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Increasing Physical Activity in Rural Pennsylvanians: The PA Moves Trial

增加宾夕法尼亚州农村地区的体育活动：宾夕法尼亚州移动审判

基本信息

批准号：
10371552
负责人：
MACK T. RUFFIN
金额：
$ 102.2万
依托单位：
PENNSYLVANIA STATE UNIV HERSHEY MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-01 至 2022-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10371552
关键词：
Address Adult Appointment Attenuated Behavioral Breast Chronic Disease Clinic Cohort Effect Collaborations Colon Colorectal Cancer Communities Computerized Medical Record Counseling Diabetes Mellitus Education Ensure Environment Exposure to Faculty Goals Health Health Benefit Health Professional Health system Healthcare Systems Incidence Individual Intervention Learning Location Logistics Malignant Neoplasms Malignant neoplasm of cervix uteri Malignant neoplasm of lung Malignant neoplasm of prostate Methodology Methods Modeling Obesity Outcome Overweight Participant Patients Pennsylvania Physical activity Physicians Population Positioning Attribute Primary Health Care Provider RALA gene Randomized Recommendation Reporting Research Resources Risk Factors Risk Reduction Rural Social Environment Source Specialist Techniques Technology Telephone Training Trust Work base built environment cancer health disparity cancer risk care providers digital fitness implementation evaluation instrument intervention cost malignant breast neoplasm moderate-to-vigorous physical activity mortality mortality disparity physical inactivity programs quitline randomized trial rural America rural dwellers rural setting smoking cessation social success urban disparity

项目摘要

Project Summary / Abstract A rural/urban disparity in mortality of 8% has been observed for lung, colorectal, prostate, breast, and cervical cancers. Physical inactivity is a modifiable cancer risk factor; physical activity (PA) is associated with risk reductions between 10-20% for breast, colon, and 6 other cancers. Further, rural residents report approximately 24% lower PA compared to urban residents. Primary care providers are a trusted source of health advice and they are in an ideal position to assess PA and advise patients regarding becoming and staying physically active. It is estimated that 84.3% of adults had an appointment with a primary health care professional in 2018. Thus, primary care encounters provide an opportunity to promote PA among the majority of rural adults, particularly among those with chronic disease profiles placing them at elevated cancer risk (e.g., overweight, obesity, diabetes). There is substantial evidence demonstrating the success of primary care providers promoting PA. Advice from providers is most effective in creating sustainable increases in PA when followed by phone or community-based support. The first challenge to implementing this type of approach in rural settings is the need for a methodology to train rural primary care providers to promote PA. We propose to apply the well validated ECHO Model to train providers toward the goal of communicating the health benefits of PA to patients, making clear recommendations, and connecting them to PA resources. Additional challenges to promoting PA in rural residents are provision of behavioral support and ensuring adequate opportunities for PA. These activities are beyond the scope of practice for primary care providers. We propose to partner with the Harrisburg YMCA to create a ‘MoveLine’ – logistically, the PA equivalent to the highly successful smoking cessation ‘QuitLine’. Providers will refer patients to the MoveLine, who will then counsel and connect patients to PA options available in their communities. Study staff and a community advisory board (CAB), in collaboration with the YMCA, Penn State Extension, and Penn State (PSU) faculty will work to identify existing PA options and to expand them as well. While intervening on the built environment is beyond the scope of this application, we acknowledge the import of environment on PA by rigorously evaluating its impact on outcomes. We propose a multi-level group randomized trial, including provider advice (patient), coaching and MoveLine (patient, social), and educating and promoting community PA opportunities and programs (community). We also evaluate the impact of the built environment on PA outcomes. We propose this work in collaboration with the Primary Health Network (8 Federally Qualified Health Clinics serving rural Pennsylvania), Penn State Health (8 clinics serving rural Pennsylvania), the Harrisburg YMCA, and Penn State Extension to increase PA levels in rural Pennsylvanians, toward the goal of reducing cancer risk. A total of 16 clinics will be randomized to the immediate or delayed treatment condition (2-3 providers nested within each clinic and 20 patients nested within each provider; 800 patients in total).

项目摘要/摘要