Promoting Physical Activity in Latinas via Interactive Web-based Technology

摘要 在美国，拉美裔女性报告的不活动率高于非西班牙裔白人和男性女性， 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)。为了应对这场公共卫生危机，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体力活动(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个月的文化疗效 在拉丁裔中采用改编的、单独定制的西班牙语互联网巴勒斯坦权力机构干预措施(Pasos Hacia La Salud，R01CA159954)VS A Wellness Contact Control Internet Group。以分钟/周为单位增加 干预组的中等到剧烈的体力活动(MVPA)显著高于 对照组在6个月和12个月(P&lt；.01)，但仍未达到国家建议的水平 体力活动指南。因为干预组PA的改善与 在父母的研究中，网站使用和自我效能感、享受性和社会支持的增加，我们使用了这些 为技术和理论支持的干预增强提供信息的数据(例如，文本消息和 自适应目标设置，以增加网站使用率，并进一步瞄准前面提到的关键字 心理社会结构)，以实现PA的更大增长，并在长期保持这些增长 (24个月)更新R01CA159954。在这项拟议的研究中，300名拉丁裔女性将被随机分配到 1)原始的Pasos Hacia La Salud量身定做的基于互联网的PA干预(原始干预)或2) 数据驱动、增强版的Pasos Hacia La Salud PA干预(增强干预)。我们 假设增强干预组的参与者每周报告的分钟数将显著增加 MVPA组患者在6个月时比原来的干预组受试者高。我们还将审查维护 12个月、18个月和24个月的治疗效果，以及提供增强版与原始版的成本 干预计划，以及干预-PA关系的潜在调解人。建议的高- REACH，低成本干预在促进和维持 PA在美国拉丁裔女性生活中的作用。

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.