Community Walks: Clinical Trial

Multilevel Physical Activity Intervention for Low Income Public Housing Residents

This research study will investigate the independent effects of an environmental intervention (E only), an individual-level eHealth phone program intervention (I only), or both (E+I) on changes in moderate intensity physical activity. A cluster randomized design will be implemented whereby all residents of one of 12 of Boston's public housing developments (PHDs) will be randomized to one of the four study groups (E only, I only, E+I, or control). The activities with this multilevel design include:

• Screening/enrollment/baseline assessment activities
• Environmental components to promote moderate intensity walking and other physical activity at the PHDs
• Changing the environment surrounding the development making it more amenable to walking through the creation of walking trails and walking maps; and advocating for changes to the built environment
• Healthy Living Advocates (HLA)-led walking groups within the community
• Individual level components to increase motivation and self-efficacy for physical activity
• eHealth program, an automated telephone-based physical activity program
• 12-month and 24-month follow up assessment activities

The investigators hypothesize that the participants living in the PHDs 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 at 24-month follow up. It is further expected that delivery of an intervention package targeting environmental and social cues to become active, combined with an individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. The findings will inform future health promotion efforts among residents in public housing developments.

Study Overview

• Status: Completed
• Conditions: Physical Inactivity
• Intervention / Treatment: Other: Environment program; Other: eHealth phone program

• Study Type: Interventional
• Enrollment (Actual): 543
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02111
      • Tufts Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Willing to wear device to track physical activity during assessment periods
• Able to speak English or Spanish
• Current resident of Boston Public Housing Development or housing property on Boston Housing Authority owned land
• No plans to move within the next 2 years
• Has access to a phone (of any kind)

Exclusion Criteria:

• Currently enrolled in a research study about physical activity that is incompatible with study participation
• Unable to provide informed consent in judgement of research assistant

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Environmental group intervention (E only); Changing the environment surrounding the PHDs making it more amenable to walking and advocating for changes to the built environment	Other: Environment program; The environment surrounding the PHDs will be changed to make it more amenable to walking by creating walking trails and walking maps and using Healthy Living Advocates (HLA)-led walking groups within the community. Also advocating for changes to the built environment.
Experimental: Individual-level eHealth phone program intervention (I only); An automated telephone-based physical activity program.	Other: eHealth phone program; The automated eHealth phone program uses text to speech technology to deliver educational content to increase awareness, confidence, and motivation for physical activity.
Experimental: Combined group (E and I interventions); Changing the environment surrounding the PHDs making it more amenable to walking and advocating for changes to the built environment and an automated telephone-based physical activity program.	Other: Environment program; The environment surrounding the PHDs will be changed to make it more amenable to walking by creating walking trails and walking maps and using Healthy Living Advocates (HLA)-led walking groups within the community. Also advocating for changes to the built environment.; Other: eHealth phone program; The automated eHealth phone program uses text to speech technology to deliver educational content to increase awareness, confidence, and motivation for physical activity.
No Intervention: Control group (no interventions); No interventions for residents to increase activity levels.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in minutes of light, moderate, and vigorous intensity physical activity per day at 12 months	Assessed by (1) evaluating the proportion of accelerometers distributed and returned, (2) downloading the data from the devices, (3) processing the data (e.g., removing outliers), and (4) examining the proportion that have valid data (i.e., minimum 3 days of wear).	baseline, 12 months
Change in minutes of light, moderate, and vigorous intensity physical activity per day at 24 months	Assessed by (1) evaluating the proportion of accelerometers distributed and returned, (2) downloading the data from the devices, (3) processing the data (e.g., removing outliers), and (4) examining the proportion that have valid data (i.e., minimum 3 days of wear).	baseline, 24 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluate the mediator effects of motivation	This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.	baseline, 12 months, 24 months
Evaluate the mediator effects of self-efficacy	This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.	baseline, 12 months, 24 months
Evaluate the mediator effects of neighborhood walkability	This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.	baseline, 12 months, 24 months
Evaluate the mediator effects of support from HLAs	This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.	baseline, 12 months, 24 months
Evaluate the mediator effects fidelity to the interventions	This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.	baseline, 12 months, 24 months

Collaborators and Investigators

• Sponsor: Tufts Medical Center
• Collaborators: National Institute on Minority Health and Health Disparities (NIMHD)
• Investigators: Principal Investigator: Lisa M Quintiliani, PhD, Tufts Medical Center

Publications and helpful links

General Publications

• Quintiliani LM, Dedier J, Amezquita M, Sierra-Ruiz M, Romero D, Murillo J, Mahar S, Goodman M, Kane JB, Cummings D, Woolley TG, Spinola I, Crouter SE. Community Walks: a cluster randomized controlled trial of a multilevel physical activity intervention for low income public housing residents. BMC Public Health. 2023 Aug 31;23(1):1676. doi: 10.1186/s12889-023-16574-y.

Study record dates

Study Major Dates

• Study Start (Actual): May 2, 2022
• Primary Completion (Actual): March 17, 2026
• Study Completion (Actual): March 18, 2026

Study Registration Dates

• First Submitted: November 24, 2021
• First Submitted That Met QC Criteria: November 24, 2021
• First Posted (Actual): December 7, 2021

Study Record Updates

• Last Update Posted (Actual): May 5, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Public housing developments (PHDs); Environmental level interventions; Individual level interventions; eHealth phone program; Healthy living advocates
• Additional Relevant MeSH Terms: Behavior; Sedentary Behavior
• Other Study ID Numbers: H-42219; 1R01MD015165-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No