Schoeny Michael E, Fogg Louis, Buchholz Susan W, Miller Arlene, Wilbur JoEllen
Rush University, College of Nursing, 600 S. Paulina St., Chicago, IL 60612, USA.
Prev Med Rep. 2016 Nov 9;5:57-64. doi: 10.1016/j.pmedr.2016.11.008. eCollection 2017 Mar.
The impact of interventions to increase physical activity (PA) may vary as a function of participants' barriers to PA. The aim of this paper is to determine whether individual barriers (demographic, physical health, psychological health, neighborhood factors, perceived barriers to PA, social support for PA) moderate treatment effects on increases in PA. Three treatment conditions tested the relative efficacy of a group-based PA intervention alone or supplemented by either personal or automated phone calls made between group meetings. From 2010 to 2012, 284 African American women (ages 40-65) living in the Chicago, IL, area were randomized to one of the three treatment conditions. Data collection occurred at baseline as well as 24 and 48 weeks after baseline. Moderation of intervention effects by barriers to PA were tested across four outcome measures (self-reported moderate-vigorous PA, self-reported walking, accelerometer steps, and aerobic fitness) using multilevel mixed-effects analyses. Significant condition by barrier interaction effects for the accelerometer steps outcome were found for material hardships, general health, depressive symptoms, neighborhood crime rate, and perceived barriers to PA. For aerobic fitness, intervention effects were moderated by material hardships and perceived pain. Increases in the outcome variables were greater for the conditions in which group sessions were supplemented with personal and/or automated calls. Among participants with greater barriers to PA, supplementing the intervention group meetings with between-session personal and/or automated phone calls may be an effective way to strengthen intervention effects. These results may inform the use of treatment supplements in the context of adaptive interventions.
增加身体活动（PA）的干预措施的效果可能会因参与者进行身体活动的障碍而有所不同。本文旨在确定个体障碍（人口统计学、身体健康、心理健康、邻里因素、对身体活动的感知障碍、对身体活动的社会支持）是否会调节对身体活动增加的治疗效果。三种治疗条件测试了单独的基于小组的身体活动干预或在小组会议之间辅以个人或自动电话的相对疗效。2010年至2012年，居住在伊利诺伊州芝加哥地区的284名非裔美国女性（年龄40 - 65岁）被随机分配到三种治疗条件之一。在基线以及基线后24周和48周进行数据收集。使用多级混合效应分析，在四项结果测量指标（自我报告的中等强度到剧烈强度的身体活动、自我报告的步行、加速度计步数和有氧适能）中测试身体活动障碍对干预效果的调节作用。对于加速度计步数这一结果，发现物质困难、总体健康状况、抑郁症状、邻里犯罪率和对身体活动的感知障碍存在显著的条件与障碍交互作用效应。对于有氧适能，干预效果受到物质困难和感知疼痛的调节。在小组会议辅以个人和/或自动电话的条件下，结果变量的增加更大。在身体活动障碍较大的参与者中，在干预小组会议之间辅以个人和/或自动电话可能是增强干预效果的有效方法。这些结果可能为适应性干预背景下治疗补充剂的使用提供参考。
