Smart Walk: A Smartphone Physical Activity Program for African American Women

 描述（由申请人提供）：项目摘要/摘要国家数据显示，82%的非洲裔美国人（AA）妇女超重或肥胖，57%肥胖。与AA女性中超重和肥胖的高患病率相关的健康风险令人担忧，因为这些风险导致随后的慢性病，包括心血管疾病（CVD）和2型糖尿病（T2 D）。体力活动（PA）是一种既定的机制，以管理体重和改善无数的心脏代谢疾病的风险因素。然而，尽管有这些好处，只有36%的AA妇女符合国家PA指南。AA妇女中PA水平低，加上超重/肥胖和其他慢性疾病的高患病率，表明需要有效的策略，以促进持续高PA在这个高风险人群。基于技术的平台（即智能手机应用程序、互联网、社交媒体）是向AA妇女提供PA干预措施的潜在渠道。然而，很少有研究人员探索这些平台提供文化相关的PA干预AA妇女。这代表了一个错失的机会，因为技术提供的行为改变干预措施取得了成功，数据表明AA女性使用互联网，社交媒体和智能手机的比率与其他种族/族裔群体相同或更高。在过去的5年里，这项拟议工作的申请人一直致力于通过开发和评估基于技术的方法来填补已发表研究中的这一空白，以增加AA妇女的PA。作为一名行为科学家，他的研究生和博士后培训一直专注于社会和心理科学，特别强调为AA妇女开发和评估理论驱动的，文化相关的基于技术的PA干预措施。当前申请中提出的研究和培训将通过以下方式扩展和完善候选人的PA和健康差异研究轨迹：1）在支持对PA干预有反应的心脏代谢疾病风险因素的生理和生化机制方面进行重点培训，和2）评估与文化相关的智能手机提供的PA计划的效果（智能步行），以改善（基线至6个月）和维持（7个月至12个月）AA妇女较高的PA水平，并改善心脏代谢疾病的风险因素。候选人已确定在亚利桑那州州立大学的支持和激励的研究环境，以追求拟议的研究。在芭芭拉·安斯沃思，科琳·凯勒，格伦·盖瑟和索尼娅·维加-洛佩兹博士的指导下，他将获得必要的技能，以建立自己作为一个独立的行为和健康差异研究科学家。在K99部分，申请人将通过教学课程和实践临床实验室经验，对支持心脏代谢疾病风险因素对PA干预反应的生理和生化机制进行明确的培训。在这一研究领域的培训将补充他已经很强的社会科学背景，让他获得与PA的健康增强效益相关的生理机制的更深入的了解。在赠款奖励的R 00阶段，申请人将部署在K99阶段获得的培训，并通过实施一项为期12个月的基于技术的PA随机对照试验，以评估与文化相关的智能手机提供的PA干预的效果，从而在逻辑上建立他以前的健康差异研究轨迹，（基线至6个月）和维持（7个月至12个月）高PA水平，降低肥胖AA女性的心脏代谢疾病风险。76名肥胖AA女性将接受使用智能手机应用程序或健康接触控制条件提供的文化相关的，基于社会认知理论的PA推广计划。将评估PA、健康和心脏代谢疾病风险因素。还将探讨PA可能影响心脏代谢疾病风险因素的潜在生理机制。拟议的研究和培训活动支持申请人的近期和长期职业目标。申请人的近期职业目标是加强其基于理论的PA研究，以包括支持PA对健康（即炎症）影响的突出机制，以预防和治疗AA女性中的心脏代谢疾病风险因素。他的长期职业目标是：a）建立一个独立的，外部资助的研究计划，重点是确定有效的策略，以促进种族/少数民族之间的持续PA，和2）减少高风险少数群体中心脏代谢疾病的不成比例的负担。目前K99/R 00申请中提出的培训和研究活动将帮助候选人实现这些职业目标，并推进PA和健康差异科学。

 DESCRIPTION (provided by applicant): Project Summary/Abstract National data show that 82% of African American (AA) women are overweight or obese, and 57% are obese. The health risks associated with the high prevalence of overweight and obesity among AA women is concerning, as these risks contribute to subsequent chronicities including cardiovascular disease (CVD) and type 2 diabetes (T2D). Physical activity (PA) is an established mechanism to manage weight and to improve myriad cardiometabolic disease risk factors. However, despite these benefits, only 36% of AA women meet the national PA guidelines. The low PA levels among AA women coupled with the high prevalence of overweight/obesity and other chronic disease conditions indicate the need for effective strategies to promote sustained high PA in this high-risk population. Technology-based platforms (i.e. Smartphone applications, Internet, social media) represent potential channels to deliver PA interventions to AA women. However, few researchers have explored these platforms to deliver culturally relevant PA interventions to AA women. This represents a missed opportunity given the established success of technology-delivered behavior change interventions and data suggesting that AA women use Internet, social media, and Smartphones at equal or greater rates than other race/ethnic groups. Over the past 5 years, the applicant of this proposed work has focused on filling this gap in the published research through the development and evaluation of technology-based approaches to increase PA among AA women. Trained as a behavioral scientist, his graduate and postdoctoral training has been focused in the social and psychological sciences, with a particular emphasis on the development and evaluation of theory- driven, culturally relevant technology-based PA interventions for AA women. The research and training proposed in the current application will extend and refine the candidate's PA and health disparities research trajectory through : 1) focused training in the physiological and biochemical mechanisms underpinning cardiometabolic disease risk factors responsive to PA intervention, and 2) evaluation of the effects of a culturall relevant Smartphone-delivered PA program (Smart Walk) to improve (baseline to 6 months) and maintain (7 months to 12 months) higher PA levels among AA women and improve cardiometabolic disease risk factors. The candidate has identified a supportive and stimulating research environment at Arizona State University to pursue the proposed research. Under the mentorship and Drs. Barbara Ainsworth, Colleen Keller, Glenn Gaesser, and Sonia Vega-Lopez, he will gain the necessary skills to establish himself as an independent behavioral and health disparities research scientist. In the K99 portion of the grant award, the applicant will gan explicit training in the physiological and biochemical mechanisms underpinning cardiometabolic disease risk factors responsive to PA intervention through didactic coursework and hands-on clinical laboratory experience. Training in this research area will complement his already strong social science background by allowing him to gain a deeper understanding of the physiological mechanisms associated with the health-enhancing benefits of PA. In the R00 phase of the grant award, the applicant will deploy the training acquired during the K99 phase and build logically upon his previous health disparities research trajectory by implementing a 12-month technology-based PA randomized controlled trial to evaluate the effects of a culturally relevant Smartphone-delivered PA intervention to improve (baseline to 6 months) and maintain (7 months to 12 months) high PA levels and reduce cardiometabolic disease risk among obese AA women. Seventy-six obese AA women will receive either a culturally relevant, Social Cognitive Theory-based PA promotion program delivered using a Smartphone application or a wellness contact control condition. PA, fitness, and cardiometabolic disease risk factors will be evaluated. Potential physiological mechanisms through which PA may impact cardiometabolic disease risk factors will also be explored. The proposed research and training activities support the immediate and long-term career goals of the applicant. The applicant's immediate career goal is to enhance his theory based PA research to include salient mechanisms that underpin PA effects on health (i.e. inflammation), towards the prevention and treatment of cardiometabolic disease risk factors among AA women. His long-term career goals are to: a) establish an independent, externally-funded program of research focused on the identification of effective strategies to promote sustained PA among racial/ethnic minorities, and 2) reduce the disproportionate burden of the cardiometabolic diseases among high-risk minority populations. The training and research activities proposed in the current K99/R00 application will assist the candidate in achieving these career goals, and advance PA and health disparities science.