The Challenges of Study Design, Implementaiton, and Data

The Challenges of Study Design, Implementaiton, and Data

The Challenges of Study Design, Implementation, and Data Collection for Physical activity in Urban Latino Neighborhoods in the United States, Colombia, Mexico, and Brazil
Active Living Research Annual Conference
International Symposium
March 9th, 2014 Physical Inactivity in the World
z Not just a first‐world problem
z 9% of premature deaths worldwide (5.3 million)
z Similar to tobacco
z Responsible for ≥15% of all cause mortality in countries as diverse as Argentina, Saudi Arabia, Namibia, Turkey, Japan, Dominican Republic, Malaysia, and the UK
z Why try to change it?
z 25% reduction in inactivity = 1.3 million lives saved
z Even making a dent makes a big difference!
Inactivity in Latinos
z Inactivity‐related deaths are among the highest in Latin America
z In the U.S., Latinos report high levels of physical inactivity (59.8% vs. 47.4% in Non‐Latino Whites)
Unique Challenges
z Heterogeneity of subgroups
z Inactivity varies greatly (66% in Cubans vs. 47% in Mexicans)
z Diverse cultural influences on behavior
z Translating isn’t enough!
z Varying levels of acculturation within groups
Environmental Barriers
z Transportation
z Walkable neighborhoods
z Safety
z Heat z Immigration worries
Incorporating Technology
z “Digital Divide”
z Differs by media channel
z Web vs. cell phones vs. smart phones
z Cultural preferences for technology use
Men?
z What about Latino men? z 80% overweight or obese in US
z Excluded from most interventions
z Gender & cultural adaptations
z Qualitative interviews
z Demonstration trial of modified intervention
z Follow‐up interviews
z Technology‐based intervention?
The Challenges of Study Design, Implementation, and Data Collection for Physical activity in Urban Latino Neighborhoods in the United States, Colombia, Mexico, and Brazil
Chair: Bess Marcus, Ph.D., University of California, San Diego
Speakers:
Rodrigo Reis, PhD, Pontiff Catholic University of Parana, Curitiba, Brazil
Deborah Salvo, PhD, Stanford University, California, and National Public Health Institute, Cuernavaca, Mexico
Olga Lucia Sarmiento, MD, PhD, los Andes University, Bogota, Colombia
Elva Arredondo, PhD, San Diego State University
Seamos Activas
z Culturally adapted print‐based individually tailored physical activity intervention
z Mostly Colombian, Dominican, Puerto Rican women
z Cultural adaption
z Translation & back‐translation
z 25 cognitive interviews
z Focus groups to identify cultural themes
R21 NR009864 SEAMOS ACTIVAS
160
147.27 (241.55)
140
PA Minutes/Week
120
96.79 (118.49)
100
80
Intervention
Control
60
40
20
16.56 (25.76)
11.88 (21.99)
0
Baseline
Time
6 Months
Pekmezi, D. W., et al. (2009). A culturally adapted physical activity intervention for Latinas: A randomized controlled trial. American Journal of Preventive Medicine, 37(6): 495‐500.
R21NR009864
Seamos Saludables
z Primary Aim: To test the efficacy of a culturally adapted print‐based individually tailored physical activity intervention in fully‐powered RCT
z First PA intervention with Latinas using mailed printed intervention materials
z Effective in hard‐to‐reach groups: majority of the women were low income, first generation, low acculturation
z Next step: incorporating technology with web‐based activity intervention with Latinas
R01NR011295
SEAMOS SALUDABLES 160
140
PA Minutes/Week
120
100
80
71.66 (89.73)*
60
40
29. 58 (82.82)
Intervention
20
1.87 (6.86)
0
Baseline
Control
3.02 (10.30)
Time
6 Months
Marcus BH, Dunsiger SI, Pekmezi DW, et al. (2013). The Seamos Saludables study: A randomized controlled physical activity trial of Latinas. American Journal of Preventive Medicine , 45(5):598‐605. * p < .01
R01NR011295
Pasos Hacia La Salud
z Culturally adapted web‐based physical activity intervention
z All Mexican American women
z Adaptations for technology AND cultural differences
R01CA159954
Pasos Hacia La Salud Homepage ACTIVO
PA Minutes/Week
125.7 (154.86)
1.5 (4.74)
Time
Larsen BA, Dunsiger SI, Hartman S, et al. (In Press). Activo: Assessing the feasibility of designing and implementing a physical activity intervention for Latino men. International Journal of Men’s Health. Lingering Issues
z Recruitment & retention of “hard to reach” populations
z Targeting multiple behaviors
z Diet
z Sedentary Behavior
z Beyond leisure time physical activity
z Whole family activity