Efficacy of a novel web-based physical activity intervention designed to promote adherence to physical activity guidelines in adults with obesity

项目名称：一种新的基于网络的身体活动干预措施的有效性，旨在促进对 肥胖成年人体力活动指南 国家心肺血液研究所（National Heart，Lung，and Blood Institute，NHLBI） 赠款类型：R 01 提交日期：2021年10月2日 请拨数额：3 167 589美元 PI：Kariuki Jacob，博士 共同研究者：Lora E.伯克，博士，公共卫生硕士;伯大尼吉布斯，博士;埃里克埃里克森，博士;安德烈克里斯卡。 顾问：大卫奥古图，BS 项目概要/摘要 国家指南建议所有美国成年人实现≥150分钟的中度至剧烈运动。 每周进行高强度的身体活动。然而，遵守《准则》的比例很低，只有24%的成年人达到了 建议的体力活动（PA）。低水平的PA会增加心脏代谢疾病的风险， 在肥胖人群中。尽管PA的任何增加都可以降低风险，但这些人面临着复杂的问题 与体重有关的障碍，包括耻辱，尴尬，健康状况差，自我效能低， 他们在PA的参与。为了减少这些障碍，已经开发了基于网络的PA干预措施，但其 功效往往因缺乏行为辅导和无法解决障碍的通用内容而受到限制 肥胖症患者的经验。我们的研究团队和其他人报告说，文化多样性的个人 肥胖者更喜欢方便、有趣的PA节目，并以他们可以接触到的人为特色。 特别是与身体大小、健康水平和年龄有关。然而，巴勒斯坦权力机构有意干预的情况很少， 旨在融合这些偏好。在我们之前的工作中，我们寻求个人的投入， 超重/肥胖，为开发基于技术的心脏体力活动（PATH）提供信息 利用YouTube等可公开访问的平台进行干预，以提供匹配的锻炼视频 在我们的形成性研究和现存文献中表达的具体偏好。我们成功地测试了 测试了PATH平台，并展示了出色的保留，干预参与和初步 在我们为期12周的可行性研究中，在本申请中，我们建议测试PATH在促进 在不活动的肥胖成年人的不同样本中遵守PA指南。我们的长期目标是 将PATH干预措施作为一个可扩展的独立计划部署，以增加访问，减少时间承诺， 避免与体重有关的耻辱，并减少不可预测的障碍，如恶劣天气对PA的影响 或者像COVID-19这样的流行病。我们将进行一项为期12个月的两组随机对照试验， 将450名成年人分配到两种干预条件之一：路径干预或注意力控制。在目标1中， 将评估PATH对改善PA指南短期和长期依从性的有效性。在目标2 我们将比较PATH干预对心血管疾病危险因素的影响。在最后的目标中，我们将探讨 与PA结果变化相关的潜在作用机制。在研究结束时，我们将 调查用户的经验和对适宜卫生技术干预措施最有用的组成部分的看法。我们的做法是 创新，因为我们利用可免费访问的资源，提供高度可扩展、方便、有趣的 参与PA计划，利用精心挑选的锻炼视频，以帮助个人与肥胖的进展 沿着PA连续体。这一贡献将是重大的，因为PATH可以提供一个新颖，方便， 令人愉快的，高度可扩展的计划，具有“类似的其他人”，以促进PA在成人肥胖。

Project Title: Efficacy of a novel web-based physical activity intervention designed to promote adherence to physical activity guidelines in adults with obesity Funding organization: The National Heart, Lung, and Blood Institute (NHLBI) Grant type: R01 Date submitted: Oct 2, 2021 Amount requested: $3,167,589 PI: Kariuki Jacob, PhD Co-investigators: Lora E. Burke, PhD, MPH; Bethany Gibbs, PhD; Erick Erickson, PhD; Andrea Kriska. Consultants: David Ogutu, BS Project Summary/Abstract The National Guidelines recommend that all American adults achieve ≥150 min of moderate to vigorous intensity physical activity weekly. Yet, adherence to the Guidelines is low, with only 24% of adults attaining the recommended physical activity (PA). The low levels of PA increase the risk cardiometabolic disease, especially among individuals with obesity. Although any increase in PA can reduce the risk, these individuals face complex weight-related impediments including stigma, embarrassment, poor fitness, and low self-efficacy that reduce their engagement in PA. To mitigate these barriers, web-based PA interventions have been developed, but their efficacy is often limited by lack of behavioral coaching and generic content that does not address barriers experienced by those with obesity. Our research team and others have reported that culturally diverse individuals with obesity prefer PA programs that are convenient, fun to engage in, and feature people to whom they can relate especially in body size, fitness level, and age. Yet, there is a paucity of PA interventions intentionally designed to incorporate these preferences. In our prior work, we sought the input of individuals with overweight/obesity to inform the development of a technology-based Physical Activity for The Heart (PATH) intervention that leverages openly accessible platforms, such as YouTube, to provide workout videos that match the specific preferences expressed in our formative studies and the extant literature. We have successfully beta tested the PATH platform and have demonstrated excellent retention, intervention engagement and preliminary efficacy in our 12-week feasibility studies. In this application, we propose to test the efficacy of PATH in promoting adherence to the PA Guidelines in a diverse sample of inactive adults with obesity. Our long-term goal is to deploy the PATH intervention as a scalable stand-alone program to increase access, reduce time commitment, avoid weight-related stigma, and lessen the impact of unpredictable barriers to PA such as inclement weather or pandemics like COVID-19. We will conduct a 12-month 2-group randomized controlled trial and equally allocate 450 adults to one of the two intervention conditions: Path intervention or attention control. In Aim 1 we will evaluate the efficacy of PATH for improving short- and long-term adherence to the PA Guidelines. In Aim 2 we will compare the effects of the PATH intervention on risk factors for CVD. In the final Aim, we will explore the potential mechanisms of action associated with changes in the PA outcomes. At the end of the study, we will survey user experience and views on the most useful components of the PATH intervention. Our approach is innovative because we leverage freely accessible resources to provide a highly scalable, convenient, fun to engage in PA program that utilizes carefully selected workout videos to help individuals with obesity progress along the PA continuum. This contribution will be significant because PATH could offer a novel, convenient, enjoyable, and highly scalable program that features “similar others” to promote PA in adults with obesity.