ENLACE: A Promotora-Led Physical Activity Intervention Trial for Latinas in Texas

描述（由申请人提供）：拉丁美洲人承受着与运动不足相关的慢性疾病的不成比例的负担，威胁着美国增长最快的人口的未来健康。缺乏运动与肥胖、2型糖尿病和各种癌症的风险增加有关。拉美裔人比非拉美裔白人更有可能达不到体育锻炼（PA）的建议，拉美裔女性的体育锻炼也少于拉美裔男性。拟议的ENLACE研究项目的目标是设计、实施和评估一项以促进者为主导的体育活动干预措施，该干预措施采用全面、多层次、基于社区的方法，在拉美裔特别缺乏服务的人群中促进中度至剧烈体育活动（MVPA）。基于社会生态模型的干预方法侧重于个体态度和技能、社会文化因素和环境对行为改变的影响。拟议的群体随机对照试验建立在形成性和试点研究（由国家心脏，肺和血液研究所R21资助，HL087765）的基础上，由一组具有丰富经验的学术调查人员和社区合作伙伴共同进行行为干预，并向拉丁裔和弱势群体推广。8个社区资源中心（crc）分布在南德克萨斯州下里约热内卢格兰德山谷的四个以拉丁裔为主的县，将被随机分配到Enlace PA干预组（4个crc）或注意力控制组（4个crc）。我们将招募704名年龄在18-64岁的拉丁裔，他们不符合国家PA指南，来自CRC服务区的殖民地（未合并的，贫困的，服务不足的拉丁裔定居点）。随机分配到Enlace PA干预组的CRC参与者（N = 352，每个CRC 88名女性）将接受16周由促销员领导的小组会议，随后是24周的维持干预（每月由促销员提供的通讯和电话咨询）。小组会议的行为目标是让拉丁美洲人每周有5天或更多的时间每天参加30分钟的MVPA。注意控制组（N = 352；每个CRC有88名妇女）将每周接受16次由宣传者领导的家庭安全/急救小组会议，并在维持干预期间每月接受一般健康教育材料和信息电话。主要指标是每周MVPA的分钟数（用加速度计测量）。次要结果是身体健康和体重维持。我们也将评估自我效能、社会支持、决策平衡和集体效能作为MVPA变化的中介。主要和次要结果的标准化测量将在基线、立即（16周）和延迟干预后（40周）进行。我们假设，与注意控制拉美裔相比，ENLACE干预会显著提高拉美裔的MVPA水平，因为他们解决了特定的个人、社会文化和环境障碍，增强了他们的社会支持和集体效能。

DESCRIPTION (provided by applicant): Latinos experience a disproportionate burden of hypokinetic-related chronic diseases, threatening the future health of the nation's fastest-growing population. Physical inactivity has been linked to increased risk of obesity, type 2 diabetes, and various cancers. Latinos are more likely than non-Hispanic whites to fail to meet physical activity (PA) recommendations, and Latino women are less physically active than Latino men. The goal of the proposed ENLACE research project is to design, implement and evaluate a promotora-led PA intervention that takes a comprehensive, multi- level, community-based approach to promoting moderate-to-vigorous physical activity (MVPA) among a particularly underserved segment of Latinas. The intervention approach, based on the social ecological model, focuses on individual attitudes and skills, socio-cultural factors and environmental influences to behavior change. The proposed group- randomized controlled trial builds on formative and pilot research (funded by a National Heart, Lung and Blood Institute R21, HL087765) by a team of academic investigators and community partners with extensive experience working together to conduct behavioral interventions and outreach with Latino and disadvantaged populations. Eight community resource centers (CRCs) in four predominantly Latino counties in South Texas' Lower Rio Grande Valley will be randomly assigned to either the Enlace PA Intervention (4 CRCs) or an attention-control condition (4 CRCs). We will recruit 704 Latinas ages 18-64 who do not meet national PA guidelines from colonias (unincorporated, impoverished, underserved Latino settlements) in the CRC service areas. Participants from CRCs randomized to the Enlace PA Intervention (N = 352; 88 women per CRC) will receive 16 weekly promotora-led group sessions followed by 24 weeks of a maintenance intervention (monthly promotora-delivered newsletters and telephone counseling). The group sessions' behavioral goal is for Latinas to engage in 30 minutes per day of MVPA on 5 or more days per week. The attention- control group (N = 352; 88 women per CRC) will receive 16 weekly promotora-led group sessions on home safety/first aid and monthly generic health education materials and informational telephone calls during the maintenance intervention period. The primary outcome is minutes per week of MVPA (measured with accelerometers). Secondary outcomes are physical fitness and weight maintenance. We also will evaluate self-efficacy, social support, decisional balance, and collective efficacy as mediators of MVPA changes. Standardized measurement of primary and secondary outcomes will occur at baseline, immediate (16 weeks) and delayed post-intervention (40 weeks). We hypothesize that Latinas in the ENLACE PA Intervention will significantly increase their MVPA levels as a result of addressing their specific individual, socio-cultural and environmental barriers and enhancing their social support and collective efficacy, compared to attention-control Latinas.