Smart Walk: A Culturally Tailored Smartphone-delivered Physical Activity Intervention for Reduction of Cardiometabolic Disease Risk among African American Women

智能步行：一种根据文化定制的智能手机提供的身体活动干预措施，可降低非裔美国女性的心血管代谢疾病风险

• 批准号: 10701114
• 负责人: Rodney Joseph
• 金额: $ 16.45万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-23 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10701114
• 关键词: Accelerometer; Accountability; Address; Adherence; Adult; Aerobic; African American; Age; Anti-Inflammatory Agents; Award; Behavior; Behavioral; Biological; Biological Markers; Blood Pressure; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Cardiovascular system; Cellular Phone; Communities; Comparison arm; Computer software; Control Groups; Cultural Characteristics; Data; Devices; Diabetes Mellitus; Diagnosis; Diastolic blood pressure; Dose; Effectiveness of Interventions; Ethnic group; Feedback; Fibrinogen; Generations; Glucose Intolerance; Guidelines; Heart Diseases; Hispanic; Inflammatory; Informal Social Control; Insulin Resistance; Interleukin-10; Interleukin-15; Interleukin-6; Internet; Intervention; Lipids; Measures; Mediating; Mediator of activation protein; Monitor; Multimedia; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Outcome Study; Participant; Patient Self-Report; Physical activity; Physiologic pulse; Population; Prevalence; Protocols documentation; Public Health; Race; Randomized; Reduce health disparities; Research; Research Personnel; Risk Factors; Self Efficacy; Serum; Site; Social support; Stress; Structure; TNF gene; Technology; Telephone; Testing; Text; Text Messaging; United States National Institutes of Health; Walking; Weight; Woman; Work; aged; arm; base; burden of illness; cardiometabolic risk; cardiometabolism; cardiorespiratory fitness; cardiovascular fitness; cardiovascular risk factor; comparative cost effectiveness; comparison group; cost effectiveness; design; disorder risk; efficacy testing; efficacy trial; exercise intervention; expectation; experience; fitbit; group intervention; health disparity; improved; intervention effect; intervention participants; mHealth; moderate-to-vigorous physical activity; mortality; novel; participant retention; post intervention; pragmatic trial; preference; prevent; primary outcome; prognostic; programs; racism; randomized trial; resilience; response; secondary outcome; sedentary; smartphone Application; social cognitive theory; social culture; social media; societal costs; text messaging intervention; theories; vigorous intensity; virtual; walking intervention

Abstract/Project Summary African American women experience a high burden of cardiometabolic disease conditions. Fifty-seven percent are obese, 57% have cardiovascular disease, and 12% have diagnosed diabetes. Engaging in regular aerobic physical activity is an established mechanism to prevent and manage these cardiometabolic diseases. The purpose of this study is test the efficacy of a culturally tailored, theory-based smartphone-delivered physical activity intervention to increase physical activity and improve cardiometabolic disease risk factors among African American women. In a 12-month, two arm randomized trial, 210 sedentary (i.e., < 60 minutes/week of moderate-to-vigorous intensity physical activity) African American women with obesity (i.e., BMI >30 kg/m2) will be assigned to receive either Smart Walk, a culturally tailored, Social Cognitive Theory-based physical activity promotion intervention (n=105), or a Fitbit-only comparison arm (n=105). The Smart Walk intervention group will receive a culturally tailored physical activity intervention delivered via the Smart Walk smartphone app, virtual physical activity coaching, and text messages. Features available on the Smart Walk app include: 1) personal profile pages, 2) culturally relevant multi-media (i.e., text and video) physical activity promotion modules, 3) message/discussion boards, and 4) physical activity self-monitoring/tracking feature that integrates with Fitbit activity monitors for participants to track their daily, weekly, and monthly activity. Virtual physical activity coaches will actively engage and facilitate group-based dialogue among participants on the discussion boards and provide individualized, one-on-one physical activity coaching via telephone or commercially available app-based video teleconferencing software, based on participant preference. Smart Walk participants also receive three physical activity promotion text messages each week for the duration of the active 4-month intervention. The Fitbit-only arm comparison arm will receive a Fitbit activity monitor and be encouraged to use the commercially available device to increase physical activity. We hypothesize participants in the Smart Walk intervention group will demonstrate significantly greater improvements in physical activity and cardiometabolic risk factors when compared to the Fitbit-only comparison group. Primary outcomes include self-reported and accelerometer-measured changes in physical activity. Secondary outcomes include traditional risk factors for cardiometabolic disease (i.e., BMI, blood pressure, serum lipid profiles, glucose intolerance, insulin resistance) and more novel and prognostic risk factors, including cardiorespiratory fitness, aortic pulse wave velocity, pro- inflammatory biomarkers of TNF-α, IL-6, and anti-inflammatory biomarkers of IL-10 and IL-15. We will also explore mediators and moderators of intervention effectiveness and determine the total societal cost per participant of delivering the Smart Walk intervention and the cost-effectiveness of the two study groups to increase minutes/week of moderate-to-vigorous physical activity.

摘要/项目摘要 非裔美国妇女经历了心脏代谢疾病状况的高负担。百分之五十七 57%的人患有心血管疾病，12%的人被诊断为糖尿病。定期参加有氧运动 身体活动是预防和管理这些心脏代谢疾病的既定机制。的 本研究的目的是测试一个文化定制的，基于理论的智能手机提供的物理效果 活动干预，以增加体力活动和改善心脏代谢疾病的危险因素， 非裔美国女性在一项为期12个月的双臂随机试验中，210名久坐（即，< 60分钟/周 中度到剧烈强度的身体活动）患有肥胖症的非裔美国妇女（即，BMI >30 kg/m2）将 被分配接受智能行走，这是一种文化定制的，基于社会认知理论的身体活动 促进干预组（n=105）或仅Fitbit比较组（n=105）。Smart Walk干预组 将通过Smart Walk智能手机应用程序接受文化定制的身体活动干预， 虚拟体育活动指导和短信。Smart Walk应用程序提供的功能包括：1） 个人简介页面，2）文化相关的多媒体（即，文字和录像）促进体育活动 模块，3）消息/讨论板，以及4）身体活动自我监测/跟踪功能， 与Fitbit活动监视器为参与者跟踪他们的日常，每周和每月的活动。虚拟物理 活动教练将积极参与并促进参与者就讨论进行小组对话 董事会，并通过电话或商业方式提供个性化的一对一体育活动指导 基于应用程序的视频电话会议软件，根据与会者的偏好。Smart Walk参与者 在活动的4个月期间，我每周还收到三条体育活动促销短信 干预仅使用Fitbit的手臂比较手臂将获得Fitbit活动监测器，并鼓励使用 市售的设备来增加身体活动。我们假设智能步行的参与者 干预组在体力活动和心脏代谢方面将表现出更大的改善， 与仅使用Fitbit的对照组相比，主要结果包括自我报告和 加速计测量的身体活动的变化。次要结局包括以下传统风险因素： 心脏代谢疾病（即，BMI、血压、血脂谱、葡萄糖耐受不良、胰岛素抵抗） 以及更多的新的和预后的危险因素，包括心肺功能，主动脉脉搏波速度，前 TNF-α、IL-6的炎性生物标志物和IL-10和IL-15的抗炎性生物标志物。我们还将 探索干预有效性的中介者和调节者，并确定每 参与者提供智能步行干预和两个研究组的成本效益， 增加每周中等至剧烈体力活动的分钟数。