Innovative Physical Activity Interventions for Overweight Latinos

描述（由申请人提供）：拉丁裔是美国增长最快的族裔群体，他们不成比例地受到慢性病（例如超重/肥胖、糖尿病）的影响，而这些慢性病可以通过体力活动来缓解。虽然基于证据的计划可用于改善身体活动，但其传播因依赖昂贵且有限的资源而受到限制。短信服务（SMS 或短信）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短信的主要用户，包括那些文化水平和计算机技能有限的人。我们建议开发一个个性化的、文化上一致的交互式短信计划，以促进超重、活动不足的拉丁裔成年人采用和维持身体活动，并测试其与已在拉丁裔中成功使用的基于证据的基于电话的建议计划的效果。这两个项目都以社会认知和自我决定理论为基础，包括一套核心的自我调节技能培养、社会支持和自主动机增强，并将针对文化、语言和读写能力的适当性进行量身定制。在个人层面上随机抽取 376 名 45 岁及以上、久坐、超重的拉丁美洲人，他们将被分配到以下三个组之一：短信发送的身体活动计划、人工发送的身体活动计划或短信发送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，然后进行为期 6 个月的维护阶段，并在 18 个月时进行最终评估。分析将确定这两种身体活动计划在采用和维持具有临床意义的身体活动增加方面是否具有同等功效，以及在 12 个月和 18 个月时优于注意力控制组。还将比较这两种身体活动干预措施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，以确定哪个计划以较低的成本增加身体活动。虽然由专业人员提供的健康促进计划可能比以电子方式提供的计划更昂贵，但尚不清楚自动化版本是否可以产生更具成本效益的结果（即，在显着降低成本的情况下实现可比的结果改善）。这项研究将确定短信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，以及是否会产生更具成本效益的计划。如果实现的话，这项研究可以通过提供有效的定制且适合文化的计划来广泛传播和快速采用，从而显着减少拉丁美洲人与身体活动相关的健康差异。

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.