Background/objective

Providing a demonstration of a 10-minute bout of moderate-to-vigorous intensity physical activity (MVPA) immediately prior to subjective reporting of MVPA could influence self-reported activity by calibrating both duration and intensity. We assessed the effect of a demonstration of MVPA on subsequent MVPA recall, and explored whether this improved agreement with objective measures of MVPA.

Methods

A total of 846 individuals participated in four different physical activity interventions; two of which included a 10-minute moderate-intensity demonstration walk on a treadmill at baseline and 6-month visits immediately prior to reporting MVPA. Participants from three studies also wore accelerometers during the week overlapping with self-reported MVPA.

Results

Overall, those completing the demonstration walk reported significantly fewer minutes of MVPA per week at baseline (b = -11.69, standard error = 2.53, p < 0.01). The effect of the demonstration walk at 6 months was not significant (p = 0.06). Correlations with accelerometers at baseline were higher in the two studies with the demonstration walk (ρ = 0.28, 0.26) than the study without (ρ = 0.04). Correlations with accelerometers increased overall from baseline to follow-up.

Conclusion

A 10-minute demonstration of MVPA was associated with reporting fewer minutes of MVPA and improved agreement with objective PA measures at baseline. These findings support combining self-report PA assessments with hands-on MVPA demonstrations.

Background: No physical activity (PA) interventions have specifically targeted Latino men despite marked health disparities in this group. Therefore, we explored the feasibility of designing a PA intervention for Latino men. Methods: We conducted six qualitative interviews with Latino men and used their feedback to modify an existing PA intervention, then conducted a 12-week demonstration trial of the adapted intervention. Results: Themes from interviews included work and family conflicts and preferring team sports. In the demonstration trial of the modified intervention, participants (N = 10) increased PA from 1.3 minutes/week (SD = 4.75) at baseline to 125.5(SD = 154.86) at follow-up (p < .05). Retention was high and participants expressed enthusiasm for the program. Conclusions: Existing interventions could be effectively modified to target physical activity in Latino men. © 2014 by the Men's Studies Press, LLC.

High rates of obesity in Latinas highlight the need to determine if physical activity interventions are equally effective across the body mass index (BMI) range. Thus, this study assessed how BMI impacts success of Spanish-speaking Latinas in a culturally and linguistically adapted theory-based physical activity intervention (N = 45). Longitudinal regression models tested the relationship between baseline BMI and outcomes. Overall, a trend for a negative association was found between baseline BMI and self-reported physical activity and theoretical constructs targeted by the intervention over time. For example, someone with a 25 kg/m(2) BMI would report, on average, 27.5 more minutes/week of activity compared to someone with a 30 kg/m(2) BMI at followup. Furthermore, higher baseline BMI was significantly associated with lower self-efficacy, behavioral and cognitive processes of change, and family social support over time. These findings suggest that participants with higher BMI may need additional intervention to promote physical activity.

Background

Latina adolescents in the USA report some of the lowest rates of physical activity of any demographic subgroup; this is paralleled by a markedly higher lifetime risk of obesity, type 2 diabetes, and other conditions related to inactivity. Despite this, to date, no fully powered clinical trials have tested physical activity interventions specifically for this population. High use of mobile technologies (including text messages, smartphone apps, and social media) suggests this could be an appropriate intervention channel, while also having potential for broad reach. This paper describes the protocol for Chicas Fuertes, a fully powered randomized trial of a mobile technology-based physical activity intervention for Latina adolescents.

Methods

We plan to recruit 200 Latina teens (age 13-18) in San Diego, CA, currently engaging in ≤ 150 min/week of moderate-to-vigorous physical activity (MVPA) to be assigned 1:1 to the intervention or control groups. Those randomly assigned to the intervention group receive a one-on-one goal setting session followed by 6 months of mobile technology-based intervention, including a personalized website, Fitbit activity tracker and app, individually tailored text messages based on Fitbit data, and daily intervention content on Instagram. Those randomized to the control group receive only a Fitbit activity tracker. The main outcome is change in weekly minutes of MVPA from baseline to 6 months, measured both objectively (ActiGraph accelerometers and Fitbit Inspire HR) and subjectively (7-Day Physical Activity Recall Interview). Additional outcomes are maintenance of activity change at 12 months and changes in psychosocial constructs, including social support and self-efficacy, engagement with mobile technology channels, and costs of intervention delivery. We are also examining the potential mediators and moderators of the intervention. The efficacy of the intervention is analyzed using a mixed effects regression model, adjusting for any potential confounders not balanced by randomization. All analyses of accelerometer measured MVPA are also adjusted for wear time.

Discussion

The Chicas Fuertes trial uses widely available mobile technologies to target critical health behavior, physical activity, in Latina teens, a population with a high lifetime risk of lifestyle-related diseases. The results will speak to the efficacy and acceptability of the intervention, which has the potential for broad dissemination.

Trial registration

ClinicalTrials.gov NCT04190225 . Registered on November 20, 2019.

Aims

We tested two aims: (1) the teachable moment (TM): whether second-hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma versus parents of healthy children (HC); and (2) whether greater intervention intensity [enhanced-precaution adoption model (PAM)] produces greater cessation than a previously tested intervention (PAM).

Design and interventions

Aim 1: two home visits (asthma education or child wellness), and cessation induction using motivational interviewing and SHSe feedback. Aim 2: post-home-visits, parents with asthmatic children were randomized to PAM (n = 171; six asthma education calls) or enhanced-PAM (n = 170; six asthma education/smoking cessation calls + repeat SHSe feedback).

Setting

Rhode Island, USA.

Participants

Parents of asthmatic (n = 341) or healthy (n = 219) children who did not have to want to quit smoking to enroll.

Measurements

Measurements were given at baseline, 2, 4, 6 and 12 months. Abstinence was bioverified. Outcomes were 7-day and 30-day point prevalence abstinence (ppa) and SHSe (primary) and asthma morbidity (secondary).

Findings

Aim 1: the TM was supported: parents of asthmatic children were more than twice as likely to achieve 30-day [odds ratio (OR) = 2.60, 95% confidence interval (CI) = 1.22-5.54] and 7-day ppa (OR = 2.26, 95% CI = 1.13-4.51) at 2 months (primary end-point) and have non-detectable levels of SHSe than HCs. Greater treatment intensity yielded stronger TM effects (OR = 3.60; 95% CI = 1.72-7.55). Aim 2: enhanced-PAM was more likely to achieve 30-day ppa at the primary end-point, 4 months (OR = 2.12, 95% CI 1.09-4.12) and improved asthma outcomes versus PAM.

Conclusions

Smoking cessation intervention (Motivational Interviewing plus biomarker feedback) appear to motivate smoking cessation more strongly among parents of asthmatic children than among parents of healthy children. Increased intervention intensity yields greater smoking cessation among parents of asthmatic children and better asthma outcomes.

Spanish-speaking Latinas have some of the lowest rates of meeting physical activity guidelines in the U.S. and are at high risk for many related chronic diseases. The purpose of the current study was to examine the maintenance of a culturally and individually-tailored Internet-based physical activity intervention for Spanish-speaking Latinas. Inactive Latinas (N  =  205) were randomly assigned to a 6-month Tailored Physical Activity Internet Intervention or a Wellness Contact Control Internet Group, with a 6-month follow-up. Maintenance was measured by assessing group differences in minutes per week of self-reported and accelerometer measured moderate to vigorous physical activity (MVPA) at 12 months after baseline and changes in MVPA between the end of the active intervention (month 6) and the end of the study (month 12). Potential moderators of the intervention were also examined. Data were collected between 2011 and 2014, and were analyzed in 2015 at the University of California, San Diego. The Intervention Group engaged in significantly more minutes of MVPA per week than the Control Group at the end of the maintenance period for both self-reported (mean diff. = 30.68, SE = 11.27, p = .007) and accelerometer measured (mean diff. = 11.47, SE = 3.19, p = .01) MVPA. There were no significant between- or within-group changes in MVPA from month 6 to 12. Greater intervention effects were seen for those with lower BMI (BMI × intervention = -6.67, SE = 2.88, p = .02) and lower perceived places to walk to in their neighborhood (access × intervention = -43.25, SE = 19.07, p = .02), with a trend for less family support (social support × intervention = -3.49, SE = 2.05, p = .08). Acculturation, health literacy, and physical activity related psychosocial variables were not significant moderators of the intervention effect during the maintenance period. Findings from the current study support the efficacy of an Internet-delivered individually tailored intervention for maintenance of MVPA gains over time.

Internet-based interventions show promise as an effective channel for promoting physical activity. However, a paucity of research has been conducted among underserved groups despite recent increases in Internet access and physical activity-related health disparities in these communities. Thus, the current randomized controlled trial will test the efficacy of an individually tailored, Internet-based physical activity intervention for Latinas. This program was culturally and linguistically adapted for the target population through extensive formative research. Two hundred eighteen sedentary Latinas were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. The Physical Activity Internet Intervention, based on Social Cognitive Theory and the Transtheoretical Model, utilizes a website with features including self-monitoring, goal setting, discussion forum, links to online resources, individually tailored and motivation-matched physical activity feedback reports, and exercise tip sheets. Participants receive regular emails over the first 6months with a tapered dose during the second 6months (maintenance phase) to alert them to new content on the website. The main outcome is differences in minutes/week of moderate to vigorous physical activity at six months as measured by the 7-Day Physical Activity Recall and accelerometer data. High reach, low cost, culturally relevant Internet-based interventions that encourage physical activity among Latinas could help reduce health disparities and thus have a substantial positive impact on public health.

Internet-based interventions show promise as an effective channel for promoting physical activity. However, a paucity of research has been conducted among underserved groups despite recent increases in Internet access and physical activity-related health disparities in these communities. Thus, the current randomized controlled trial will test the efficacy of an individually tailored, Internet-based physical activity intervention for Latinas. This program was culturally and linguistically adapted for the target population through extensive formative research. Two hundred eighteen sedentary Latinas were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. The Physical Activity Internet Intervention, based on Social Cognitive Theory and the Transtheoretical Model, utilizes a website with features including self-monitoring, goal setting, discussion forum, links to online resources, individually tailored and motivation-matched physical activity feedback reports, and exercise tip sheets. Participants receive regular emails over the first 6months with a tapered dose during the second 6months (maintenance phase) to alert them to new content on the website. The main outcome is differences in minutes/week of moderate to vigorous physical activity at six months as measured by the 7-Day Physical Activity Recall and accelerometer data. High reach, low cost, culturally relevant Internet-based interventions that encourage physical activity among Latinas could help reduce health disparities and thus have a substantial positive impact on public health.

Spanish-speaking Latinas have some of the lowest rates of meeting physical activity guidelines in the U.S. and are at high risk for many related chronic diseases. The purpose of the current study was to examine the maintenance of a culturally and individually-tailored Internet-based physical activity intervention for Spanish-speaking Latinas. Inactive Latinas (N  =  205) were randomly assigned to a 6-month Tailored Physical Activity Internet Intervention or a Wellness Contact Control Internet Group, with a 6-month follow-up. Maintenance was measured by assessing group differences in minutes per week of self-reported and accelerometer measured moderate to vigorous physical activity (MVPA) at 12 months after baseline and changes in MVPA between the end of the active intervention (month 6) and the end of the study (month 12). Potential moderators of the intervention were also examined. Data were collected between 2011 and 2014, and were analyzed in 2015 at the University of California, San Diego. The Intervention Group engaged in significantly more minutes of MVPA per week than the Control Group at the end of the maintenance period for both self-reported (mean diff. = 30.68, SE = 11.27, p = .007) and accelerometer measured (mean diff. = 11.47, SE = 3.19, p = .01) MVPA. There were no significant between- or within-group changes in MVPA from month 6 to 12. Greater intervention effects were seen for those with lower BMI (BMI × intervention = -6.67, SE = 2.88, p = .02) and lower perceived places to walk to in their neighborhood (access × intervention = -43.25, SE = 19.07, p = .02), with a trend for less family support (social support × intervention = -3.49, SE = 2.05, p = .08). Acculturation, health literacy, and physical activity related psychosocial variables were not significant moderators of the intervention effect during the maintenance period. Findings from the current study support the efficacy of an Internet-delivered individually tailored intervention for maintenance of MVPA gains over time.

Latinas report disproportionately low physical activity (PA) levels and related health conditions. Reducing chronic disease in Latinas requires interventions to increase and maintain health-enhancing PA levels; yet limited intervention studies have examined PA maintenance among Latinas. The present study evaluated the efficacy during the maintenance phase (months 6-12) of the Enhanced PA intervention for Latina adults in Seamos Activas II compared to the Original PA Intervention. Seamos Activas II was conducted in San Diego, California from 2015 to 2020. Underactive adult Latina women (N = 199), mainly of Mexican descent (89%) were randomized to the original intervention or a theory- and technology-enhanced intervention. Their PA was measured objectively (via accelerometers) and via self-report at baseline, 6, and 12 months. Quantile regression models assessed treatment effects on min/week of moderate to vigorous PA (MVPA) at 12 months. Generalized linear models examined treatment effects on indicators of meeting 2008 National PA Guidelines. Both groups maintained the significant gains in MVPA they had made during the first 6 months of the intervention, neither increasing nor decreasing their MVPA over the maintenance period, with no significant between-group differences. At 12 months, 46.3% of Enhanced Intervention participants were meeting self-reported PA guidelines (vs 35.6 % of the Original PA Intervention arm, p = .02). Even with minimal contact throughout the maintenance phase, participants maintained their MVPA, which underscores the importance of continued use of evidence-based behavior change tools and techniques to reinforce newly established habits. Theoretical and technological enhancements may help Latinas to continue meeting PA guidelines during maintenance periods.