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

描述（由申请人提供）：拉丁美洲人经历了不成比例的运动功能减退相关的慢性疾病的负担，威胁着该国增长最快的人口的未来健康。缺乏身体活动与肥胖、2型糖尿病和各种癌症的风险增加有关。拉丁美洲人比非西班牙裔白人更有可能不符合体育活动（PA）的建议，拉丁美洲妇女的体育活动比拉丁美洲男子少。拟议的ENLACE研究项目的目标是设计，实施和评估一个促进者主导的PA干预措施，采取全面，多层次，以社区为基础的方法，以促进中度到剧烈的身体活动（MVPA）之间的一个特别欠发达的部分拉丁美洲人。基于社会生态模型的干预方法，侧重于个人态度和技能，社会文化因素和环境对行为改变的影响。拟议的分组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，HL 087765资助）的基础上，由一组具有丰富经验的学术研究人员和社区合作伙伴共同开展行为干预和拉丁美洲和弱势群体的外展。南德克萨斯州下格兰德河谷四个主要拉丁裔县的八个社区资源中心（CRC）将被随机分配到Enlace PA干预（4个CRC）或注意力控制条件（4个CRC）。我们将招募704名年龄在18-64岁之间的拉丁裔，他们不符合CRC服务区殖民地（未合并，贫困，服务不足的拉丁裔定居点）的国家PA指南。随机分配至Enlace PA干预组的CRC参与者（N = 352;每个CRC 88名女性）将接受16次每周一次的促销员领导的小组会议，随后进行24周的维持干预（每月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5天或更多天每天参加30分钟的MVPA。注意力-对照组（N = 352;每个CRC 88名女性）将在维持干预期间接受16次由宣传员领导的关于家庭安全/急救的每周小组会议和每月通用健康教育材料和信息电话。主要结果是每周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。我们还将评估自我效能，社会支持，决策平衡和集体效能作为MVPA变化的中介。主要和次要结局的标准化测量将在基线、干预后即刻（16周）和延迟（40周）进行。我们假设，在ENLACE PA干预拉丁美洲将显着增加他们的MVPA水平作为解决其特定的个人，社会文化和环境障碍，并提高他们的社会支持和集体效能的结果，相比，注意力控制拉丁美洲。

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.