"A Faith-Based Intervention to Increase Physical Activity Among Blacks"

描述(由申请人提供)：体力活动(PA)已被证明可以降低影响大部分非裔美国人社区的慢性病后果的风险。尽管已知有好处，但在非裔美国女性中，PA很低。还需要开展更多的工作，以确定增加和保持参与PA的成功战略，特别是在不参与或低参与与健康相关的行为而导致不良健康结果发生率最高的人群中。教堂在非裔美国人社区中是精神指导的中心，也是沟通、社会支持和网络的来源，被认为是健康教育和健康促进努力的理想场所。已经在教堂内进行了几项研究，以提高非裔美国人的身体活动水平，并显示出促进健康行为的希望。然而，信仰原则影响已建立的行为改变理论中的结构的具体机制还没有被充分阐明。此外，对于在密集干预后保持行为变化，基于信仰的干预是否比其他策略更合适，目前尚不清楚。这项拟议研究的目标是确定在教堂环境中增加和保持PA水平的策略的影响。久坐不动的非裔美国女性(18岁)，没有因每天增加PA而产生不良后果的风险因素，将被招募并随机分为三种情况之一-基于信仰的干预、非基于信仰的干预或对照。我们将从24个教堂招募480名参与者。干预条件的随机化将在教会层面发生。这两种积极干预措施将包括24次以小组为基础的会议，从每周会议(n=16次)开始，然后分阶段减少两周一次(n=4次)和每月一次(n=4次)的接触。控制组的参与者将收到鼓励参与日常体育活动的标准教材。随访数据将在24个疗程后立即测量，并在随机化一年后进行测量，以确定PA行为的即时和持续变化。感兴趣的主要结果是以步数/天为单位的变化。感兴趣的次要结果包括每日中度到剧烈的PA，满足国家PA建议，体重指数，以及与健康相关的生活质量。对于感兴趣的结果，我们将比较积极干预的效果与对照组。我们预计治疗效果会显现，与对照组相比，分配给任何一种积极干预措施与感兴趣的结果的更大变化相关。我们还将评估基于信仰的干预对拟议概念模型中构建的促进日常体力活动增加的机制的影响，并进一步假设基于信仰的干预组的变化将大于非基于信仰的干预组的变化。公共卫生相关性：这个项目之所以重要，是因为它解决了一个重大的公共卫生问题--在社区和文化相关环境中，非裔美国妇女的体力活动水平不断提高，这是最需要干预的一部分，重点是减少与慢性病相关的风险因素。如果成功，这个拟议的项目将通过描述一种成功地启动和维持行为变化的方法来增加现有文献，这种行为是与低水平体力活动相关的各种健康后果的风险因素。

DESCRIPTION (provided by applicant): Physical activity (PA) has been shown to decrease the risk of chronic disease outcomes that affect a large proportion of the African American community. Despite known benefits, PA is low among African American women. Additional work is needed to identify successful strategies for increasing and maintaining participation in PA, particularly among populations with the highest prevalence of poor health outcomes associated with non- or low participation in health-related behaviors. Churches are central in the African American community for spiritual guidance as well as a source of communication, social support, and networking and are recognized as an ideal setting for health education and health promotion efforts. Several studies have been conducted within churches to increase physical activity levels among African Americans and have shown promise for promoting health behaviors. However, the specific mechanisms by which tenets of faith operate to impact constructs within established behavior change theories have not been adequately elucidated. In addition, it is not clear whether a faith-based intervention is more appropriate than other strategies for maintaining changes in behavior after an intensive intervention. The goal for the proposed study is to determine the impact of strategies for increasing and maintaining levels of PA in church settings. Sedentary African American women (> 18 years), with no risk factors for adverse outcomes associated with increasing daily PA, will be recruited and randomized to one of three conditions-a faith-based intervention, a non-faith-based intervention, or a control. We will recruit 480 participants from 24 churches. Randomization to intervention conditions will occur at the church level. Both active interventions will include 24 group-based sessions, which will begin with weekly sessions (n = 16 sessions), and then phase to less frequent contact with bi-weekly sessions (n = 4 sessions) and monthly sessions (n = 4 sessions). Participants in the control group will receive standard educational material encouraging participation in daily physical activity. Follow-up data will be measured immediately after the 24 sessions and one year after randomization to determine immediate and sustained changes in PA behaviors. The primary outcome of interest is change in steps/day. Secondary outcomes of interest include daily moderate-to-vigorous PA, meeting national PA recommendations, body mass index, and health-related quality of life. For outcomes of interest, we will compare the effect of the active intervention with the control group. We expect treatment effects to emerge such that assignment to either of the active interventions is associated with greater changes in outcomes of interest compared to the control group. We will also evaluate the mechanisms by which a faith-based intervention impacts constructs in the proposed conceptual model to promote increases in daily physical activity, and we further hypothesize that changes in the faith-based intervention group will be greater than changes in the non-faith-based intervention group. PUBLIC HEALTH RELEVANCE: This project is relevant because it addresses a significant public health issue-increasing physical activity levels among African American women in community-based and culturally relevant settings, a segment of the population most in need of interventions focused on decreasing risk factors associated with chronic disease. If successful, the proposed project will add to existing literature by describing an approach that is successful for initiating and sustaining change in a behavior that is a risk factor for various health outcomes associated with low levels of physical activity.