Linking Churches with Parks to Increase Physical Activity Among Latinos

项目摘要 经常参加体育锻炼有助于健康，包括更长寿，更好 生活质量，降低心血管疾病、糖尿病、抑郁症、某些癌症的发病率，以及 肥胖；然而，只有一小部分美国成年人达到了中度到剧烈PA的最低标准 (MVPA)，拉美裔比白人报告符合指导方针的可能性更小。公园由地方公园组成 可用于社区PA的基础设施，但往往未得到充分利用，特别是在低收入人群中 社区。低收入和少数族裔社区的公园往往较少有PA节目，特别是 以成年人为目标，较高的犯罪率和其他影响公园使用的因素。有必要进行干预，以 解决社区关注的问题，瞄准已建成的环境，并“激活”公园使用。教堂是可信的， 在拉美裔社区有重要影响并有提供社会服务历史的稳定实体 以及与健康和福祉有关的宣传。我们的研究发现，基于教会的干预可以 在广泛的健康问题和类型的教会中有效。我们建议将各种方法结合起来 从我们团队之前与教堂和公园进行的广泛的随机对照试验中 多层次干预，将拉丁裔天主教堂(n=12)与当地公园联系起来，以增加PA 在洛杉矶的拉美裔教区居民中(n=1500)。具体目标是：(1)检查 基于教会的多层次干预，将天主教教区与拉丁裔教区居民PA上的当地公园联系起来 以及与健康相关的结果(对教区居民的MVPA和自我报告的PA、心率/健康、腰围的影响 腰围、腰臀比、体脂、心理健康和对老年人的社会支持)；(2)探索 性别干预效果的差异；以及(3)评估与以下方面有关的因素 干预实施(促进者、障碍、保真度和复制成本)，以供未来传播。我们的 方法针对多个层次，通过以公园为基础的健身课程来促进健康PA，由 运动学学生、同伴领袖带领的散步小组、公园的教堂活动和教堂的PA支持 活动。它将教会庞大的社会网络、道德权威和影响力与公园的结构和 组织能力和人体运动学学生实习生的专业专长。这项干预利用了 各部门内部和跨部门的创新伙伴关系--基于信仰的、地方公园/市政府和地方 大学。我们的跨部门协作方法使我们的干预措施真正具有可扩展性和可持续性。 世界设定并结合了多个层面的行动(个人、教堂和社区)。致我们的 知识，这将是第一次研究以教堂和公园为基础的整合的有效性 对拉丁裔PA的干预，它将为低收入群体PA规划提供一个可持续的模式 社区。如果干预被证明有效，通过这种伙伴关系增加的社区能力 将为在美国最大的教区扩大规模奠定基础，甚至可能扩大到美国。

Project Summary Engaging in regular physical activity (PA) contributes to positive health outcomes, including longevity, better quality of life, and reduced incidence of cardiovascular diseases, diabetes, depression, certain cancers, and obesity; however, only a minority of U.S. adults meet the minimum guidelines for moderate to vigorous PA (MVPA), and Latinos are less likely than whites to report meeting the guidelines. Public parks comprise local infrastructure that can be leveraged for community PA, but tend to be underutilized, particularly in low-income communities. Parks in low-income and minority communities tend to have less PA programming, especially targeting adults, and higher crime and other factors that affect park use. There is a need for interventions that address community concerns, target the built environment, and “activate” park use. Churches are credible, stable entities that have significant reach within Latino communities and a history of social service provision and advocacy related to health and well-being. Our research has found that church-based interventions can be effective across a wide range of health issues and types of churches. We propose to combine approaches from our team's extensive prior work with churches and parks to conduct a cluster randomized controlled trial of a multi-level intervention that links Latino Catholic churches (n=12) with their local parks to increase PA among Latino parishioners (n=1500) in Los Angeles. The specific aims are to: (1) Examine the impact of a multi-level church-based intervention that links Catholic parishes to their local parks on Latino parishioners' PA and health-related outcomes (effects on parishioners' MVPA and self-reported PA, heart rate/fitness, waist circumference, waist to hip ratio, body fat, mental health, and perceived social support for PA); (2) Explore differences in the effectiveness of the intervention by gender; and (3) Evaluate factors associated with intervention implementation (facilitators, barriers, fidelity, and replication costs) for future dissemination. Our approach targets multiple levels to promote health-enhancing PA through park-based fitness classes led by kinesiology students, peer leader-led walking groups, park-based church events, and church-based PA support activities. It integrates churches' vast social networks, moral authority, and influence with parks' structural and organizational capacity and kinesiology student interns' professional expertise. The intervention makes use of innovative partnerships within and across sectors – faith-based, local parks/city government, and local universities. Our inter-sectoral, collaborative approach makes our intervention scalable and sustainable in real- world settings and incorporates action at multiple levels (individuals, churches, and neighborhoods). To our knowledge, this will be the first study to examine the effectiveness of an integrated church and park-based intervention on Latinos' PA, and it will provide a sustainable model of PA programming in low-income communities. If the intervention proves effective, the increased community capacity through this partnership will lay the groundwork for scale-up across the largest diocese in the U.S. and, potentially, the nation.