Development and Evaluation of a Physical Activity Intervention for Latina Girls

描述（由申请人提供）：年轻的拉丁女孩报告身体活动率特别低，并且最近也显示出与久坐有关的疾病（如糖尿病和肥胖症）的发病率明显增加。增加体育活动可以减少这些疾病的风险因素，但这一人群在很大程度上被排除在干预措施之外。这一群体面临着文化、性别和社会经济地位方面的活动障碍，因此需要针对其独特需求采取干预措施。我们的研究团队在开发和实施最先进的个性化计算机专家系统驱动的身体活动干预措施（基于社会认知理论和跨理论模型）方面拥有丰富的经验，并专门为拉丁裔女性修改了这些干预措施。在R21 NR 009864中，我们在文化和语言上调整了我们现有的针对久坐不动的拉丁裔妇女的定制干预措施，并对修改后的计划进行了一项小型试点试验（N=93）。[This最近在一项针对拉丁裔的RCT中进行了测试（R 01 NR 011295），6个月的结果显示，干预组的PA增加（平均增加=71.66 min/wk，sd=89.92）显著大于对照组（M=29.58，sd=84.37）。目前正在一项大型基于网络的RCT中对此进行测试（R 01 CA 15995401）。]对于目前的建议，我们将进一步修改这一干预措施，专门为年轻的拉丁裔女孩，然后测试其可行性和可接受性，在一个单臂示范试验。社会支持，特别是父母的支持，我强烈预测更多的体力活动，在青少年，因此，纳入父母的支持， 提供支持可能会提高这一干预措施的效力。因为拉丁妇女完成我们目前的基于网络的干预（R 01 CA 15995401）将最近增加自己的身体活动，他们是独一无二的准备提供宝贵的支持，他们的女儿。因此，为了充分利用父母支持的作用，我们将招募和瞄准那些母亲已经完成我们目前RCT的年轻拉丁裔。在第一阶段，我们将与15名年轻拉丁人（年龄[13-18]）及其母亲进行形成性半结构化访谈，以指导我们的干预网站和材料的修改，使其适合年轻拉丁人，并对用户友好，以确定这一人群特有的活动的主要障碍，[并确定母亲的社会支持需求]。在第二阶段，我们将对25名母亲已经完成我们正在进行的干预的年轻拉丁人进行为期12周的单组开放试验。将在基线和12周时使用7天PAR和加速计以及专门为青少年开发的综合心理社会措施收集数据。本试验的数据将用于确定干预的可行性和可接受性，并在完成时进行深入的定性访谈，以告知对母亲和女儿进行更大规模试验的干预修改。这种基于网络的互动干预措施覆盖面广，成本低，因此有很大的潜力被更大规模地采用，从而有可能减少日益扩大的公共卫生差距。

DESCRIPTION (provided by applicant): Young Latina girls report especially low rates of physical activity, and have also shown the marked recent increases in incidence of sedentary-related diseases such as diabetes and obesity. Increasing physical activity could reduce risk factors for these diseases, yet this population has largely been excluded from interventions. This population faces cultural, gender, and SES barriers to activity, and as such needs interventions tailored to their unique needs. Our research team has extensive experience developing and implementing state-of-the-art individually tailored computer expert system-driven physical activity interventions (based on Social Cognitive Theory and the Transtheoretical Model), and has done extensive work modifying these interventions specifically for Latina women. In R21NR009864, we culturally and linguistically adapted our existing tailored intervention for sedentary Latina women and conducted a small pilot trial of the modified program (N=93). [This was recently tested in an RCT with Latinas (R01NR011295), and six-month findings showed significantly greater increases in PA in the intervention group (Mean Increase=71.66 min/wk, sd=89.92) than in controls (M=29.58, sd=84.37). This is now being tested (R01CA15995401) in a large web-based RCT.] For the current proposal, we will further modify this intervention specifically for young Latina girls and then test its feasibility and acceptability in a single arm demonstration trial. Social support, particularly parental support, i strongly predictive of greater physical activity in adolescents, thus the incorporation of parental support is likely to enhance the effectiveness of this intervention. Because the Latina women completing our current web-based intervention (R01CA15995401) will have recently increased their own physical activity, they are uniquely poised to provide invaluable support to their daughters. Therefore, to capitalize on the role of parental support, we will recruit and target young Latinas whose mothers have completed our current RCT. In Phase 1, we will conduct formative semi-structured interviews with 15 young Latinas (age [13-18]) and their mothers to guide the modification of our intervention website and materials to make them appropriate and user friendly for young Latinas, to determine the key barriers to activity unique to this populatio, [and to determine social support needs in mothers]. In Phase 2, we will conduct a one-arm 12-week open trial of the intervention with 25 young Latinas whose mothers have completed our ongoing intervention. Data will be collected at baseline and 12- weeks using the 7-Day PAR and accelerometers, as well as comprehensive psychosocial measures developed specifically for youth. Data from this trial will be used to determine the feasibility and acceptability of the intervention, and in-depth qualitative interviews will be conducted at completion to inform modification of the intervention for a larger trial for mothers and daughters. Such interactive web-based interventions are high reach and low cost, thus they have great potential for adoption on a larger scale and, consequently, have potential to reduce widening public health disparities.