Evaluating Multilevel Factors that Predict Physical Activity Among Latinos with Chronic Spine Pain: A Mixed-Methods Study

项目总结 拉丁裔因患有慢性脊椎疼痛(CSP)的风险较低而面临医疗不足的风险 社会经济地位，获得医疗保健的机会不一致，英语水平有限，并存条件，高 职业伤害和系统性偏见歧视的盛行。体力活动(PA)一直是 被广泛认为是一种有效的非药物疼痛管理策略，但许多拉丁裔疼痛患者 不要参与PA活动。患有CSP的拉丁裔在参与PA方面面临着明显的挑战，这些挑战可能会受到 社会生态模式的多个层面，包括个人内部(例如，社会身份、痛苦或与PA有关 信仰)、人际关系(例如，社会支持)和环境因素(例如，社区可步行)。这些 多层次的因素也可能交织在一起，影响PA在拉丁裔与CSP之间的接触。考虑到 PA行为的复杂性、整合的社会生态模型和交叉框架支持 评估预测因素如何相交以影响PA。此外，还存在PA的时变元素 (例如，疼痛、社会支持和环境)可由特定事件触发的拉丁裔CSP 或者是随机的。因此，评估多水平因素与PA之间关系的瞬时波动 并确定促进或阻碍PA参与的特定环境背景是有必要的。这个 拟议的研究旨在对正在进行的临床试验的基线数据进行二次分析 美国-墨西哥边界评估多层次因素如何交叉影响巴勒斯坦权力机构(目标1)。一种混合的方法 然后，将采用方法首先探索哪些多层次因素有可能影响 第二，使用生态瞬时评估(EMA)来评估这些实时 因素交叉形成特定人的网络，预测患有CSP的拉美裔人自由生活的PA(目标2)。 这两个目标都将进行一项交叉性的子分析，以评估可能处于更大 身体活动机会的劣势。这项研究的发现有望为宾夕法尼亚州带来光明 CSP拉丁裔之间的差异，同时为申请者未来的研究目标奠定基础 开发针对这一人群的即时性和个性化的行为干预。通过此F31 申请者将获得体力活动、疼痛和运动领域的高级跨学科训练 数字健康将大大有助于申请者成为独立的、公共的长期目标 健康研究员。

PROJECT SUMMARY Latinos are at an elevated risk for medical undertreatment of chronic spine pain (CSP) due to having a lower socioeconomic status, inconsistent access to healthcare, limited English proficiency, comorbid conditions, high prevalence of occupational injuries, and systemic prejudicial discrimination. Physical activity (PA) has been widely accepted as an effective non-pharmacological pain management strategy, yet many Latinos with pain do not engage in PA. Latinos with CSP face distinct challenges to engaging in PA that may be influenced by multiple levels of the socioecological model including intrapersonal (e.g., social identities, pain or PA-related beliefs), interpersonal (e.g., social support), and environmental factors (e.g., neighborhood walkability). These multilevel factors may also intersect to influence PA engagement in Latinos with CSP. Considering the complexity of PA behavior, integrating the socioecological model and intersectional framework support the assessment of how predictors intersect to influence PA. Furthermore, there are time-varying elements of PA (e.g., pain, social support, and environment) among Latinos with CSP that can be triggered by a specific event or at random. Thus, assessing momentary fluctuations in the relationships between multilevel factors with PA and identifying specific environmental contexts that facilitate or impede PA engagement is warranted. The proposed study aims to conduct a secondary analysis of baseline data from an ongoing clinical trial near the US-Mexico border to assess how multilevel factors intersect to influence PA (Aim 1). A mixed methods approach will then be conducted to first explore what multilevel factors have the potential to influence momentary PA and second, use Ecological Momentary Assessment (EMA) to assess how these real-time factors intersect to form person-specific networks predicting free-living PA among Latinos with CSP (Aim 2). Both aims will conduct an intersectional sub-analysis that evaluates subgroups that may be at a greater disadvantage for physical activity opportunities. Findings from this study are expected to shed light on PA disparities among Latinos with CSP while setting the foundation for the applicant’s future research goals of developing momentary and personalized behavioral interventions targeting this population. Through this F31 mechanism, the applicant will gain advanced interdisciplinary training in the fields of physical activity, pain, and digital health that will significantly contribute to the applicant’s long-term goal of being an independent, public health researcher.