Designing a Culturally Tailored Partially Randomized Patient Preference Controlled Trial to Increase Physical Activity Among Low-Income Immigrant Latinas

2020 ◽  
Author(s):  
Karen D’Alonzo ◽  
Eun-Hea You
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Patient Preference ◽  
Controlled Trial ◽  
Culturally Tailored ◽  
Immigrant Latinas

scholarly journals Outcomes of a Culturally Tailored Partially Randomized Patient Preference Controlled Trial to Increase Physical Activity Among Low-Income Immigrant Latinas

2017 ◽  
Vol 29 (4) ◽  
pp. 335-345 ◽  
Author(s):  
Karen T. D’Alonzo ◽  
Barbara A. Smith ◽  
Lee H. Dicker
Keyword(s):  
Physical Activity ◽  
Muscle Strength ◽  
Aerobic Fitness ◽  
Low Income ◽  
Patient Preference ◽  
Leisure Time Physical Activity ◽  
Controlled Trial ◽  
Chronic Illnesses ◽  
Culturally Tailored ◽  
Immigrant Latinas

Introduction: Almost half (47.8%) of adult Latinas report they never engage in any leisure time physical activity (PA) which is an independent risk factor for the development of cardiovascular disease and other chronic illnesses. There is a pressing need to develop and test PA interventions among Latinas. Therefore, the purpose of this study was to evaluate the effects of a PA Intervention for Latinas, a culturally tailored, promotora-facilitated 12-week PA intervention. It was hypothesized that at the completion of the intervention, participants would have (a) higher daily PA levels; (b) improved aerobic fitness, muscle strength, and flexibility; and (c) lower body mass index and percentage of body fat. Methodology: A partially randomized patient preference trial design with lag group was used to test the intervention. Participants ( N = 76) attended twice weekly, low-impact aerobic/Latin dance PA classes taught by laywomen trained as promotoras. Results: Significant improvements were measured in aerobic fitness, muscle strength and flexibility, and daily PA levels ( p < .001). Sixty percent of the participants attended at least 60% of the PA sessions. Discussion: Findings suggest laywomen trained as promotoras can successfully facilitate the delivery of an intervention to increase PA among immigrant Latinas.

scholarly journals Salud paso por paso : a culturally-tailored physical activity intervention with hispanic adults with type 2 diabetes mellitus

2021 ◽  
Author(s):  
◽  
Julio Cesar Loya
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Physical Activity Intervention ◽  
Controlled Trial ◽  
Control Group ◽  
Culturally Tailored ◽  
Hispanic Adults

Limited information is available regarding culturally-tailored physical activity (PA) interventions for Hispanic adults with type 2 diabetes mellitus (T2DM). A community-partnered approach was used to examine a novel culturally-tailored PA intervention using a pre-post, no control group design. The intervention consisted of six weekly 45-minute sessions for participants to engage in PA led by the researcher. A total of 21 individuals participated in the study. The typical participant was a 53-year-old female (90 percent) Hispanic adult living with T2DM with low acculturation. On average, before the intervention, the participants walked 10,285 (sd 14,779) steps per week with 43.4 (sd 68.1) minutes of PA per week. Despite implementation during the COVID-19 pandemic, the intervention was feasible and acceptable, and 19 (90.5 percent) participants attended all intervention sessions. There were significant increases in steps per week (p=0.007; d=1.03) and minutes of PA per week (p=0.000; d=1.62). Findings suggest that Salud Paso por Paso has promise as a strategy to enhance PA behaviors in the priority population. A randomized, controlled trial with a larger study sample is warranted to examine efficacy and impact on the diabetes health outcomes of Hispanic adults with T2DM.

scholarly journals Testing the effect of summer camp on excess summer weight gain in youth from low-income households: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
E. Whitney Evans ◽  
Rena R. Wing ◽  
Denise F. Pierre ◽  
Whitney C. Howie ◽  
Morgan Brinker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Energy Intake ◽  
Low Income ◽  
Summer Camp ◽  
Controlled Trial ◽  
Group Differences ◽  
Randomized Controlled ◽  
School Year ◽  
Low Income Households

Abstract Background Children from racial and ethnic minority groups, low-income households, and those with overweight or obesity gain more weight during the summer than the school year. Summer day camps, which offer routine opportunities for physical activity and regular meal and snack times, have potential to mitigate excess weight gain. This randomized controlled trial was done to determine the feasibility and preliminary effectiveness of summer camp in preventing excess summer weight gain among youth from low-income households. Methods Children, ages 6 to 12 years, were randomized to attend 8-weeks of summer day camp (CAMP) or to experience an unstructured summer as usual (SAU) in 2017–2018. Primary feasibility outcomes included retention, engagement and completion of midsummer measures. Secondary outcomes included changes in BMIz, engagement in moderate to vigorous physical activity (MVPA) and sedentary behavior, and diet quality and energy intake from the school year to summer. Multivariable linear mixed models were used to assess group differences. Results Ninety-four participants were randomized to CAMP (n = 46) or SAU (n = 48), of whom 93.0 and 91.6% completed end of school and end of summer assessments, respectively. While CAMP participants attended only 50% of camp days offered, on average, they lost − 0.03 BMIz units while those in SAU gained 0.07 BMIz units over the summer (b = 0.10; p = .02). Group differences in change in energy intake from the school year to summer were borderline significant, as energy intake remained relatively unchanged in CAMP participants but increased among participants in SAU (p = 0.07). Conclusions Randomizing children to attend summer day camp or experience an unstructured summer as usual was effective in this low-income sample. Our findings support the potential for summer camps in mitigating excess summer weight gain. A larger randomized trial is needed explore efficacy, cost-effectiveness and longer-term effects of attending summer camp on weight and weight-related behaviors. Trial registration ClinicalTrials.gov Registration: NCT04085965 (09/2019, retrospective registration).

scholarly journals Effects Of Educational Intervention Based On Integrated Social Marketing Approach On Regular Physical Activity of Female Students: A Study Protocol For A Cluster Randomised Trial

2021 ◽  
Author(s):  
Babak Moeini ◽  
Forouzan Rezapur-Shahkolai ◽  
Rashid Heidarimoghadam ◽  
Leili Tapak ◽  
Azam Geravandi
Keyword(s):  
Physical Activity ◽  
Clinical Trials ◽  
Social Marketing ◽  
Educational Intervention ◽  
Low Income ◽  
Primary Schools ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Regular Physical Activity ◽  
Control Group

Abstract Background: A sedentary lifestyle is recognized as a risk factor for chronic diseases. The aim of this study was to identify the factors related to regular physical activity in adolescents. Also design effective social marketing interventions on these factors in primary schools in Kermanshah (western Iran).Method: This study will be a parallel randomised controlled trial (RCT) conducted at a secondary school in Kermanshah. This protocol conforms to the Consolidated Standard of Reporting Trials (CONSORT) Statement and is registered at the Iranian Registry of Clinical Trials (IRCT:IRCT20200621047858N1). This research will be conducted in three phases that correspond to the first to seventh stages of the social marketing operational model, i.e. the SMART model. Given that this study is a three-stage study, an interventional study will be conducted to investigate the effect of educational intervention on regular physical activity behavior among female junior high school students. In this study, we will have an intervention group and a control group. In each area (north and south of the city), using the division by the school education department, is divided into three categories (rich, middle-income and low-income) and a simple random method is selected from each category of one school (3 intervention schools and 3 control schools. The sample size required for the intervention and control group is calculated as 108 people. Individuals are evaluated for regular physical activity according to the stages of behavior change before and after the intervention.Trial registration: IRAN Clinical Trials Register IRCT20200621047858N1 (date of registration: 2020/7/25 randomized controlled trial registered).Ethics approval: IR.UMSHA.REC.1398.952

Abstract P200: Effects Of A 2-year Randomized Controlled Trial Physical Activity Intervention On Accelerometer-measured Sleep Characteristics Among Older Adults In Senior Center Communities

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Kelsie M Full ◽  
Katie Crist ◽  
Marta Jankowska ◽  
Pamela L Lutsey ◽  
Loki Natarajan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sleep Duration ◽  
Low Income ◽  
Controlled Trial ◽  
Intervention Group ◽  
Sleep Efficiency ◽  
Control Group ◽  
Senior Center ◽  
Intervention Effect

Background: Targeting daily increases in physical activity (PA) is a common lifestyle strategy for cardiovascular disease (CVD) risk reduction. While less targeted in lifestyle interventions, poor sleep is also consistently linked to CVD. Emerging evidence connects changes in daily PA to beneficial changes in sleep; however, little is known about the impact of community-based PA interventions on habitual sleep among older adults. We leveraged accelerometer data from the Peer Empowerment Program for Physical Activity in Low Income & Minority Seniors (PEP4PA) randomized controlled trial to examine the effect of a PA intervention on accelerometer-measured sleep characteristics among older adults in low income and diverse senior center communities. Methods: PEP4PA participants (N=476; mean age=71.0 ± 9 years, 75% female, 60% low income, 36% non-white) were recruited from senior centers and randomized to a healthy control condition(n=209) or a peer-lead walking intervention (N=267). The peer-led PA intervention included self-monitoring techniques, health coach counseling, group walks, and community advocacy to improve walking conditions. Participants wore Actigraph GT3X+ accelerometers on the wrist at baseline, 6, 12, and 24 months. Data were processed for sleep characteristics including weekly average sleep duration and sleep efficiency. Mixed effects regression models provided estimates of the intervention effect on sleep characteristics at each time point. Models were adjusted for age, sex, and race. Three way interaction terms (time*treatment*sleep duration status) were used to assess differential intervention effects by short (<7) and long (>8 hours) sleep duration status at baseline. Results: At baseline, the average sleep duration of participants was 7 hours (SD: 1.07 hours) and the average sleep efficiency was 87.0% (SD: 6.2%). Compared to participants in the control group, participants in the intervention group had shorter sleep durations (7.1 hours vs 7.0 hours; p value: 0.08) and poorer sleep efficiency 86.0% vs 88.2%; p<0.001) at baseline. At 12 or 24-months, there was no intervention effect on participants’ average sleep duration or efficiency. Although not significant, at 6 months, long sleepers in the intervention group experienced an average 6-minute reduction in sleep duration (-B: 6.25, p=0.45) compared to those in the control group. Conclusions: Over the 2-year period, the PA intervention did not appear to have an impact on participants’ average sleep duration or quality. More investigation is needed into the temporal and daily relations of PA and sleep among older adults in interventions to understand if increases in daily PA are associated with better sleep characteristics at night.

Abstract 070: Community-based, Cluster Randomized Controlled Trial Increases Physical Activity In Diverse, Low Income Older Adults Over 2-year Period

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Katie Crist ◽  
Fatima Tuz Zahra ◽  
Kelsie M Full ◽  
Marta M Jankowska ◽  
Loki Natarajan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Low Income ◽  
Controlled Trial ◽  
Community Based ◽  
Randomized Controlled ◽  
Income Status ◽  
Cluster Randomized

Objective: Older adults are the least active population group in the U.S. Low income and ethnically diverse communities have fewer physical activity (PA) related resources and facilities, which contributes to lower PA levels and disparities in cardiovascular (CVD) risk factors and disease outcomes. This study assessed the hypothesis that low income and diverse older adults participating in the multilevel Peer Empowerment Program 4 Physical Activity (PEP4PA) would increase moderate-to-vigorous PA (MVPA), improve blood pressure (BP), perceived quality of life (PQoL), and depressive symptoms to a greater extent than older adults receiving usual senior center programming. Methods: In a cluster-randomized controlled trial (RCT) in 12 senior centers, 476 older adults (mean age 71.4 years, 76% female, 60% low income, 38% minority) were assigned to a PA intervention (n=267) or control (n=209) condition. The peer-led intervention included individual self-monitoring and counseling, group walks and social support, and community advocacy to improve walking conditions. Outcomes included minutes of MVPA per day (7-day accelerometer), systolic and diastolic BP (automatic cuff), PQoL (PQoL-20) and depressive symptoms (CES-D 10) at baseline, 6, 12, 18 and 24 months. To account for multiple measurement days and clustering of participants within senior centers, mixed effects regression models with random effects estimated the intervention effects on all outcomes between groups over time. Models were adjusted for imbalanced baseline covariates. A three-way interaction term assessed whether intervention effects differed by income status. Results: Compared to the control group, intervention participants significantly increased MVPA from baseline at 6, 12, 18 and 24 months by 8, 11, 9 and 9 minutes/day respectively (p<0.001), with increases remaining statistically significant across the 2-year period. The intervention group significantly increased mean PQoL scores from 7.2 at baseline to 7.6 (p<0.001), 7.8 (p=0.008) and 7.7 (p<0.001) at 12, 18 and 24 months, compared to control participants. No significant effects were observed for BP or depressive symptoms. Low income participants decreased minutes of MVPA, compared to higher income participants, at 12 and 24 months (β=-7.9, p=0.008 and β=-10.8, p=0.001). Conclusions: The multilevel RCT achieved sustained increases in MVPA and QoL in a diverse cohort of older adults across 2 years of follow up. The peer-led, community-based intervention provides a sustainable model to improve health behaviors related to CVD in an at-risk and often difficult to reach aging population. Further exploration is needed to understand what components of the intervention may be modified to address the differential effects by income status.

scholarly journals Parent BMI Increase 2 to 5 Years Post-study Related to Change in Age but Independent of Other Sociodemographics, Health Behavior, and Study Engagement (P16-001-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Brenda Abu ◽  
Barbara Lohse ◽  
Leslie Cunningham-Sabo
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Low Income ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Family Intervention ◽  
Activity Level ◽  
Nutrition Intervention ◽  
Post Intervention ◽  
Age Change

Abstract Objectives Characterize parent (P) weight change 2–5 y post participation in Fuel for Fun (FFF) a controlled trial of a school and family intervention focused on culinary and physical activity experiences for 4th grade youth. Methods P who had participated with their 4th grader in FFF were recruited via email to enroll in a follow-up (FFF-FU) assessment. FFF-FU survey set included measures from the original study and new items pertinent to P of adolescents. Physical activity was measured with the IPAQ; low income was denoted as using an income-based program or worry about money for food. Height, weight, age in FFF and FFF-FU were self-reported. Perimenopausal age included 47 y within BL and FFF-FU. Youth in FFF cohorts 1 and 4 were controls and cohorts 2 and 3 included the multi-component intervention. P were enrolled in 1 of 4 treatments varying in type and intensity. FFF and FFF-FU data were collected online using the Qualtrics platform. FFF P completed surveys at baseline (BL), post-intervention, and 4 months post-study. FFF-FU data were collected spring 2018, about 2 to 5 years years post-BL. Data were analyzed with repeated measures controlling for BL or FFF-FU sociodemographics, engagement, health behaviors. Results Of the 418 FFF P, 127 completed FFF-FU surveys (mean age 42.5 6.0 y) with 115 providing weight and height. FFF-FU sample was female (88%), white (84%), active (44% high activity), educated (69% college degree or higher), but had lower BMI and fewer with low income than FFF P. Of FFF-FU providing heights/weights at the 4 assessments, mean (SE) BMIs were 24.2 (0.5), 24.4 (0.5), 24.6 (0.6) and 25.7 (0.6) respectively. Change in BMI was significant after controlling for age, stress, ethnicity, sex, physical activity level, P treatment and engagement, but not when BL to FFU-FU change in age or perimenopausal age were controlled. The significantly greater increase in BMI for P of intervention youth than controls persisted when controlling for sociodemographic and health behavior findings, but not when BL to FFF-FU age change, perimenopausal age or activity level were controlled. Conclusions Significant weight gain by P of youth in a nutrition intervention 2 to 5 years post-study was unrelated to stress, ethnicity, activity level, income, but was related to the FFF-FU age change from BL and perimenopausal age. Funding Sources NIFA.

scholarly journals Research Design, Protocol, and Participant Characteristics of COLEAFS: A Cluster Randomized Controlled Trial of a Childcare Garden Intervention

2021 ◽  
Vol 18 (24) ◽  
pp. 13066
Author(s):  
Nilda Graciela Cosco ◽  
Nancy M. Wells ◽  
Muntazar Monsur ◽  
Lora Suzanne Goodell ◽  
Daowen Zhang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Research Design ◽  
Low Income ◽  
Controlled Trial ◽  
Childcare Centers ◽  
Randomized Controlled ◽  
Diet And Physical Activity ◽  
Cluster Randomized ◽  
Design Protocol ◽  
To Receive

Childcare garden interventions may be an effective strategy to increase fruit and vegetable (FV) consumption and physical activity among young children. The objective of this paper is to describe the research design, protocol, outcome measures, and baseline characteristics of participants in the Childcare Outdoor Learning Environments as Active Food Systems (“COLEAFS”) study, a cluster randomized controlled trial (RCT) examining the effect of a garden intervention on outcomes related to diet and physical activity. Fifteen childcare centers in low-income areas were randomly assigned to intervention (to receive garden intervention in Year 1), waitlist control (to receive garden intervention in Year 2), and control group (no intervention). The garden intervention comprised six raised beds planted with warm-season vegetables and fruits, and a garden activity booklet presenting 12 gardening activities. FV knowledge and FV liking were measured using a tablet-enabled protocol. FV consumption was measured by weighing FV before and after a snack session. Physical activity was measured using Actigraph GT3x+ worn by children for three consecutive days while at the childcare center. Of the 543 eligible children from the 15 childcare centers, 250 children aged 3–5 years received parental consent, assented, and participated in baseline data collection. By employing an RCT to examine the effect of a garden intervention on diet and physical activity among young children attending childcare centers within low-income communities, this study offers compelling research design and methods, addresses a critical gap in the empirical literature, and is a step toward evidence-based regulations to promote early childhood healthy habits.

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