。由于干预组中PA的改善与以下因素显著相关： 网站使用和自我效能，享受和社会支持的增加在父母的研究中，我们使用了这些 用于告知技术和理论支持的对干预的增强的数据（即，短信和 自适应目标设定，以增加网站的使用，并进一步针对上述关键 心理社会结构），以实现PA的更大增加，并长期保持这些收益 (24在R 01 CA 159954的更新中。对于拟议的研究，300名拉丁裔妇女将被随机分配至 1）原始Pasos Hacia La Salud定制的基于互联网的PA干预（原始干预）或2） 数据驱动的增强版Pasos Hacia La Salud PA干预（增强干预）。我们 假设强化干预组的参与者将报告更多分钟/周的 在6个月时，MVPA高于原始干预组的参与者。我们亦会研究如何保养 第12、18和24个月的治疗效果，以及提供增强型与原始型的成本 干预方案，以及干预-PA关系的潜在介导者。建议的高- 低成本的干预措施在促进和保持积极的健康益处方面具有很大的希望， 在美国的拉丁裔妇女的生活PA。

Abstract In the U.S., Latina women report higher rates of inactivity than their non-Hispanic White and male counterparts, and are disproportionately affected by related health conditions (e.g., cancer, hypertension, heart disease, stroke, diabetes). To address this public health crisis, evidence-based interventions that utilize state-of-the-art technology, theory and methods are needed to increase physical activity (PA) among this high-risk population. Recently, our team conducted a randomized controlled trial (N=205) to test the efficacy of a 6-month culturally adapted, individually tailored, Spanish-language Internet-based PA intervention among Latinas (Pasos Hacia La Salud, R01CA159954) vs. a Wellness Contact Control Internet Group. Increases in minutes/week of moderate-to-vigorous physical activity (MVPA) were significantly greater in the Intervention Group compared to the Control Group at 6 and 12 months (p < .01) but still did not reach levels recommended in the national physical activity guidelines. As improvements in PA in the Intervention Group were significantly associated with website use and increases in self-efficacy, enjoyment, and social support in the parent study, we used these data to inform technology and theory-supported enhancements to the intervention (i.e., text messaging and adaptive goal setting to increase website use and further targeting of the previously mentioned key psychosocial constructs) to achieve even greater increases in PA, and maintain these gains over the long term (24 months) in the renewal of R01CA159954. For the proposed study, 300 Latina women will be randomized to either 1) the original Pasos Hacia La Salud tailored Internet-based PA intervention (Original Intervention) or 2) the data driven, enhanced version of the Pasos Hacia La Salud PA intervention (Enhanced Intervention). We hypothesize that participants in the Enhanced Intervention arm will report significantly more minutes/week of MVPA than participants in the Original Intervention arm at 6 months. We will also examine the maintenance of treatment effects at 12, 18, and 24 months, as well as the costs of delivering the Enhanced vs. Original Intervention programs, and the potential mediators of the intervention-PA relationship. The proposed high- reach, low-cost intervention holds great promise in promoting and maintaining the positive health benefits of PA in the lives of Latina women in the United States.