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 非洲裔美国妇女经历了心脏代谢疾病状况的高燃烧。五十七个百分比 肥胖，有57％的人患有心血管疾病，而12％的糖尿病患有诊断性糖尿病。进行常规有氧运动 体育活动是预防和管理这些心脏代谢疾病的既定机制。这 这项研究的目的是测试以文化量身定制的，基于理论的智能手机提供的物理的有效性 活动干预以增加体育活动并改善心脏代谢疾病危险因素 非洲裔美国妇女。在12个月的两个手臂随机试验中，久坐210个（即，<60分钟/周 中度到剧烈的体育活动）肥胖症的非洲裔美国妇女（即BMI> 30 kg/m2）将 被分配接受智能步行，这是一种以文化量身定制的社会认知理论的体育锻炼 促进干预（n = 105）或仅FITBIT比较组（n = 105）。智能步行干预小组 将获得通过Smart Walk智能手机应用程序提供的文化量身定制的体育锻炼干预措施， 虚拟体育活动教练和短信。 Smart Walk应用程序上可用的功能包括：1） 个人资料页面，2）与文化相关的多媒体（即文本和视频）体育活动促进 模块，3）消息/讨论板和4）集成的体育活动自我监控/跟踪功能 通过Fitbit活动监控，参与者可以跟踪他们的每日，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之间的基于小组的对话 董事会并通过电话或商业上提供个性化的，一对一的体育活动教练 基于参与性的偏好，可用的基于应用程序的视频电话会议软件。聪明的步行参与者 在活动的4个月期间，每周还会收到三个体育活动促进短信 干涉。仅Fitbit的手臂比较臂将接收Fitbit活动监视器，并鼓励使用 商业上可用的设备，以增加体育锻炼。我们假设参与者在智能步行中 干预组将表现出显着改善体育锻炼和心脏代谢 与仅Fitbit比较组相比，风险因素。主要结果包括自我报告和 加速度计测量体育锻炼的变化。次要结果包括传统的风险因素 心脏代谢性疾病（即BMI，血压，血清脂质谱，葡萄糖耐药，胰岛素抵抗） 以及更多新颖和预后的危险因素，包括心肺适应性，主动脉脉冲波速度 IL-10和IL-15的TNF-α，IL-6和抗炎生物标志物的炎症生物标志物。我们也会 探索干预有效性的调解人和主持人，并确定每项社会成本的总成本 特别是提供智能步行干预和两个研究小组的成本效益 增加中度至剧烈体育锻炼的数分钟/周。