Evidence-based intervention to improve walking engagement in El Paso, Texas.

摘要 住在美国的墨西哥裔美国人-墨西哥边境地区遭受不成比例的 可预防的心脏代谢疾病。经常快走是一种有效的措施， 调节代谢过程并预防疾病。基于雇主的健康计划 是解决这一公共卫生问题的有希望的策略，因为它们利用了 工作场所环境，以改善MVPA参与的机会，同时解决 与不活动有关的障碍。以雇主为基础的MVPA计划尚未得到广泛实施。 在美国进行测试墨西哥边境。我们计划进行一个集群顺序多 分配随机试验（SMART），以确定基于雇主的 步行挑战干预-50，000 for Life（50K4Life）-改善快走 参与度（每天至少7,000步）。拟议 干预策略基于PI Salinas在El 合作研究者的Paso和行为、环境和工作现场干预。审判 将包括30所随机选择的公立学校， 来自埃尔帕索县学区的员工。50K4Life中的干预策略 将分为两个阶段：1）50K4Life与50K4Life+短信和2）个人与 学校一级的适应校园与低响应的初始干预阶段。我们 假设步行挑战与多层次的能力建设和适应， 干预反应将导致更好地遵守PA指南。这一建议的社会- 基于生态模型的研究通过西班牙裔服务机构（HSI）利用资源 来自得克萨斯州和专业知识，在雇主为基础的工作场所干预从大学 格鲁吉亚（UGA）基于合作伙伴的累积工作，以解决PA和 促进墨西哥裔美国人的健康公平。作为我们干预的一部分 评估，我们将进行过程评估和成本效益，以提供深入了解 成本和可扩展性。这项研究将提供优化实施所需的信息 以证据为基础的行为干预，以改善墨西哥人的步行参与， 住在美国的美国人-墨西哥边境地区。

ABSTRACT Mexican Americans who live in the U.S.-Mexico border region suffer disproportionately from preventable cardiometabolic diseases. Regular brisk walking is an effective measure in regulating metabolic processes and preventing disease. Employer-based wellness programs are promising strategies to address this public health problem because they take advantage of workplace environments to improve opportunities for MVPA engagement while also addressing barriers associated with inactivity. Employer-based MVPA programs have not been widely tested on the U.S.-Mexico border. We plan to conduct a clustered Sequential Multiple Assignment Randomized Trial (SMART) to determine the effectiveness of an employer-based walking challenge intervention- 50,000 for Life (50K4Life)- in improving brisk walking engagement (at least 7,000 steps/day) among school district employees. The proposed intervention strategies are based on the walking interventions conducted by PI Salinas in El Paso and behavioral, environmental and worksite interventions by the Co-Investigators. The trial will include 30 randomly selected public schools with predominantly Mexican American employees from El Paso County area school districts. The intervention strategies in 50K4Life will be in two phases: 1) 50K4Life vs. 50K4Life + SMS text messaging and 2) Individual vs. School level adaptation for campuses with a low response to the initial intervention phase. We hypothesize that walking challenges with multilevel capacity building and adaptations based on intervention response will lead to improved adherence to PA guidelines. This proposed socio- ecological model-based study leverages resources through Hispanic Serving Institutions (HSI) from Texas and expertise in employer-based workplace interventions from the University of Georgia (UGA) based on the partner's accumulative work to address the disparity in PA and advance health equity in the Mexican American population. As part of our intervention evaluation, we will conduct a process evaluation and cost-effectiveness to provide insight into cost and scalability. This study will provide needed information on optimizing the implementation of evidence-based behavioral interventions to improve walking engagement among Mexican Americans living in the U.S.-Mexico border region.