Physical Activity in Underserved Populations: Using Epidemiologic Assessments to Inform Sustainable Intervention

摘要 体力活动(PA)，包括定期锻炼，可以防止体重增加，延缓功能 限制和改善心血管功能，但三分之一的美国人不活跃。帕 衡量和推广服务不足的人群，如低收入种族/族裔 少数族裔社区，尤其具有挑战性。文化适应不足导致 自我管理和连续监控之间的显著测量误差(例如， 基于设备的)PA评估。在#年的背景下，确定PA的决定因素 社会文化和地理规范是发展可持续和成本-- 有效的PA推广策略。新出现的证据表明，适应文化的PA 推广战略，例如那些使用社区卫生工作者的战略，可以提供文化 对社会文化敏感性的测量和干预的解释和适应 规范，增加干预活动的治疗依从性和社会支持。然而， 这些干预措施很难扩大规模。移动健康(MHealth)技术，包括文本 消息传递，已经显示出在行为干预和疾病自我保护方面的巨大希望 管理，但共同的关切包括文本的非个性化性质和不确定性 关于有效频率和内容。适应文化的健康指导和社交 由社区卫生工作者提供支持，并通过短信进行频繁联系 消息传递，可能是一种有效的、可扩展的PA推广工具，但可行性并不好 在服务不足的社区中得到理解。这一职业发展奖将提供 我接受了健康行为理论、PA测量策略和同伴支持方面的培训 移动健康干预的发展和评价。我们建议对PA进行一项分析 全国妇女健康的纵向研究--不同的妇女样本 他们已经跟踪了20年，并招募了60名墨西哥裔拉丁裔 来自联邦合格健康中心的女性比较自我管理和基于设备的 多个种族/族裔群体的PA数据(目标1)。然后，我们将开发(目标2)并进行试点 (目标3)使用社区卫生工作者和mHealth工具进行PA行为干预 增加拉丁裔参与者的社会支持和PA。这项指导性研究的目标是 科学家发展奖(K01)是为了让Kelly Ylitalo博士成为一名独立的 在整个生命周期内拥有创新PA推广专业知识的调查员，具有特定的 强调适应文化的衡量和干预，以支持实现以下长期目标 预防或延缓优先人群的功能受限和与衰老相关的残疾。

ABSTRACT Physical activity (PA), including regular exercise, prevents weight gain, delays functional limitations, and improves cardiovascular function, yet one in three Americans is inactive. PA measurement and promotion in underserved populations, such as low-income race/ethnic minority communities, is especially challenging. Inadequate cultural adaptation contributes to substantial measurement error between self-administered and continuously-monitored (e.g., device-based) PA assessments. Identification of the determinants of PA, within the context of sociocultural and geographic norms, is a central component of developing sustainable and cost- effective PA promotion strategies. Emerging evidence suggests that culturally-adapted PA promotion strategies, such as those that use community health workers, can provide cultural interpretation and adaptation of measurement and intervention, sensitivity to sociocultural norms, and increase treatment adherence and social support of intervention activities. However, these interventions are difficult to scale. Mobile health (mHealth) technology, including text messaging, has shown great promise for behavioral interventions and disease self- management, but common concerns include the impersonalized nature of texts and uncertainty regarding effective frequency and content. Culturally-adapted health coaching and social support provided by community health workers, combined with frequent contact via text messaging, may be an effective, scalable PA promotion tool, but the feasibility is not well understood among underserved communities. This career development award will provide me with training in health behavior theories, PA measurement strategies, and peer support and mHealth intervention development and evaluation. We propose to conduct an analysis of PA in the longitudinal Study of Women’s Health Across the Nation, a diverse sample of women that have been followed for 20 years, and recruit a sample of 60 Mexican-heritage Latina women from a federally-qualified health center to compare self-administered and device-based PA data among multiple race/ethnic groups (Aim 1). Then, we will develop (Aim 2) and pilot (Aim 3) a PA behavioral intervention using community health workers and mHealth tools to increase social support and PA among Latina participants. The goal of this Mentored Research Scientist Development Award (K01) is to prepare Dr. Kelly Ylitalo to become an independent investigator with expertise in innovative PA promotion throughout the lifecourse, with a specific emphasis on culturally-adapted measurement and intervention, to support the long-term goal of preventing or delaying functional limitations and aging-related disability in priority populations.