Evaluating Multilevel Factors that Predict Physical Activity Among Latinos with Chronic Spine Pain: A Mixed-Methods Study

评估预测患有慢性脊柱疼痛的拉丁美洲人体力活动的多层次因素：一项混合方法研究

• 批准号: 10680088
• 负责人: Patricia Dionicio
• 金额: $ 3.74万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-05 至 2026-07-04
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10680088
• 关键词: Accelerometer; Address; Adult; Affect; Behavior; Behavior Therapy; Belief; Chronic; Clinical Trials; Data; Development; Disadvantaged; Discrimination; Disparity; Ecological momentary assessment; Elements; Emotions; Environment; Environmental Risk Factor; Event; Facial Pain; Foundations; Future; Gender; Goals; High Prevalence; Individual; Inequity; Intervention; Interview; Investigation; Knowledge; Latina Population; Latino; Latino Population; Limited English Proficiency; Measurement; Measures; Medical; Medical Care Costs; Methods; Mexico; Modeling; National Institute on Minority Health and Health Disparities; Neighborhoods; Occupational injury; Pain; Pain Nature; Pain management; Pathway interactions; Patients; Persons; Phase; Physical activity; Population; Predictive Factor; Psychosocial Factor; Public Health; Reporting; Research; Research Design; Research Methodology; Research Personnel; Risk; Sampling; Science; Social Identification; Social support; Spine pain; Strategic Planning; Structure; Subgroup; Target Populations; Testing; Time; Time Factors; Training; United States; United States National Institutes of Health; Wages; Woman; adaptive intervention; chronic pain; chronic pain management; comorbidity; digital health; experience; health care availability; health determinants; health disparity; health outcome disparity; intersectionality; low socioeconomic status; moderate-to-vigorous physical activity; pain perception; prevent; secondary analysis; social structure; walkability

PROJECT SUMMARY Latinos are at an elevated risk for medical undertreatment of chronic spine pain (CSP) due to having a lower socioeconomic status, inconsistent access to healthcare, limited English proficiency, comorbid conditions, high prevalence of occupational injuries, and systemic prejudicial discrimination. Physical activity (PA) has been widely accepted as an effective non-pharmacological pain management strategy, yet many Latinos with pain do not engage in PA. Latinos with CSP face distinct challenges to engaging in PA that may be influenced by multiple levels of the socioecological model including intrapersonal (e.g., social identities, pain or PA-related beliefs), interpersonal (e.g., social support), and environmental factors (e.g., neighborhood walkability). These multilevel factors may also intersect to influence PA engagement in Latinos with CSP. Considering the complexity of PA behavior, integrating the socioecological model and intersectional framework support the assessment of how predictors intersect to influence PA. Furthermore, there are time-varying elements of PA (e.g., pain, social support, and environment) among Latinos with CSP that can be triggered by a specific event or at random. Thus, assessing momentary fluctuations in the relationships between multilevel factors with PA and identifying specific environmental contexts that facilitate or impede PA engagement is warranted. The proposed study aims to conduct a secondary analysis of baseline data from an ongoing clinical trial near the US-Mexico border to assess how multilevel factors intersect to influence PA (Aim 1). A mixed methods approach will then be conducted to first explore what multilevel factors have the potential to influence momentary PA and second, use Ecological Momentary Assessment (EMA) to assess how these real-time factors intersect to form person-specific networks predicting free-living PA among Latinos with CSP (Aim 2). Both aims will conduct an intersectional sub-analysis that evaluates subgroups that may be at a greater disadvantage for physical activity opportunities. Findings from this study are expected to shed light on PA disparities among Latinos with CSP while setting the foundation for the applicant’s future research goals of developing momentary and personalized behavioral interventions targeting this population. Through this F31 mechanism, the applicant will gain advanced interdisciplinary training in the fields of physical activity, pain, and digital health that will significantly contribute to the applicant’s long-term goal of being an independent, public health researcher.

项目摘要 拉丁美洲人在慢性脊柱疼痛（CSP）的医疗治疗不足的风险较高，由于有较低 社会经济地位，不一致的医疗保健，有限的英语水平，共病条件，高 职业伤害的普遍性和系统性偏见歧视。体力活动（PA） 被广泛接受为一种有效的非药物疼痛管理策略，但许多拉丁美洲人的疼痛 不要参与PA。具有CSP的拉丁美洲人面临着参与PA的独特挑战，可能受到以下因素的影响： 社会生态模型的多个层次包括个人内部（例如，社会身份、疼痛或PA相关 信仰），人际关系（例如，社会支持），和环境因素（例如，邻里步行能力）。这些 多层次因素也可能交叉影响PA参与拉丁美洲人与CSP。考虑 PA行为的复杂性，整合社会生态模型和交叉框架支持 评估预测因素如何交叉影响PA。此外，存在PA的时变元素 (e.g.,疼痛，社会支持和环境）与CSP的拉丁美洲人，可以由特定事件触发 或者随机的。因此，评估多水平因素与PA之间关系的瞬时波动， 并确定促进或阻碍巴勒斯坦权力机构参与的具体环境背景是必要的。的 拟议的研究旨在对来自一项正在进行的临床试验的基线数据进行二次分析， 美墨边境，以评估多层次因素如何交叉影响PA（目标1）。混合方法 然后，我们将采用一种方法，首先探索哪些多层次因素有可能影响 第二，使用生态瞬时评估（EMA）来评估这些实时 因素相交，形成特定于个人的网络预测自由生活的PA与CSP拉丁美洲人（目的2）。 这两个目标都将进行交叉子分析，评估可能处于更高水平的亚组。 不利于身体活动的机会。这项研究的结果预计将为PA提供线索 拉丁美洲人与CSP之间的差异，同时为申请人未来的研究目标奠定基础， 针对这一人群制定临时和个性化的行为干预措施。通过F31 机制，申请人将获得先进的跨学科培训，在身体活动，疼痛， 数字健康，这将大大有助于申请人的长期目标是一个独立的，公共的 健康研究员。