ENLACE: A partnership to promote physical activity among Mexican immigrant women

描述(申请人提供)：拉美裔是美国人口中增长最快的部分，患有肥胖症和糖尿病等慢性病的比例不成比例，在拉丁裔亚群中缺乏运动的水平最高；墨西哥裔美国女性的肥胖率和久坐不动的生活方式是最高的。每天增加中等强度的体力活动(PA)可以防止体重增加，改善整体身心健康。其目的是：1)确定和了解影响南加州哥伦比亚MSA墨西哥移民妇女PA行为的因素；2)开发和评估具有文化能力的PA干预措施，目标是墨西哥移民妇女中的个人、家庭和社区影响；以及3)评估聘请社区Lay Health Advisors(LHA)作为参与式研究人员的可行性和有效性。在第一年，我们建议进行形成性评估，并通过项目咨询团队与当地的拉美裔服务组织和其他社区合作伙伴建立全面的合作伙伴关系，制定干预措施。将聘请六个土地管理协会参与策划和实施形成性评估。从12个焦点小组和25个深入访谈中收集的数据将为在墨西哥移民妇女中促进中等强度的PA的干预措施的制定提供信息。在第二年，每个LHA将招募两组10名妇女(N=12组；N=120名妇女)参与研究。每组将被随机分配到两种情况中的一种：立即干预或延迟干预。随机化将在LHA内部得到平衡。6组将接受即时干预，6组将作为延迟干预的一部分进行测量。在为期6个月的干预结束时，延迟干预组将接受干预(但没有测量)。这项干预基于社会认知理论和PEN-3和社会生态模型，将由LHAs提供，并强调满足CDC-ACSM的建议，即每周5天或更长时间进行30分钟的中等强度PA。因此，除了个人行为的改变外，干预还将针对拉丁裔家庭和社区内的社会和文化影响。标准化评估将在基线和6个月的随访中进行，PA将使用加速计进行评估。我们假设，与随机接受延迟干预的参与者相比，即时干预参与者将表现出每天中等强度体力活动分钟数(主要结果)的更大增加，感受到的社会支持和身体活动自我效能的更大增加，以及较少的体重增加(次要结果)。这项建议将为严格评估将非专业健康顾问纳入参与性研究方法以影响墨西哥移民妇女的身体活动奠定基础。这项研究将为这种方法的可行性提供初步证据，包括后勤问题、社区参与程度、对行为结果的潜在影响大小，以及措施的文化适宜性和可靠性。这些初步调查结果将被用来开发参与性非专业健康顾问方法的大规模社区试验，以促进拉美裔社区的体育活动，并协助减少健康差距。

DESCRIPTION (provided by applicant): Latinos, the fastest growing segment of the US population, carry disproportionate rates of chronic illnesses such as obesity and diabetes and have the highest levels of physical inactivity Among Latino subgroups; Mexican American women experience some of the highest rates of obesity and sedentary lifestyles. Increasing daily moderate-intensity physical activity (PA) can prevent weight gain and improve overall physical and mental health. The aims are to: 1) identify and understand the factors that influence PA behavior for Mexican immigrant women in the Columbia MSA, SC; 2) develop and evaluate a culturally competent PA intervention that targets individual, family and community influences among Mexican immigrant women; and, 3) assess the feasibility and effectiveness of engaging community-based Lay health advisors (LHAs) as participatory researchers. In year 1 we propose to conduct formative assessments and develop the intervention in full partnership with a local Hispanic-serving organization and other community partners via a Program Advisory Team. Six LHAs will be recruited to participate in the planning and implementing the formative assessments. Data gathered from 12 focus groups and 25 in-depth interviews will inform the development of an intervention to promote moderate intensity PA among Mexican immigrant women. In year 2, each LHA will recruit 2 groups of 10 women (N=12 groups; N=120 women) to participate in the study. Each group will be randomly assigned to one of two conditions: an immediate intervention or a delayed intervention. Randomization will be balanced within LHA. Six groups will receive the immediate intervention and 6 groups will be measured as part of the delayed intervention. At the conclusion of the 6- month intervention, delayed intervention groups will receive the intervention (but no measurements). The intervention, based on Social Cognitive Theory and PEN-3 and Socio- ecological models, will be delivered by LHAs and emphasize meeting CDC-ACSM recommendations of 30 minutes of moderate-intensity PA on 5 or more days per week. Thus, in addition to individual behavior change, the intervention will target the social and cultural influences within the Latino family and community. Standardized assessments will occur at baseline and 6-months follow-up and PA will be assessed using accelerometers. We hypothesize that compared to participants randomized to the delayed intervention, immediate intervention participants will show greater increases in minutes per day moderate intensity physical activity (primary outcome), show greater increases in perceived social support and self- efficacy for physical activity and less weight gain (secondary outcomes). PUBLIC HEALTH RELEVANCE This proposal will lay the foundation for rigorous evaluation of the incorporation of lay health advisors in a participatory research approach to affecting physical activity among Mexican immigrant women. The study will provide preliminary evidence for the feasibility of this approach, including logistical issues, levels of community participation, potential effect sizes for behavioral outcomes, and the cultural suitability and reliability of measures. These preliminary findings will be used to develop a large-scale, community-based trial of the participatory, lay health advisor approach to promoting physical activity in Latino communities and assisting in the reduction of health disparities.