Virtual Advisors for Physical Activity Promotion in Underserved Communities

描述(由申请人提供)：在老龄化的拉丁裔社区促进身体活动的虚拟顾问背景：年迈的拉丁裔成年人不成比例地患有一些慢性疾病(如糖尿病、肥胖症)，通过增加体育活动(PA)，如步行改善。由于语言、教育、计算机和健康素养的障碍，年长的拉丁裔成年人往往无法随时获得美国社区提供的面对面或在线的典型健康促进计划。非专业健康顾问(西班牙语中的“促进者”)为拉美裔社区提供了一种国家认可的、文化上量身定做的、具有成本效益的健康行为改变模式。然而，就像所有“人类”提供的健康计划一样，他们对参与者的日程安排施加了限制，即使制定了谨慎的干预保真程序，在不同顾问之间的计划交付也不可避免地存在一些差异。基于计算机的文化定制的体力活动顾问计划可能会减少人与人之间的调度和保真度限制，并扩大计划的覆盖范围。在最近完成的一项为期4个月的实验中，一个带有触摸屏互动(不需要键盘或鼠标)的基于计算机的双语虚拟顾问被安置在社区中心，并被编程为根据低收入、年迈的拉丁裔成年人的需求和偏好定制PA建议。与健康教育对照组相比，虚拟顾问计划成功地提高了参与者的定期步行水平。目的：该研究的主要目的是进行一项比较有效性试验，评估基于社区的虚拟顾问PA计划相对于成熟的Lay Advisor计划在更广泛的老年拉丁裔成年人中的12个月影响。第二个目标是确定虚拟顾问计划与Lay Advisor计划的比较成本效益。设计：这项为期12个月的随机试验将纳入55岁及以上居住在16个社区中心附近的不活跃的拉丁裔成年人(n=265/ARM；总共530人)。主要结果是每周步行几分钟，其他感兴趣的结果包括体重指数、久坐行为、功能表现和与健康相关的生活质量。其他调查领域是评估干预成功的理论基础和经验支持的主持人和调解人，并确定干预措施的潜在普适性。影响：这项研究试图证明，为年迈的拉丁裔成年人量身定做的基于计算机的虚拟顾问可以在这一群体经常光顾的社区环境中提供一种有效且潜在的成本效益高的替代方案。这类方案在一系列社区环境(如诊所、药房、图书馆)使用的潜在扩展范围为积极影响当前的健康差距提供了巨大的希望。

DESCRIPTION (provided by applicant): Virtual Advisors for Physical Activity Promotion in Aging Latino Communities BACKGROUND: Aging Latino adults suffer disproportionately from a number of chronic conditions (e.g., diabetes, obesity) improved by increased physical activities (PA) such as walking. Due to language, education, computer, and health literacy barriers, older Latino adults often cannot readily access typical health promotion programs offered in-person or online in U.S. communities. Lay health advisors ("promoters" in Spanish) offer a nationally recognized, culturally tailored and cost-efficient health behavior change model for Latino communities. However, as with all "human" delivered health programs, they impose constraints on participant schedules, and, even with careful intervention fidelity procedures in place, some variability in program delivery across advisors is inevitable. Computer-based culturally tailored physical activity advisor programs can potentially reduce human- to-human scheduling and fidelity constraints and extend program reach. In a recently completed 4- month experiment, a computer-based bilingual Virtual Advisor with touch-screen interactivity (no keyboard or mouse needed) was housed in a community center and programmed to tailor PA advice to the needs and preferences of low-income, aging Latino adults. The Virtual Advisor program successfully increased regular walking levels in participants compared to a health education control. OBJECTIVE: The primary study aim is to conduct a comparative effectiveness trial evaluating the 12- month impacts of the community-based Virtual Advisor PA program relative to a proven Lay Advisor program in a broader population of aging Latino adults. The secondary aim is to determine the comparative cost effectiveness of the Virtual vs. Lay Advisor programs. DESIGN: The 12-month randomized trial will enroll inactive Latino adults ages 55 years and older living near 16 neighborhood community centers (n=265/arm; 530 total). The primary outcome is minutes of walking per week, and additional outcomes of interest include BMI, sedentary behavior, functional performance, and health- related quality of life. Additional areas of investigation are to evaluate theoretically based and empirically supported moderators and mediators of intervention success and determine the potential generalizability of the interventions. IMPACT: The study seeks to demonstrate that a computer-based Virtual Advisor tailored to the needs of aging Latino adults can provide an effective and potentially cost-efficien alternative to Lay Advisors in community settings frequented by this population. The potential extended reach of such programs for use in a range of community settings (e.g., clinics, pharmacies, libraries) provides substantial promise for positively impacting the current health disparities gap.