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

描述（由申请人提供）：体育活动（PA）已被证明可以降低影响很大一部分非裔美国人社区的慢性疾病结局的风险。尽管有已知的好处，但非裔美国女性的PA水平很低。需要进一步的工作来确定成功的战略，以增加和维持参与PA，特别是在与不参与或很少参与健康相关行为相关的不良健康结果最普遍的人群中。教堂在非裔美国人社区中是精神指导的中心，也是交流、社会支持和网络的来源，被认为是健康教育和健康促进工作的理想场所。在教堂内进行了几项研究，以增加非裔美国人的体育活动水平，并显示出促进健康行为的希望。然而，在已建立的行为改变理论中，信仰原则影响结构的具体机制尚未得到充分阐明。此外，目前尚不清楚在密集干预后，基于信仰的干预是否比其他策略更适合维持行为变化。这项研究的目标是确定在教会环境中增加和维持个人护理水平的策略的影响。久坐不动的非裔美国妇女（18岁以上），无与每日PA增加相关的不良后果风险因素，将被招募并随机分为三种情况：基于信仰的干预，非基于信仰的干预或对照。我们将从24个教会招募480名参与者。干预条件的随机化将在教会层面进行。两种积极的干预措施都将包括24个以小组为基础的疗程，从每周疗程（n = 16次）开始，然后逐步减少接触频率，改为每两周疗程（n = 4次）和每月疗程（n = 4次）。对照组的参与者将收到标准的教育材料，鼓励他们参与日常体育活动。随访数据将在24个疗程后和随机分组后一年内立即测量，以确定私人助理行为的即时和持续变化。感兴趣的主要结果是每天的步数变化。次要结局包括每日中度至高强度PA、满足国家PA建议、体重指数和健康相关生活质量。对于感兴趣的结果，我们将比较积极干预与对照组的效果。我们期望治疗效果的出现，即与对照组相比，分配到任何一种积极干预措施都与更大的兴趣结果变化相关。我们还将评估基于信仰的干预在概念模型中的作用机制，以促进日常身体活动的增加，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：该项目具有相关性，因为它解决了一个重要的公共卫生问题——在社区和文化相关环境中增加非裔美国妇女的体育活动水平，这是最需要采取干预措施的人群，重点是减少与慢性病相关的风险因素。如果成功，拟议的项目将通过描述一种成功地启动和维持一种行为变化的方法来补充现有文献，这种行为是与低水平体育活动相关的各种健康结果的风险因素。

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.