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%的非裔美国人(AA)女性超重或肥胖，57%肥胖。与再生障碍性贫血妇女超重和肥胖率高相关的健康风险令人担忧，因为这些风险会导致随后的慢性病，包括心血管疾病(CVD)和2型糖尿病(T2D)。体力活动(PA)是控制体重和改善多种心脏代谢性疾病危险因素的既定机制。然而，尽管有这些好处，只有36%的再生障碍性贫血妇女符合国家PA指南。再生障碍性贫血妇女的PA水平低，加上超重/肥胖和其他慢性病的高患病率，表明需要采取有效的战略，在这一高危人群中促进持续的PA高水平。以技术为基础的平台(即智能手机应用程序、互联网、社交媒体)是向再生障碍性贫血妇女提供PA干预的潜在渠道。然而，很少有研究人员探索这些平台来向再生障碍性贫血妇女提供与文化相关的PA干预。这意味着错失了机会，因为技术提供的行为改变干预措施已经取得了既定的成功，而且有数据表明，再生障碍性贫血女性使用互联网、社交媒体和智能手机的比例与其他种族/民族持平或更高。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以技术为基础的方法来填补已发表研究中的这一空白，以增加再生障碍性贫血妇女的PA。作为一名行为科学家，他的研究生和博士后培训侧重于社会和心理科学，特别强调为再生障碍性贫血妇女制定和评估以理论为导向、基于文化相关技术的PA干预措施。本申请中提议的研究和培训将通过以下方式扩展和完善候选人的PA和健康差距研究轨迹：1)重点培训支持PA干预后心脏代谢疾病风险因素的生理和生化机制；2)评估所有相关智能手机交付的PA计划(Smart Walk)的效果，以改善(基线为6个月)并保持(7个月至12个月)AA女性较高的PA水平，并改善心脏代谢性疾病风险因素。候选人已经在亚利桑那州立大学确定了一个支持性和激励性的研究环境来进行拟议的研究。在芭芭拉·安斯沃斯、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，将自己确立为一名独立的行为和健康差距研究科学家。在拨款的K99部分，申请者将通过授课课程和实际临床实验室经验，接受支持心脏代谢疾病风险因素的生理和生化机制方面的明确培训，以应对PA干预。在这一研究领域的培训将补充他已经强大的社会科学背景，使他能够更深入地了解与PA促进健康相关的生理机制。在赠款奖励的R00阶段，申请者将部署在K99阶段获得的培训，并通过实施为期12个月的基于技术的PA随机对照试验，在他之前的健康差距研究轨迹的基础上，评估具有文化相关性的智能手机提供的PA干预的效果，以改善(基线为6个月)和保持(7个月至12个月)高PA水平，并降低肥胖AA女性的心脏代谢性疾病风险。76名肥胖的AA女性将接受基于社会认知理论的文化相关PA推广计划，该计划使用智能手机应用程序提供，或者接受健康接触控制条件。将评估PA、健身和心脏代谢性疾病的风险因素。还将探讨PA可能影响心脏代谢性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者的近期和长期职业目标。申请人的直接职业目标是加强他基于理论的PA研究，包括支持PA对健康(即炎症)影响的显著机制，以预防和治疗再障女性的心脏代谢性疾病风险因素。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，重点是确定有效的战略，在种族/少数民族中促进持续的PA，以及2)减少高危少数群体中心脏代谢性疾病的不成比例的负担。在目前的K99/R00申请中提出的培训和研究活动将帮助应聘者实现这些职业目标，并促进PA和健康差距科学。

 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.