Innovative Physical Activity Interventions for Overweight Latinos

描述（由申请人提供）：拉丁美洲人是美国增长最快的种族群体，受慢性疾病（例如，超重/肥胖症、糖尿病），可以通过身体活动来缓解。虽然有基于证据的计划可以改善身体活动，但由于依赖昂贵且有限的资源，传播受到限制。短信服务（SMS或文本信息）作为拉丁美洲人的干预手段具有很大潜力，因为他们是移动的电话和文本信息的主要用户，包括那些识字和计算机技能有限的人。我们建议开发一个个性化的，文化上一致的和互动的短信程序，以促进超重，活动不足的拉丁美洲成年人的体力活动的采用和维护，并测试它的可比功效，以证据为基础的电话为基础的咨询程序，已成功地与拉丁美洲人。这两个项目都以社会认知和自我决定理论为基础，将包括一套核心的自我调节技能建设、社会支持和自主动机增强，并将针对文化、语言和识字的适当性进行量身定制。在个体水平上随机化，376名45岁及以上久坐不动、超重的拉丁美洲人将被分配到三个组中的一个：SMS提供的身体活动计划、人类提供的身体活动计划或SMS提供的基本健康营养建议的注意力控制组。他们将接受为期12个月的指定计划，然后将接受为期6个月的维护阶段，并在18个月时进行最终评估。分析将确定两种体力活动计划在采用和维持有临床意义的体力活动增加方面是否具有等效疗效，以及在12个月和18个月时是否优于注意力控制组。还将比较两种体力活动干预在预防体重增加和减少腹部肥胖方面的等效性。我们将探讨这些计划的相对成本，以确定哪种计划以较低的成本增加体力活动。虽然由专业人员提供的健康促进计划可能比电子方式提供的更昂贵，但目前还不清楚自动化版本是否能产生更具成本效益的结果（即，结果的可比改进，成本显著降低）。这项研究将确定SMS在增加体力活动和防止体重增加方面是否与传统的人工传递渠道具有同等功效，以及它是否会导致更经济有效的计划。如果实现，这项研究可以显着减少与拉丁美洲人的身体活动相关的健康差距，提供一个有效的量身定制和文化上适当的计划，准备广泛传播和快速吸收。

DESCRIPTION (provided by applicant): Latinos are the fastest growing ethnic group in the US and are disproportionately impacted by chronic conditions (e.g., overweight/obesity, diabetes) that can be mitigated by physical activity. While evidence-based programs are available to improve physical activity, dissemination is constrained by reliance on costly, limited resources. Short message service (SMS or text messaging) has strong potential as an intervention medium for Latinos, as they are dominant users of mobile phones and text messaging, including those with limited literacy and computer skills. We propose to develop a personalized, culturally-congruent and interactive SMS program to promote the adoption and maintenance of physical activity for overweight, underactive Latino adults and test it for comparable efficacy to an evidence-based telephone-based advising program that has been used successfully with Latinos. Grounded in Social Cognitive and Self-Determination Theories, both programs will include a core set of self-regulatory skill building, social support, and autonomous motivation enhancement, and will be tailored for cultural, linguistic and literacy appropriateness. Randomized at the individual level, 376 sedentary, overweight Latinos ages 45 years and older will be assigned to one of three arms: the SMS- delivered physical activity program, the Human-delivered physical activity program, or an attention-control arm of SMS-delivered basic healthful nutrition advice. They will receive their assigned program for 12 months, and then will be followed for a 6-month maintenance phase, with a final assessment at 18 months. Analyses will determine if the two physical activity programs result in equivalent efficacy in adoption and maintenance of clinically meaningful physical activity increases, and superiority over the attention-control arm at 12 and 18 months. The two physical activity interventions will also be compared for equivalency in prevention of weight gain and reduction in abdominal adiposity. We will explore the relative costs of the programs to determine which program increases physical activity for a lower cost. While health promotion programs delivered by professional staff may be more expensive than those delivered electronically, it is unclear if the automated version can produce more cost-efficient outcomes (i.e., comparable improvements in outcomes for significantly reduced cost). This study will determine if SMS is equivalent in efficacy to the traditional human-delivery channel in increasing physical activity and preventing weight gain, and if it results in a more cost-efficient program. If achieved, this research can significantly reduce health disparities associated with physical activity for Latinos by providing an efficacious tailored and culturally appropriate program poised for widespread dissemination and rapid uptake.