Dataset Information

A culturally adapted physical activity intervention for Latinas: a randomized controlled trial.

ABSTRACT:

Background

In the U.S., Latinos report particularly high levels of inactivity and related chronic illnesses and are in need of intervention. Thus, the purpose of the current study was to culturally and linguistically adapt an empirically supported, individually tailored physical activity print intervention for Latinos and then conduct an RCT of the modified program.

Design

An RCT was conducted.

Setting/participants

The sample included 93 overweight/obese (80%) Latinas with low income and acculturation.

Intervention

Data were collected in 2007-2008 and analyzed by intent-to-treat in 2009. Participants were randomly assigned to either (1) a culturally and linguistically adapted physical activity intervention (Seamos Activas) or (2) a wellness contact control condition.

Main outcome measures

Self-report physical activity, as measured pre- and post-intervention (6 months, 87% retention) by the 7-Day Physical Activity Recall.

Results

Moderate-intensity (or greater) physical activity increased from an average of 16.56 minutes/week (SD=25.76) at baseline to 147.27 (SD=241.55) at 6 months in the intervention arm (n=45), and from 11.88 minutes/week (SD=21.99) to 96.79 (SD=118.49) in the wellness contact control arm (n=48). No between-group differences were seen in overall physical activity. Intervention participants reported significantly greater increases in cognitive (F[1, 91]=9.53, p=0.003) and behavioral processes of change (F[1, 91]=8.37, p=0.005) and available physical activity supplies and equipment at home (F[1, 91]=4.17, p=0.04) than control participants.

Conclusions

Results supported the hypothesized feasibility, acceptability, and preliminary efficacy of individually tailored physical activity print interventions among Latinas. Although more research is needed to corroborate these findings, such high-reach, low-cost approaches have great potential to positively affect public health.

Trial registration

NCT00724165.

SUBMITTER: Pekmezi DW

PROVIDER: S-EPMC2814545 | biostudies-literature | 2009 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A culturally adapted physical activity intervention for Latinas: a randomized controlled trial.

Pekmezi Dorothy W DW Neighbors Charles J CJ Lee Christina S CS Gans Kim M KM Bock Beth C BC Morrow Kathleen M KM Marquez Becky B Dunsiger Shira S Marcus Bess H BH

American journal of preventive medicine 20091201 6

<h4>Background</h4>In the U.S., Latinos report particularly high levels of inactivity and related chronic illnesses and are in need of intervention. Thus, the purpose of the current study was to culturally and linguistically adapt an empirically supported, individually tailored physical activity print intervention for Latinos and then conduct an RCT of the modified program.<h4>Design</h4>An RCT was conducted.<h4>Setting/participants</h4>The sample included 93 overweight/obese (80%) Latinas with ...[more]

PMID: 19944914

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Project description:BackgroundThe internet's low cost and potential for high reach makes Web-based channels prime for delivering evidence-based physical activity (PA) interventions. Despite the well-studied success of internet-based PA interventions in primarily non-Hispanic white populations, evidence on Spanish-speaking Latinas' use of such interventions is lacking. The recent rise in technology use among Latinas in the United States, a population at heightened risk for low PA levels and related conditions, suggests that they may benefit from Web-based PA interventions tailored to their cultural and language preferences.ObjectiveThe goal of the research was to examine participant engagement with various features of an internet-based PA intervention for Latinas and explore how use of these features was differentially associated with adoption and maintenance of PA behavior change.MethodPasos Hacia la Salud tested a Spanish-language, culturally adapted, individually tailored, internet-based PA intervention versus a Spanish language, internet-based, Wellness Contact Control condition for underactive Latinas (N=205, mean age 39.2 [SD 10.5] years, 84% Mexican American). These analyses examined engagement with the website and explored how use was associated with adoption and maintenance of moderate to vigorous physical activity (MVPA) behavior.ResultsOverall, participants logged on to the website an average of 22 times (SD 28) over 12 months, with intervention participants logging on significantly more than controls (29 vs 14.7, P<.001). On average, participants spent more time on the website at months 1, 4, and 6 compared to all other months, with maximum use at month 4. Both log-ins and time spent on the website were significantly related to intervention success (achieving higher mean minutes of MVPA per week at follow-up: b=.48, SE 0.20, P=.02 for objectively measured MVPA and b=.74, SE 0.34, P=.03 for self-reported MVPA at 12 months, controlling for baseline). Furthermore, those meeting guidelines by the Centers for Disease Control and Prevention for PA at 12 months (≥150 minutes per week of MVPA) logged on significantly more than those not meeting guidelines (35 vs 20 over 12 months, P=.002). Among participants in the intervention arm, goal-setting features, personal PA reports, and PA tips were the most used portions of the website. Higher use of these features was associated with greater success in the program (significantly more minutes of self-reported MVPA at 12 months controlling for baseline). Specifically, one additional use of these features per month over 12 months translated into an additional 34 minutes per week of MVPA (goals feature), 12 minutes per week (PA tips), and 42 minutes per week (PA reports).ConclusionsThese results demonstrate that greater use of a tailored, Web-based PA intervention, particularly certain features on the site, was significantly related to increased PA levels in Latinas.Trial registrationClinicalTrials.gov NCT01834287; https://clinicaltrials.gov/ct2/show/NCT01834287.

Project description:BACKGROUND:Internet-delivered treatments for depressive symptoms have proved to be successful in high-income Western countries. There may be potential for implementing such treatments in low- and middle-income countries such as Colombia, where access to mental health services is limited. OBJECTIVE:The objective of this study was to assess the efficacy of a culturally adapted cognitive behavioral internet-delivered treatment for college students with depressive symptoms in Colombia. METHODS:This was a randomized controlled trial with a 3-month follow-up. The program comprised seven modules. A total of 214 Colombian college students were recruited. They were assessed and randomly assigned to either the treatment group (n=107) or a waiting list (WL) control group (n=107). Participants received weekly support from a trained supporter. The primary outcome was symptoms of depression, as measured by the Patient Health Questionnaire - 9, and the secondary outcomes were anxiety symptoms assessed by the Generalized Anxiety Disorder questionnaire - 7. Other measures, including satisfaction with treatment, were evaluated after 7 weeks. RESULTS:Research attrition and treatment dropouts were high in this study. On average, 7.6 sessions were completed per user. The mean time spent on the program was 3 hours and 18 min. The linear mixed model (LMM) showed significant effects after treatment (t197.54=-5.189; P<.001) for the treatment group, and these effects were maintained at the 3-month follow-up (t39.62=4.668; P<.001). Within-group results for the treatment group yielded a large effect size post treatment (d=1.44; P<.001), and this was maintained at the 3-month follow-up (d=1.81; P<.001). In addition, the LMM showed significant differences between the groups (t197.54=-5.189; P<.001). The results showed a large effect size between the groups (d=0.91; P<.001). In the treatment group, 76.0% (16/107) achieved a reliable change, compared with 32.0% (17/107) in the WL control group. The difference between groups was statistically significant (X22=10.5; P=.001). CONCLUSIONS:This study was the first contribution to investigating the potential impact of a culturally adapted internet-delivered treatment on depressive symptoms for college students as compared with a WL control group in South America. Future research should focus on identifying variables associated both with premature dropout and treatment withdrawal at follow-up. TRIAL REGISTRATION:ClinicalTrials.gov NCT03062215; https://clinicaltrials.gov/ct2/show/NCT03062215.

Project description:BackgroundOnline social networks, such as Facebook™, have extensive reach, and they use technology that could enhance social support, an established determinant of physical activity. This combination of reach and functionality makes online social networks a promising intervention platform for increasing physical activity.PurposeTo test the efficacy of a physical activity intervention that combined education, physical activity monitoring, and online social networking to increase social support for physical activity compared to an education-only control.DesignRCT. Students (n=134) were randomized to two groups: education-only controls receiving access to a physical activity-focused website (n=67) and intervention participants receiving access to the same website with physical activity self-monitoring and enrollment in a Facebook group (n=67). Recruitment and data collection occurred in 2010 and 2011; data analyses were performed in 2011.Setting/participantsFemale undergraduate students at a large southeastern public university.InterventionIntervention participants were encouraged through e-mails, website instructions, and moderator communications to solicit and provide social support related to increasing physical activity through a physical activity-themed Facebook group. Participants received access to a dedicated website with educational materials and a physical activity self-monitoring tool.Main outcome measuresThe primary outcome was perceived social support for physical activity; secondary outcomes included self-reported physical activity.ResultsParticipants experienced increases in social support and physical activity over time but there were no differences in perceived social support or physical activity between groups over time. Facebook participants posted 259 times to the group. Two thirds (66%) of intervention participants completing a post-study survey indicated that they would recommend the program to friends.ConclusionsUse of an online social networking group plus self-monitoring did not produce greater perceptions of social support or physical activity as compared to education-only controls. Given their promising features and potential reach, efforts to further understand how online social networks can be used in health promotion should be pursued.Trial registrationThis study is registered at clinicaltrials.govNCT01421758.

Project description:BackgroundPhysical activity (PA) interventions typically include components or doses that are static across participants. Adaptive interventions are dynamic; components or doses change in response to short-term variations in participant's performance. Emerging theory and technologies make adaptive goal setting and feedback interventions feasible.ObjectiveTo test an adaptive intervention for PA based on Operant and Behavior Economic principles and a percentile-based algorithm. The adaptive intervention was hypothesized to result in greater increases in steps per day than the static intervention.MethodsParticipants (N = 20) were randomized to one of two 6-month treatments: 1) static intervention (SI) or 2) adaptive intervention (AI). Inactive overweight adults (85% women, M = 36.9 ± 9.2 years, 35% non-white) in both groups received a pedometer, email and text message communication, brief health information, and biweekly motivational prompts. The AI group received daily step goals that adjusted up and down based on the percentile-rank algorithm and micro-incentives for goal attainment. This algorithm adjusted goals based on a moving window; an approach that responded to each individual's performance and ensured goals were always challenging but within participants' abilities. The SI group received a static 10,000 steps/day goal with incentives linked to uploading the pedometer's data.ResultsA random-effects repeated-measures model accounted for 180 repeated measures and autocorrelation. After adjusting for covariates, the treatment phase showed greater steps/day relative to the baseline phase (p<.001) and a group by study phase interaction was observed (p ?.017). The SI group increased by 1,598 steps/day on average between baseline and treatment while the AI group increased by 2,728 steps/day on average between baseline and treatment; a significant between-group difference of 1,130 steps/day (Cohen's d = .74).ConclusionsThe adaptive intervention outperformed the static intervention for increasing PA. The adaptive goal and feedback algorithm is a "behavior change technology" that could be incorporated into mHealth technologies and scaled to reach large populations.Trial registrationClinicalTrials.gov NCT01793064.

Project description:BackgroundPhysicians are expected to serve as role models for healthy lifestyles, but long work hours reduce time for healthy behaviors. A hospital-based physical activity intervention could improve physician health and increase counseling about exercise.MethodsWe conducted a two-phase intervention among 104 medical residents at a large hospital in Boston, Massachusetts. Phase 1 was a 6-week randomized controlled trial comparing daily steps of residents assigned to an activity monitor displaying feedback about steps and energy consumed (intervention) or to a blinded monitor (control). Phase 2 immediately followed and was a 6-week non-randomized team steps competition in which all participants wore monitors with feedback. Phase 1 outcomes were: 1) median steps/day and 2) proportion of days activity monitor worn. The Phase 2 outcome was mean steps/day on days monitor worn (≥500 steps/day). Physiologic measurements were collected at baseline and study end. Median steps/day were compared using Wilcoxon rank-sum tests. Mean steps were compared using repeated measures regression analyses.ResultsIn Phase 1, intervention and control groups had similar activity (6369 vs. 6063 steps/day, p = 0.16) and compliance with wearing the monitor (77% vs. 77% of days, p = 0.73). In Phase 2 (team competition), residents recorded more steps/day than during Phase 1 (CONTROL: 7,971 vs. 7,567, p = 0.002;Intervention7,832 vs. 7,739, p = 0.13). Mean compliance with wearing the activity monitor decreased for both groups during Phase 2 compared to Phase 1 (60% vs. 77%, p<0.001). Mean systolic blood pressure decreased (p = 0.004) and HDL cholesterol increased (p<0.001) among all participants at end of study compared to baseline.ConclusionsAlthough the activity monitor intervention did not have a major impact on activity or health, the high participation rates of busy residents and modest changes in steps, blood pressure, and HDL suggest that more intensive hospital-based wellness programs have potential for promoting healthier lifestyles among physicians.Trial registrationClinicaltrials.gov NCT01287208.

Dataset Information

A culturally adapted physical activity intervention for Latinas: a randomized controlled trial.

Background

Design

Setting/participants

Intervention

Main outcome measures

Results

Conclusions

Trial registration

Publications

A culturally adapted physical activity intervention for Latinas: a randomized controlled trial.

Similar Datasets

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