De Pié y a Movernos Study: Promoting physical activity in older Latinx adults

总结 拉丁裔老年人患阿尔茨海默病和相关痴呆症（ADRD）的风险高于 白色老年人。尽管老年拉丁裔成年人的体力活动率较低（PA）， 与ADRD相关的合并症，很少有研究针对这一人群进行基于理论的， 文化适应的方法来降低ADRD的风险。在小组试点工作的基础上， 该项目将使我们能够在文化上适应基于理论的干预，以促进中度到剧烈的身体 活动（MVPA）为拉丁美洲成人年龄55至89岁。在第一阶段（R61/Aim 1），我们会完成招聘工作， 和干预战略（包括最后确定遵守MVPA的目标机制， 通过与社区咨询委员会的会议和与10个社区的试点测试， 拉丁裔成年人。在第二阶段（R33/Aim 2），我们将随机选择130名拉丁裔成年人接受16周的完全远程治疗。 De Pié y a Movernos（De Pié）干预或控制条件。干预措施将针对 自我效能，PA习惯强度，社会支持和PA享受使用阶梯方法， 参与者最初将通过更多地移动来减少他们的坐姿，以建立对参与MVPA的信心。 参与者还将获得Fitbit活动跟踪器，健康教练联系人，会议目标反馈，以及 会找到一个支持者。我们将确定De Pié干预对activPAL的影响 基于加速计的MVPA分钟/天（主要结局）和对MVPA指南的依从性 每周150分钟（次要结局）。此外，将进行调解分析，以确定 干预对坚持机制的影响（自我效能、习惯强度、社会支持、享受） 并确定这些机制是否解释了干预对MVPA分钟/周和遵守 MVPA指南。我们将探讨认知，文化适应，年龄和性别作为这些协会的主持人。 结果将有助于确定坚持MVPA的重要机制，并为文化适应，理论- 在拉丁裔社区预防ADRD的方法。

SUMMARY Latinx older adults are at higher risk for developing Alzheimer’s Disease and Related Dementias (ADRD) than White older adults. Despite older Latinx adults having lower rates of physical activity (PA) and a high burden of comorbidities that are associated with ADRD, few studies have targeted this population with theory-based and culturally adapted approaches to reduce risk for ADRD. Building on pilot work by the team, the proposed project would allow us to culturally adapt a theory-based intervention to promote moderate-to-vigorous physical activity (MVPA) for Latinx adults ages 55 to 89 years. In Stage I (R61/Aim 1), we will finalize the recruitment and intervention strategy (including finalizing the target mechanisms of adherence to MVPA, initial cultural adaptation and translation) through meetings with our community advisory board and pilot testing with 10 Latinx adults. In Stage II (R33/Aim 2), we will randomize 130 Latinx adults to receive the 16-week, fully remote De Pié y a Movernos (De Pié) intervention or a control condition. The intervention will target the mechanisms of self-efficacy, PA habit strength, social support, and PA enjoyment using a staircase approach where participants will initially reduce their sitting by moving more to build confidence towards engaging in MVPA. Participants will also receive a Fitbit activity tracker, health coaching contacts, feedback on meeting goals, and will identify a support person. We will determine the effect of the De Pié intervention on activPAL accelerometer-based MVPA minutes/day (primary outcome) and adherence to meeting the MVPA guidelines of 150 minutes per week (secondary outcome). Further, mediation analyses will be conducted to determine the effect of the intervention on mechanisms of adherence (self-efficacy, habit strength, social support, enjoyment) and identify whether these mechanisms explain intervention effects on MVPA minutes/week and adherence to MVPA guidelines. We will explore cognition, acculturation, age and sex as moderators of these associations. Results will help identify important mechanisms of adherence to MVPA and inform culturally adapted, theory- based approaches to prevent ADRD in the Latinx community.