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 拉丁美洲人患慢性脊柱疼痛（CSP）的医疗治疗风险较高，因为 社会经济状况，获得医疗保健的不一致，英语能力有限，合并症，高 职业伤害的患病率和全身性偏见歧视。体育活动（PA）已经 被广泛接受为有效的非药物疼痛管理策略，但许多有疼痛的拉丁裔 不要参与PA。具有CSP的拉丁美洲人面临着可能受到PA的明显挑战 社会生态模型的多个级别，包括人际（例如社会身份，痛苦或与PA有关的） 信念），人际关系（例如，社会支持）和环境因素（例如，邻里的行动性）。这些 多层次因素也可能干扰使用CSP的拉丁美洲人的参与度。考虑到 PA行为的复杂性，整合社会生态模型和交叉框架支持 评估预测因素如何相交以影响PA。此外，PA还有时间变化的元素 （例如，痛苦，社会支持和环境）在带有CSP的拉丁美洲人中，可以由特定事件触发 或随机。这是评估多层因素与PA之间关系的瞬时波动 并确定有助于或阻碍参与的特定环境环境。 拟议的研究旨在对正在进行的临床试验的基线数据进行次要分析 美墨边界评估多层因素如何干预影响PA（AIM 1）。混合方法 然后将进行方法，首先探索哪些多层次因素有可能影响 暂时的PA，第二，使用生态瞬时评估（EMA）评估这些实时的方式 与CSP一起在拉丁美洲人中预测自由生活PA的因素相交（AIM 2）。 两种目标都将进行交叉亚分析，以评估可能更大的亚组 体育锻炼机会的劣势。这项研究的发现预计会揭示PA 拉丁裔与CSP之间的差异，同时为申请人的未来研究目标奠定基础 开发针对该人群的瞬时和个性化行为干预措施。通过这个F31 机制，申请人将在体育锻炼，疼痛和 数字健康将极大地促进申请人成为独立公众的长期目标 健康研究员。