ENLACE: A partnership to promote physical activity among Mexican immigrant women

描述（由申请人提供）：拉丁美洲人是美国人口中增长最快的部分，他们患有肥胖症和糖尿病等慢性疾病的比例不成比例，并且在拉丁美洲亚群体中缺乏体育锻炼的水平最高；墨西哥裔美国女性的肥胖率和久坐不动的生活方式最高。每天增加中等强度的身体活动（PA）可以防止体重增加，改善整体身心健康。本研究的目的是：1)确定并了解影响南卡罗来纳州哥伦比亚市墨西哥移民妇女PA行为的因素；2)制定和评估文化上有竞争力的PA干预措施，针对个人、家庭和社区对墨西哥移民妇女的影响；3)评估社区非专业健康顾问（LHAs）参与研究的可行性和有效性。在第一年，我们建议与当地的西班牙裔服务组织和其他社区合作伙伴通过项目咨询团队进行形成性评估并制定干预措施。将征聘六名地方行政官参与规划和实施形成性评价。从12个焦点小组和25个深度访谈中收集的数据将为制定干预措施提供信息，以促进墨西哥移民妇女中中等强度的PA。在第二年，每个LHA将招募2组10名女性（N=12组；N=120名女性）参与研究。每一组将被随机分配到两种情况中的一种：立即干预或延迟干预。随机化将在LHA内得到平衡。6组将接受即时干预，6组将作为延迟干预的一部分进行测量。在6个月的干预结束时，延迟干预组将接受干预（但没有测量）。基于社会认知理论和PEN-3和社会生态模型的干预将由lha提供，并强调满足CDC-ACSM建议的每周5天或更多天30分钟中等强度的PA。因此，除了个人行为改变外，干预还将针对拉丁裔家庭和社区内的社会和文化影响。将在基线和6个月随访时进行标准化评估，并使用加速度计评估PA。我们假设，与随机分配到延迟干预的参与者相比，立即干预的参与者将表现出每天中等强度体力活动分钟的更大增加（主要结局），表现出感知社会支持和体力活动自我效能的更大增加，体重增加更少（次要结局）。这项建议将为严格评估将非专业健康顾问纳入影响墨西哥移民妇女体育活动的参与性研究方法奠定基础。该研究将为该方法的可行性提供初步证据，包括后勤问题、社区参与水平、行为结果的潜在效应大小，以及措施的文化适用性和可靠性。这些初步调查结果将用于开展一项大规模、基于社区的参与性、非专业健康顾问方法试验，以促进拉丁裔社区的体育活动，并协助缩小健康差距。

DESCRIPTION (provided by applicant): Latinos, the fastest growing segment of the US population, carry disproportionate rates of chronic illnesses such as obesity and diabetes and have the highest levels of physical inactivity Among Latino subgroups; Mexican American women experience some of the highest rates of obesity and sedentary lifestyles. Increasing daily moderate-intensity physical activity (PA) can prevent weight gain and improve overall physical and mental health. The aims are to: 1) identify and understand the factors that influence PA behavior for Mexican immigrant women in the Columbia MSA, SC; 2) develop and evaluate a culturally competent PA intervention that targets individual, family and community influences among Mexican immigrant women; and, 3) assess the feasibility and effectiveness of engaging community-based Lay health advisors (LHAs) as participatory researchers. In year 1 we propose to conduct formative assessments and develop the intervention in full partnership with a local Hispanic-serving organization and other community partners via a Program Advisory Team. Six LHAs will be recruited to participate in the planning and implementing the formative assessments. Data gathered from 12 focus groups and 25 in-depth interviews will inform the development of an intervention to promote moderate intensity PA among Mexican immigrant women. In year 2, each LHA will recruit 2 groups of 10 women (N=12 groups; N=120 women) to participate in the study. Each group will be randomly assigned to one of two conditions: an immediate intervention or a delayed intervention. Randomization will be balanced within LHA. Six groups will receive the immediate intervention and 6 groups will be measured as part of the delayed intervention. At the conclusion of the 6- month intervention, delayed intervention groups will receive the intervention (but no measurements). The intervention, based on Social Cognitive Theory and PEN-3 and Socio- ecological models, will be delivered by LHAs and emphasize meeting CDC-ACSM recommendations of 30 minutes of moderate-intensity PA on 5 or more days per week. Thus, in addition to individual behavior change, the intervention will target the social and cultural influences within the Latino family and community. Standardized assessments will occur at baseline and 6-months follow-up and PA will be assessed using accelerometers. We hypothesize that compared to participants randomized to the delayed intervention, immediate intervention participants will show greater increases in minutes per day moderate intensity physical activity (primary outcome), show greater increases in perceived social support and self- efficacy for physical activity and less weight gain (secondary outcomes). PUBLIC HEALTH RELEVANCE This proposal will lay the foundation for rigorous evaluation of the incorporation of lay health advisors in a participatory research approach to affecting physical activity among Mexican immigrant women. The study will provide preliminary evidence for the feasibility of this approach, including logistical issues, levels of community participation, potential effect sizes for behavioral outcomes, and the cultural suitability and reliability of measures. These preliminary findings will be used to develop a large-scale, community-based trial of the participatory, lay health advisor approach to promoting physical activity in Latino communities and assisting in the reduction of health disparities.