A Multilevel Physical Activity Intervention for South Asian Women and Girls

针对南亚妇女和女孩的多层次体育活动干预

• 批准号: 10675709
• 负责人: NAMRATHA R KANDULA
• 金额: $ 56.06万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10675709
• 关键词: Acculturation; Address; Adolescence; Affect; American; American Heart Association; Asian Indian; Asian population; Behavior; Behavioral; Belief; Blood Pressure; Body Weight decreased; Cardiometabolic Disease; Child; Child Health; Communication; Communities; Conflict (Psychology); Control Groups; Counseling; Daughter; Disparity; East Asian; Education; Effectiveness; Environment; Environmental Risk Factor; Exercise; Family; Fathers; Feeling; Female Adolescents; Foundations; Gender; Generations; Glycosylated hemoglobin A; Growth; Happiness; Health; Heterogeneity; High Prevalence; Hispanic Populations; Hypertension; Immigrant; Immigrant community; Immigration; India; Individual; Intervention; Language; Life Cycle Stages; Linguistics; Lipids; Maintenance; Mediating; Mediator; Methods; Mothers; Motivation; Neighborhoods; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Pakistan; Physical activity; Pilot Projects; Population; Positioning Attribute; Process; Public Health; Randomized; Randomized, Controlled Trials; Research Design; Resources; Risk; Risk Factors; Role; Running; Same-sex; Self Efficacy; Shapes; Social isolation; Social support; South Asian; Spouses; Strenuous Exercise; System; Thinness; Time; United States; Waiting Lists; Walking; Weight; Woman; Work; aspirate; cardiometabolic risk; community based participatory research; community organizations; effective intervention; effectiveness testing; efficacy evaluation; efficacy testing; empowerment; exercise intervention; expectation; experience; girls; health disparity; high risk; implementation evaluation; improved; intervention effect; motivational enhancement therapy; peer; physical inactivity; physical model; process evaluation; psychosocial; role model; secondary outcome; sedentary; social culture; theories; vigorous intensity; waist circumference

Project Summary Asian Indian and Pakistani (South Asian) immigrants have a high prevalence of physical inactivity and cardiometabolic risk factors. South Asian (SA) women and girls are particularly at high risk due to a confluence of immigration, culture, and gender which shape the health risk of SA women and girls across the life course. Our community-based participatory research found that SA women (85% of whom were 1st generation immigrants) experienced: a) social isolation and low social support, which reduced physical activity (PA) motivation and self-efficacy; b) desire to maintain traditional values and norms, which conflicted with local PA environments (e.g., mixed-gender exercise classes); and c) linguistic and environmental barriers. When SA girls (majority 2nd generation) entered adolescence, they described: a) acculturation-related family conflict because exercise was perceived as an “American behavior”; b) gender constraints; c) lack of role models; and d) their community's shared illness belief that “if you are thin, you don't need to exercise.” Importantly, the community also identified individual, interpersonal, and familial processes that empowered SA women and girls to become more active, including holistic benefits of PA, aspirations for children's health, and feeling connected and happy when exercising with other women and family. Building on a pilot study demonstrating feasibility and preliminary efficacy, the proposed study aims to testing the efficacy and implementation of the South Asians Active Together (SAATH) intervention. The 16-week intervention targets individual, interpersonal, and family levels through four main components: 1) group exercise classes for mother-daughter dyads; 2) dyadic mother-daughter PA counseling using motivational interviewing; 3) peer discussion groups, and 3) family walking groups. The intervention also targets the environment level by working with park districts, a public health department, and community organizations to make changes to the local environment that take into account sociocultural (e.g., gender, family focus) and environmental (e.g., same sex classes) expectations of SA. Aim 1 of the study is to determine the efficacy of the SAATH intervention to increase moderate-vigorous PA in SA mother-daughter dyads using a randomized wait-list control study design. Secondary outcomes are: walking and sedentary time in dyads and cardiometabolic risk factors in mothers. Aim 2 will evaluate the impact of the intervention on individual (self-efficacy, autonomy support, social support, motivation) and dyadic (acculturation conflict, communication, connectedness) factors hypothesized to mediate the intervention effect on PA. Aim 3 is to evaluate implementation and sustainability of SAATH, including the environment and systems changes made by cross-sector partners to promote and sustain PA in SA women and girls. Given the growth of the SA population and their increased risk for cardiometabolic disease, identifying interventions that increase PA among Asian Indian and Pakistani immigrant women is of significant public health import.

项目概要 亚裔印度裔和巴基斯坦裔（南亚裔）移民普遍缺乏身体活动， 心脏代谢危险因素。由于人口汇合，南亚 (SA) 妇女和女孩面临的风险特别高 移民、文化和性别影响着南澳妇女和女孩一生的健康风险。 我们基于社区的参与性研究发现，南澳女性（其中 85% 是第一代） 移民）经历：a）社会孤立和低社会支持，减少了体力活动（PA） 动机和自我效能感； b) 渴望维持与当地巴勒斯坦权力机构相冲突的传统价值观和规范 环境（例如混合性别的运动课程）； c) 语言和环境障碍。当SA 女孩（大多数是第二代）进入青春期，她们描述：a）与文化适应相关的家庭冲突 因为锻炼被认为是一种“美国人的行为”； b) 性别限制； c) 缺乏榜样；和 d) 他们社区的共同疾病信念是“如果你很瘦，你就不需要锻炼”。重要的是， 社区还确定了赋予南澳妇女和女孩权力的个人、人际和家庭进程 变得更加活跃，包括 PA 的整体益处、对儿童健康的渴望以及感觉 与其他女性和家人一起锻炼时保持联系并快乐。以试点研究为基础，证明 可行性和初步有效性，拟议的研究旨在测试该方案的有效性和实施情况 南亚人一起积极行动（SAATH）的干预。为期 16 周的干预针对个人、 人际和家庭层面通过四个主要组成部分：1）母女团体运动课程 成对的； 2) 采用动机访谈的二元母女 PA 咨询； 3）同行讨论小组， 3）家庭步行团体。该干预措施还通过与公园区合作来针对环境水平， 公共卫生部门和社区组织，以改变当地环境 考虑社会文化（例如性别、家庭重点）和环境（例如同性阶层）期望 南澳。该研究的目的 1 是确定 SAATH 干预对于增加中等强度 使用随机等待名单对照研究设计对南澳母女二人进行 PA。次要结果是： 夫妻的步行和久坐时间以及母亲的心脏代谢危险因素。目标 2 将评估 干预对个人（自我效能、自主支持、社会支持、动机）和二元的影响 （文化适应冲突、沟通、联系）假设调节干预效果的因素 在宾夕法尼亚州。目标 3 是评估 SAATH 的实施和可持续性，包括环境和 跨部门合作伙伴进行系统变革，以促进和维持南澳妇女和女童的 PA。鉴于 SA 人口的增长及其心脏代谢疾病风险的增加，确定干预措施 增加亚裔印度和巴基斯坦移民妇女的体力活动对于公共卫生具有重要意义。