Peer-support motivational interviewing PA intervention for African American women

描述（由申请人提供）：PA的健康益处被广泛接受，有助于降低心血管疾病、糖尿病、中风、肥胖和某些癌症的风险。建议是在一周的大部分时间里每天进行30分钟的运动，但是，成年人的不活动率低于少数种族和少数民族妇女的不活动率。《社区预防服务指南》发现社会支持干预措施可以有效增加PA。因此，拟议中的研究旨在探讨一种新的“文化适当的基于同伴的动机面试”（CAPMI）干预的可行性和有效性，其目标是行为技能，沟通和社会支持，以增加久坐的非洲裔美国人（AA）妇女的PA。CAPMI的总体理论基础集中在行为改变过程中社会影响的作用。家人、朋友和其他支持者会对一个人的动机、偏好、行为和结果产生影响。因此，在行为改变研究中显然需要针对自然网络。动机性访谈是一种可以帮助个体提高从他人那里获得的支持质量的方法。MI专注于帮助个人通过减少改变的障碍来增加动力，并通过使用同情，鼓励和非对抗性方法来解决特定行为的矛盾心理。这种方法已被广泛用于成瘾研究，但显示出改善其他健康行为，如饮食和PA，以及少数群体的希望。建议的干预措施的主要目标是检查使用动机访谈技术，以促进更好的互惠社会支持的有效性。具体目标是：（1）采用半结构式深度访谈和焦点小组对久坐的AA妇女进行形成性研究，探讨社会支持对PA的作用和重要性;（2）确定在久坐的AA妇女中招募和实施CAPMI的可行性;（3）对CAPMI在提高PA、社会支持自我效能和减少障碍PA在干预后相比，注意力控制组。女性（N=80; 40对）在自然非亲密的二人组（即，家庭成员或朋友）将被随机分配到CAPMI：（1）基于同伴的MI和行为技能（例如，目标设定和问题解决）训练;（2）自助材料（例如，练习册、训练DVD和PA时事通讯）;（3）计步器;或注意力控制（AC）：（1）自助材料（仅PA时事通讯）;（2）计步器。在干预开始之前，将对AA妇女进行焦点小组和配对半结构化深入访谈，以研究PA的社会支持来源。将在四个时间点（基线和基线后第4、8和12周）比较干预组和对照组受试者的自我报告中等强度PA分钟数、社会支持和PA障碍。我们还提出了一个简短的计划，使用RE-AIM框架进行过程评估，以确定干预的范围、有效性和实施情况。公共卫生相关性：非亲密自然网络，即，家庭成员/朋友可以在增加非裔美国妇女的身体活动（PA）方面发挥重要作用。提出的文化上适当的同伴提供的MI干预（CAPMI）的目的是解决这个问题，通过提高类型的动机和支持，同伴提供PA。本研究的目标是通过开发针对AA妇女社会资源的预防干预措施，最终减少癌症的种族/民族差异，并提高我们对如何使妇女从久坐不动到满足PA癌症预防建议的认识。

DESCRIPTION (provided by applicant): The health benefits of PA are widely accepted, aiding in reducing the risk of cardiovascular disease, diabetes, stroke, obesity, and some cancers. Recommendations are to engage in 30 minutes a day on most days of the week, however, < of adults are inactive with higher rates of inactivity among racial and ethnic minority women. The Guide to Community Preventive Service found social support interventions to be effective in increasing PA. Therefore, the proposed study seeks to examine the feasibility and efficacy of a novel "Culturally-Appropriate Peer-based Motivational Interviewing" (CAPMI) intervention that targets behavioral skills, communication and social support for increasing PA in sedentary African American (AA) women. The overarching theoretical rationale for CAPMI centers on the role of social influence in the behavior change process. Family, friends and supportive others exert influence on one's motives, preferences, behaviors, and outcomes. As such, there is a clear need to target natural networks in behavior change studies. Motivational Interviewing (MI) is an approach that may help individuals enhance the quality of support given and received from their supportive others. MI focuses on helping individuals increase motivation by reducing barriers to change and resolving ambivalence for a given behavior by using empathy, encouragement, and non- confrontational methods. This method has been used extensively in addiction studies, but is showing promise for improving other health behaviors such as diet and PA, and among minority populations. The primary goal of the proposed intervention is to examine the efficacy of using motivational interviewing techniques to foster better reciprocal social support. Specific aims are: (1) to conduct formative research using semi-structured in- depth interviews and focus groups with sedentary AA women to investigate the role and importance of social support for PA; (2) to determine the feasibility of recruiting and implementing CAPMI in sedentary AA women; and (3) to pilot test and evaluate the efficacy of the CAPMI in increasing PA, social support, self-efficacy and reducing barriers to PA at post-intervention compared to an attention control group. Women (N=80; 40 dyads) recruited in natural non-intimate dyads (i.e., family members or friends) will be randomly assigned to either the CAPMI: (1) peer-based MI and behavioral skills (e.g., goal setting and problem solving) training; (2) self-help materials (e.g., workbook, training DVD and PA newsletters); (3) pedometer; or Attention Control (AC): (1) self- help materials (PA newsletter only); (2) pedometer. Prior to the start of the intervention, focus groups and paired semi-structured in-depth interviews will be conducted with AA women to examine sources of social support for PA. Intervention and control participants will be compared on minutes of self-report moderate- intensity PA, social support, and PA barriers at four time-points: baseline and Weeks 4, 8, and 12 post-baseline. We also propose a brief plan of process evaluation using the RE-AIM framework to determine reach, efficacy, and implementation of the intervention. Public Health Relevance: Non-intimate natural networks, i.e., family members/friends, can play a major role in increasing physical activity (PA) in African American women. The proposed culturally- appropriate peer-delivered MI intervention (CAPMI) is designed to address this issue by enhancing the type of motivation and support that peers provide for PA. The goal of this study is to ultimately reduce racial/ethnic disparities in cancer by developing prevention interventions that address AA women's' social resources, and to enhance our knowledge of how to move women from being sedentary to meeting PA recommendations for cancer prevention.