The Together Everyone Achieves More Physical Activity Trial (TEAM-PA)

项目总结/摘要 与白色人相比，非裔美国人（AA）妇女的慢性病发病率高得不成比例 女性，包括死于心血管疾病的可能性是男性的两倍。身体活动（PA）是关键 然而，只有35%的AA妇女符合国家PA指南。 美国黑人妇女成年后慢性病和过早死亡的持续差异 寿命的增长突出表明，需要制定有效的干预措施，以增加AA妇女的PA。我们 建议社区环境作为接触AA妇女的重要背景，具有巨大的希望，但 在过去以社区为基础的干预措施中，社会联系的作用作为一种关键机制没有得到充分研究 让AA女性参与长期的PA。各种各样的理论都强调了社会关系的重要性 为促进健康，并通过几个不同但相关的结构定义了社会联系。社会 认知理论（SCT）认为，群体情境促进社会学习和集体效能，而 自我决定理论（SDT）和群体动力学理论（GDT）强调了 小组成员之间的积极互动，以促进相关性，相互支持，和小组 凝聚力基于群体的方案中的社会关系可能对AA妇女特别重要，因为 集体主义（相信集体高于个人的重要性）是一个突出的文化价值观， 许多Aa。尽管有越来越多的证据强调了社会关系的重要性， 从文化角度来看，这一因素在干预设计中的整合程度最低，很少有针对性地作为 增加PA的中心机制。我们的调查团队提供了强有力的初步数据， 以前的社区为基础的PA干预措施，为不活跃的AA妇女，通过针对社会关系， 合作和竞争战略的结合。从SDT、SCT、GDT和文化价值观中汲取经验 在这个框架下，每个人一起实现更多的身体活动（TEAM-PA）试验评估了 基于组的社会关系干预（与标准组提供的PA比较程序）， 非活跃AA妇女中的PA。使用在社区中心实施的组群随机设计 在五年的时间里，本研究的主要目的是评估10周TEAM-PA组的疗效。 干预（与比较程序）增加加速度计评估的总PA（光）的每日分钟数 从基线到干预后和6个月随访时的维持治疗[主要目的 1]。此外，我们将评估TEAM-PA干预对次要结局的影响（百分比 符合PA、轻度PA、久坐行为、体重指数、血压的国家建议） [次要目的1-2]和干预对PA变化影响的潜在介质[次要目的3]。

Project Summary/Abstract African American (AA) women experience disproportionately higher rates of chronic diseases compared to White women, including being twice as likely to die from cardiovascular disease. Physical activity (PA) is a key protective factor for reducing risk for chronic diseases, yet only 35% of AA women meet national PA guidelines. Persistent disparities in chronic disease and pre-mature death among African American women across the adult lifespan highlight the need for developing effective interventions for increasing PA among AA women. We propose that community settings hold tremendous promise as an important context for reaching AA women, but the role of social affiliation has been understudied in past community-based interventions as a key mechanism for engaging AA women in long-term PA. A variety of theories have highlighted the importance of social affiliation for health promotion and have defined social affiliation through several distinct but related constructs. Social Cognitive Theory (SCT) proposes that the group context promotes social learning and collective efficacy, while Self-Determination Theory (SDT) and Group Dynamics Theory (GDT) have emphasized the importance of positive interactions between group members in order to promote relatedness, reciprocal support, and group cohesion. Social affiliation within group-based programs may be especially important to AA women, given that collectivism (belief in the importance of advancing the group over the individual) is a prominent cultural value for many AAs. Despite converging evidence highlighting the importance of social affiliation from a motivational and cultural perspective, this factor has been minimally integrated within intervention designs and rarely targeted as a central mechanism for increasing PA. Our investigative team provides strong preliminary data for expanding on previous community-based PA interventions for inactive AA women by targeting social affiliation through a combination of collaborative and competitive strategies. Drawing from SDT, SCT, GDT, and a cultural values framework, The Together Everyone Achieve More Physical Activity (TEAM-PA) trial evaluates the efficacy of a group-based social affiliation intervention (vs. a standard group-delivered PA comparison program) for increasing PA among inactive AA women. Using a group cohort randomized design implemented at community centers across five years, the primary aim of this study is to evaluate the efficacy of the 10-week TEAM-PA group-based intervention (vs. comparison program) on increasing accelerometry-assessed minutes per day of total PA (light to vigorous activities) from baseline to post-intervention and maintenance at a 6-month follow-up [Primary Aim 1]. Additionally, we will evaluate the impact of the TEAM-PA intervention on secondary outcomes (percentage meeting national recommendations for PA, light PA, sedentary behavior, body mass index, blood pressure) [Secondary Aims 1-2] and potential mediators of the intervention effect on changes in PA [Secondary Aim 3].