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，并且不成比例地受到慢性疾病（例如，超重/肥胖，糖尿病）的影响，这些疾病可以通过体育活动缓解。虽然有以证据为基础的方案可以改善身体活动，但由于依赖昂贵而有限的资源，传播受到限制。短消息服务（SMS或文本消息）作为拉丁美洲人的干预媒介具有强大的潜力，因为他们是移动电话和文本消息的主要用户，包括那些读写能力和计算机技能有限的用户。我们建议开发一个个性化的、文化一致的、互动的短信项目，以促进超重、运动不足的拉丁裔成年人接受和保持体育活动，并测试其与基于证据的电话咨询项目的有效性，该项目已成功地应用于拉丁裔人。这两个课程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，并将根据文化、语言和读写能力的适宜性进行量身定制。376名年龄在45岁及以上的久坐、超重的拉丁美洲人将被随机分配到三组中的一组：短信提供的体育活动计划，人工提供的体育活动计划，或短信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个月的指定项目，然后将进行为期6个月的维护阶段，最后在18个月时进行最终评估。分析将确定两种体育活动方案是否在采用和维持临床有意义的体育活动方面产生相同的效果，并且在12个月和18个月时优于注意控制组。还将比较两种体育活动干预在预防体重增加和减少腹部肥胖方面的等效性。我们将探讨项目的相对成本，以确定哪个项目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提供的计划更昂贵，但目前尚不清楚自动化版本是否能产生更具成本效益的结果（即，在显著降低成本的情况下改善结果）。这项研究将确定SMS在增加身体活动和防止体重增加方面是否与传统的人工输送渠道同等有效，以及它是否会产生更经济有效的方案。如果取得成功，这项研究可以通过提供一个有效的量身定制和文化上合适的计划来广泛传播和迅速吸收，从而显著减少与拉丁美洲人体育活动相关的健康差距。

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.