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

项目标题：一种新的基于网络的体力活动干预的有效性，旨在促进对 肥胖成人的体力活动指南 资助机构：国家心肺血液研究所(NHLBI) 授予类型：R01 提交日期：2021年10月2日 申请金额：3,167,589美元 少年派：Kariuki Jacob，博士 共同调查人员：洛拉·E·伯克，博士，公共卫生硕士；贝萨尼·吉布斯，博士；埃里克·埃里克森，博士；安德里亚·克里斯卡。 顾问：大卫·奥古图，BS 项目摘要/摘要 国家指南建议所有美国成年人达到150分钟的≥中等到剧烈运动 每周高强度的体力活动。然而，对指南的遵守程度很低，只有24%的成年人达到了 推荐的体力活动(PA)。低水平的PA会增加心脏代谢性疾病的风险，尤其是 在肥胖症患者中。尽管PA的任何增加都可以降低风险，但这些人面临的情况复杂 与体重相关的障碍，包括耻辱、尴尬、不健康和低自我效能，这些都会降低 他们在宾夕法尼亚州的订婚。为了缓解这些障碍，已经开发了基于网络的PA干预措施，但他们的 疗效往往受到缺乏行为指导和不解决障碍的一般性内容的限制 肥胖者也会经历这种情况。我们的研究团队和其他人报告说，文化多样性的人 有肥胖症的人更喜欢方便、有趣的PA计划，并以他们能找到的人为特色 尤其与体型、健康水平和年龄有关。然而，巴勒斯坦权力机构故意干预的情况很少 旨在结合这些首选项。在我们之前的工作中，我们寻求具有以下特征的个人的意见 超重/肥胖，以促进基于技术的心脏体力活动的发展(路径) 利用YouTube等可公开访问的平台提供匹配的锻炼视频的干预 在我们的形成性研究和现存文献中表达的特定偏好。我们已经成功地进行了测试 测试了PATH平台，并展示了出色的固位力、干预参与度和初步 在我们为期12周的可行性研究中取得了成效。在这个应用中，我们建议测试PATH在促进 在不活跃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 将路径干预部署为可扩展的独立计划，以增加访问、减少时间投入、 避免与体重相关的污名，减少恶劣天气等不可预测的障碍对PA的影响 或者像新冠肺炎这样的流行病。我们将进行为期12个月的2组随机对照试验， 将450名成年人分配到两种干预条件中的一种：路径干预或注意力控制。在目标1中，我们 将评估PATH在改善短期和长期遵守PA指南方面的有效性。在AIM 2 我们将比较路径干预对心血管疾病危险因素的影响。在最终目标中，我们将探索 与PA结果变化相关的潜在作用机制。在研究结束时，我们将 调查用户体验和对路径干预最有用组件的看法。我们的方法是 创新，因为我们利用免费访问的资源来提供高度可扩展、方便、有趣的 参与PA计划，利用精心挑选的锻炼视频帮助肥胖患者取得进展 沿着PA连续体。这一贡献将是重大的，因为路径可以提供一种新颖、方便、 令人愉快的，高度可扩展的计划，以“相似的其他人”为特色，在肥胖的成年人中推广PA。

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.