Improving Safety and Access for Physical Activity

描述（由申请人提供）：有规律的中高强度体育活动（PA）与肥胖呈负相关，然而，很少有成年人成功地在日常生活中加入足够的PA。少数民族和低收入的成年人肥胖率最高，而常规PA水平最低。增加环境支持，为PA提供安全和便利的场所，是一项新的PA干预公共卫生战略。Wilson （PI）及其同事通过焦点小组的初步数据显示，低收入的少数族裔成年人希望在他们的社区中增加PA的安全场所（没有犯罪的地区，收容流浪狗，增加警察巡逻）和PA的使用（人行道/小径和扩大PA的机会）。此外，我们的初步研究结果表明，非裔美国人在PA方面存在心理障碍，包括缺乏自我激励、文化身体形象问题以及由于家庭义务而缺乏时间。目前的建议是创新的，因为它特别测试了包括巡逻步行和社会营销因素在内的干预措施的有效性，以增加低收入非洲裔美国人的PA。三个社区将随机接受三个项目中的一个：警察巡逻步行项目加社会营销干预，警察巡逻步行干预，或不步行干预（仅进行一般健康教育；N=390； 130/组）。为期24个月的干预将侧重于提高安全性（培训社区领导人担任步行队长，雇用休班警察巡逻步行计划，并收容流浪狗），增加PA的准入（标记步行路线），并将包括量身定制的社会营销活动，以增加PA（在一个干预社区）。我们将收集基线、6个月、12个月、18个月和24个月时PA的数据（7天加速度计估计值、4周PA病史）、身体成分、血压、社会心理测量以及对PA安全性和可及性的环境支持的看法。主要假设是，与仅进行巡逻行走干预或不进行干预相比，巡逻行走加社会营销干预将在12个月后导致中度和剧烈PA的更大增加，并且这些影响将在18个月和24个月的评估中保持不变。

DESCRIPTION (provided by applicant): Regular moderate and vigorous intensity physical activity (PA) is inversely related with obesity, however, few adults are successful in incorporating sufficient PA into their daily lives. Minority and lower-income adults have among the highest obesity rates and lowest levels of regular PA. Increasing environmental supports for safe and convenient places for PA is an emerging public health strategy for PA interventions. Preliminary data by Wilson (PI) and colleagues has revealed through focus groups that low-income minority adults would like to increase the safe places for PA (areas free from crime, containment of stray dogs, increased police patrol) and access to PA (sidewalks/trails and expand opportunities for PA) in their community. In addition, the results of our preliminary studies suggest that African Americans had psychosocial barriers to PA that included lack of self-motivation, cultural body image issues, and lack of time due to family obligations. The present proposal is innovative in that it specifically tests the efficacy of an intervention that includes both patrolled-walking and social marketing elements to increase PA in low-income African Americans. Three communities will be randomized to receive one of three programs: a police patrolled-walking program plus social marketing intervention, a police patrolled-walking only intervention, or no walking intervention (general health education only; N=390; 130/group). The 24- month intervention will focus on increasing safety (training community leaders to serve as walking captains, hiring off-duty police officers to patrol the walking program, and containing stray dogs), increasing access for PA (marking a walking route), and will include a tailored social marketing campaign for increasing PA (in one intervention community). We will collect data for PA (7-day accelerometer estimates, 4-week PA history), body composition, blood pressure, psychosocial measures, and perceptions of environmental supports for safety and access for PA at baseline, 6-, 12-, 18-, and 24-months. The primary hypotheses are that the patrolled-walking plus social marketing intervention will result in greater increases in moderate and vigorous PA as compared to a patrolled walking only intervention or no-intervention by 12-months and that these effects will be maintained at 18-month and 24-month assessments.