A Web-App Based Lifestyle Physical Activity Promotion Program to Improve Depressive Symptom Experience: Midlife Korean American Women

随着美国多元文化老龄化人口的增加，中年种族/民族中的抑郁症状 少数族裔正变得越来越重要。亚裔美国人中抑郁症的流行率是 大约是美国人总体水平的4.5倍。在亚裔美国人中，韩国人 美国人的抑郁症患病率最高。在韩裔美国人群体中，中年韩裔美国人 由于性别和年龄的原因，女性患抑郁症状的风险更高。此外， 最近的COVID19大流行给这一特定人群带来了额外的压力。韩裔美国人有一种 对自然生活方式管理战略的文化偏好(例如，促进生活方式体力活动) 抑郁症，而不是药物治疗，而且有一种文化强调一个人的处理能力 强调没有外部帮助。使用Web应用程序的基于技术的程序可以提供高度 创新有效方式促进生活方式体力活动，改善抑郁症状 这一特定人群以迎合他们的文化偏好的方式体验。然而，很少有程序 适用于这一特定人群，对基于技术的干预措施的有效性知之甚少 改善包括这一群体在内的种族/少数民族妇女的抑郁症状。基于 初步研究，研究团队已经开发并试点测试了基于Web-App的生活方式体检 活动促进计划改善中年韩裔美国女性抑郁症状体验 (WPAPP-K)。WPAPP-K有几个独特的功能，可以克服现有程序的缺点 比如表层和深层的文化剪裁和社交媒体功能。这种随机化的目的是 干预研究旨在确定WPAPP-K改善抑郁症患者抑郁症状体验的疗效 中年韩裔美国女性。具体目标是：(A)确定干预组是否将 在自我报告的抑郁症状方面，与对照组相比有显著改善 从测试前(T0)到6个月后(T1)和12个月后(T2)的经验；(B)确定 干预组在自我报告的生活方式上比对照组有更大的改善 从T0到T1和T2的体力活动体验；(C)确定体力活动体验是否起中介作用 WPAPP-K对T0~T2抑郁症状体验的干预作用； WPAPP-K对抑郁症状体验的影响是否受选定因素的调节。这个 研究以班杜拉的行为改变理论和压力与应对理论为指导 拉撒路和福克曼的框架。本研究采用随机重复测量前测/后测 对照组设计在300名韩裔美国中年妇女中，她们是国家招募的。长期的 目标是：(A)在各种初级保健环境中执行该方案；(B)审查以下方面的成本效益 该计划；以及(C)确定WPAPP-K是否将导致长期改善健康结果。

With an increasing multicultural aging population in the U.S., depressive symptoms in midlife racial/ethnic minorities are becoming increasingly significant. The prevalence of depression among Asian Americans is about 4.5 times higher than that of Americans in general. Within the Asian- American demographic, Korean Americans have the highest rate of depression. Within the Korean-American group, midlife Korean-American women are at increased risk of depressive symptoms because of their gender and age. Furthermore, the recent COVID19 pandemic has placed additional stress to this specific population. Korean Americans have a cultural preference for natural lifestyle management strategies (e.g., promotion of lifestyle physical activity) for depression as opposed to pharmacotherapy, and there is a cultural emphasis on one’s ability to handle stresses without outside assistance. A technology-based program using a web app could provide a highly innovative and effective way to promote lifestyle physical activity and improve depressive symptoms experienced by this specific population in a manner that appeals to their cultural preference. Yet, few programs are available for this specific population and little is known about the efficacy of technology-based interventions in improving depressive symptoms of racial/ethnic minority women including this population. Based on Preliminary Studies, the research team has developed and pilot-tested the Web-App based Lifestyle Physical Activity Promotion Program in improving depressive symptom experience of midlife Korean American women (WPAPP-K). WPAPP-K has several unique features that overcome the shortcomings of existing programs such as surface and deep cultural tailoring and social media functions. The purpose of this randomized intervention study is to determine the efficacy of WPAPP-K in improving depressive symptom experience of midlife Korean American women. The specific aims are to: (a) determine whether the intervention group will show significantly greater improvements than the control group in self-reported depressive symptom experience from a pre-test (T0) to post 6-months (T1) and post 12-months (T2); (b) determine whether the intervention group will show significantly greater improvements than the control group in self-reported lifestyle physical activity experience from T0 to T1 and T2; (c) identify whether physical activity experience mediates the intervention effects of the WPAPP-K on depressive symptom experience from T0 to T2; and (d) determine whether the effects of WPAPP-K on depressive symptom experience are moderated by selected factors. The study is theoretically guided by the Bandura’s Theory of Behavioral Change and the Stress and Coping framework by Lazarus and Folkman. The study adopts a randomized repeated measures pretest/posttest control group design among 300 midlife Korean American women who are nationally recruited. The long-term goals are to: (a) implement the program in various primary care settings; (b) examine the cost-effectiveness of the program; and (c) determine if the WPAPP-K will lead to long-term improved health outcomes.