Boston University, Chobanian and Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.
Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Boston, MA, 02118, USA.
BMC Public Health. 2023 Aug 31;23(1):1676. doi: 10.1186/s12889-023-16574-y.
Physical activity behavioral interventions to change individual-level drivers of activity, like motivation, attitudes, and self-efficacy, are often not sustained beyond the intervention period. Interventions at both environmental and individual levels might facilitate durable change. This community-based study seeks to test a multilevel, multicomponent intervention to increase moderate intensity physical activity among people with low incomes living in U.S. public housing developments, over a 2 year period.
The study design is a prospective, cluster randomized controlled trial, with housing developments (n=12) as the units of randomization. In a four-group, factorial trial, we will compare an environmental intervention (E) alone (3 developments), an individual intervention (I) alone (3 developments), an environmental plus individual (E+I) intervention (3 developments), against an assessment only control group (3 developments). The environmental only intervention consists of community health workers leading walking groups and indoor activities, a walking advocacy program for residents, and provision of walking maps/signage. The individual only intervention consists of a 12-week automated telephone program to increase physical activity motivation and self-efficacy. All residents are invited to participate in the intervention activities being delivered at their development. The primary outcome is change in moderate intensity physical activity measured via an accelerometer-based device among an evaluation cohort (n=50 individuals at each of the 12 developments) from baseline to 24-month follow up. Mediation (e.g., neighborhood walkability, motivation) and moderation (e.g., neighborhood stress) of our interventions will be assessed. Lastly, we will interview key informants to assess factors from the Consolidated Framework for Implementation Research domains to inform future implementation.
We hypothesize participants living in developments in any of the three intervention groups (E only, I only, and E+I combined) will increase minutes of moderate intensity physical activity more than participants in control group developments. We expect delivery of an intervention package targeting environmental and social factors to become active, combined with the individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. If effective, this trial has the potential for implementation through other federal and state housing authorities.
Clinical Trails.gov PRS Protocol Registration and Results System, NCT05147298 . Registered 28 November 2021.
改变个体活动驱动因素的体育活动行为干预，如动机、态度和自我效能感，往往在干预期后无法持续。环境和个体层面的干预措施可能会促进持久的改变。本社区研究旨在测试一项多层次、多成分的干预措施，以增加美国公共住房开发项目中低收入人群的中等强度体力活动，为期 2 年。
研究设计是一项前瞻性、集群随机对照试验，以住房开发项目（n=12）为随机分组单位。在四组、析因试验中，我们将单独比较环境干预（E）（3 个开发项目）、个体干预（I）（3 个开发项目）、环境加个体（E+I）干预（3 个开发项目），以及仅评估对照组（3 个开发项目）。环境干预仅包括社区卫生工作者带领步行小组和室内活动、为居民开展的步行宣传计划以及提供步行地图/标志。个体干预仅包括一个为期 12 周的自动电话程序，以提高身体活动动机和自我效能感。所有居民都被邀请参加在其开发项目中提供的干预活动。主要结局是通过基于加速度计的设备评估评估队列（n=12 个开发项目中的每个开发项目 50 名个体）从基线到 24 个月随访期间的中等强度体力活动变化。将评估我们干预措施的中介（例如，邻里可步行性、动机）和调节（例如，邻里压力）。最后，我们将采访主要知情人，评估综合实施研究领域框架的因素，为未来的实施提供信息。
我们假设居住在任何三个干预组（仅 E、仅 I 和 E+I 联合）的开发项目中的参与者比对照组开发项目中的参与者将增加中等强度体力活动的分钟数。我们预计，针对环境和社会因素的干预方案的实施，结合个体层面的干预措施，将提高开发项目层面的总体体力活动水平，达到推荐指南。如果有效，该试验有可能通过其他联邦和州住房管理局实施。
Clinical Trails.gov PRS 方案注册和结果系统，NCT05147298。于 2021 年 11 月 28 日注册。
