Free Time 4 Wellness

摘要 缺乏体力活动是慢性病风险和健康状况不佳的重要因素。这段关系是 在美国，社会经济地位较低的女性尤为突出，其中60%的女性没有达到 建议的指导方针是每周至少进行150分钟的适度体力活动。先前的研究已经 记录这一人群的体力活动障碍，包括个人因素(例如，有限的时间， 健身房会员资格或日托资金不足)和社区层面的因素(例如，传统的性别角色， 限制进入娱乐空间)。以前增加体力活动的尝试通常都是有针对性的 个人，只取得了不大的成果。增加贫困母亲的体力活动 社区，创新研究，以确定可在社区轻松实施的多层次干预 迫切需要的是水平和适合几乎没有时间的母亲。对母亲时间的要求越来越高 在新的大流行时代，免费获得儿童保育成为一个有吸引力的选择。我们成功地设计并实现了 试点了一项创新的干预措施，通过将健身课程与 免费托儿和技术，在社区层面为母亲提供联系和支持。该项目将评估 我们多层次干预的有效性，自由健康时间(FT4W)计划。概念性 FT4W方案的框架是基于社会认知理论和NIMHD少数民族健康和健康 差异研究框架。干预措施包括：1)免费健身课上的免费儿童保育；2)同伴 支持包括集体游戏约会和集体志愿者活动在内的活动。之前没有任何健康干预措施 包括这些成分，我们假设它们单独或结合在一起，会增加体力活动， 基于前人的理论和试点工作。我们将FT4W计划作为一种混合方法进行测试，集群随机 在以社区为基础的卫生中心进行的对照试验，服务于种族小型化和社会经济 弱势群体。参与者将被随机分配到三个手臂中的一个：对照组，只接受托儿所 手臂，或儿童保育+同伴支持手臂。该试验将评估：(1)FT4W增加体力活动的能力 加速度计确认的12周内；(2)FT4W计划的潜在机制 促进体育活动(例如，环境资源、社会凝聚力)；以及(3) 跨交叉社会分层参数的影响程度，包括种族/民族、社会经济 位置和迁移状态。在我们的研究完成后，我们将免费提供FT4W协议 并努力在社会经济水平较低的地区扩大该计划的规模。因此，拟议的项目旨在引入一种 有效的多层次干预，易于在社区实施，适合有以下情况的母亲 时间到了。这种可扩展的干预措施将有助于减少阻碍母亲参与体检的障碍 多运动，防止今后与不运动有关的高慢性病发病率。

SUMMARY Physical inactivity is a significant contributor to risk of chronic diseases and poor health. This relationship is particularly salient for women of low socioeconomic position in the US, for which >60% do not reach the recommended guidelines of at least 150 minutes of moderate physical activity each week. Prior research has documented barriers to physical activity for this population, including individual factors (e.g., limited time, insufficient funds for gym memberships or daycare) and community-level factors (e.g., traditional gender roles, limited access to recreation space). Prior attempts to increase physical activity have generally targeted individuals, with only modest results. To increase physical activity among mothers living in low-resourced communities, innovative research to identify a multilevel intervention that is easily implemented at the community level and appropriate for mothers with little time is urgently needed. The increasing demands on mothers' time in a new pandemic era makes freely accessible childcare an attractive option. We successfully designed and piloted an innovative intervention to increase physical activity among mothers by combining fitness classes with free childcare and technology to connect and support mothers at the community level. This project will evaluate the effectiveness of our multilevel intervention, the Free Time for Wellness (FT4W) program. The conceptual framework for the FT4W program is based on social cognitive theory and the NIMHD Minority Health and Health Disparities Research Framework. The intervention includes: 1) free childcare at free fitness classes, and 2) peer support activities including group play dates and group volunteer activities. No prior health intervention has included these components that we hypothesize, separately or in combination, will increase physical activity, based on prior theory and pilot work. We will test the FT4W program as a mixed method, cluster randomized controlled trial conducted in community-based health centers serving racially minoritized and socioeconomically disadvantaged populations. Participants will be randomized to one of three arms: a control arm, a childcare only arm, or a childcare + peer support arm. The trial will evaluate: (1) the ability of FT4W to increase physical activity within 12 weeks as confirmed by accelerometers; (2) the potential mechanisms by which the FT4W program facilitates physical activity (e.g., environmental resources, social cohesion); and (3) potential differences in the magnitude of effect across intersecting social stratification parameters including race/ethnicity, socioeconomic position, and migration status. At the completion of our study, we will make the FT4W protocol freely available and work to scale the program in low-socioeconomic areas. The proposed project thus aims to introduce an effective multilevel intervention that is easily implemented in communities and appropriate for mothers with little time. This scalable intervention will help reduce the barriers that prevent mothers from participating in physical activity, preventing future high rates of chronic diseases associated with inactivity.