Efficacy of a multi-component intervention to promote physical activity among Latino adults: A randomized controlled trial

Tracie C Collins, Liuqiang Lu, M Gabriela Valverde, M Ximena Silva, Deborah Parra-Medina, Tracie C Collins, Liuqiang Lu, M Gabriela Valverde, M Ximena Silva, Deborah Parra-Medina

Abstract

Physical inactivity is highly prevalent in Latinos. Use of smartphone technology may improve physical activity (PA) among Latino adults. We sought to determine the efficacy of a multi-component intervention to promote PA among Latino adults. We conducted a 3-month, 2-arm randomized trial among Latino adults with one or more risk factors for cardiovascular disease (CVD). We adapted a scripted, counseling approach into text messages and combined this intervention with brief motivational interviewing delivered by telephone. We compared this intervention to a control group. Both groups received a handout on the benefits of PA. During the baseline visit, participants completed a validated medical history survey as well as an assessment of quality of life and exercise behaviors. The primary outcome was change at three months in mean steps per week. We enrolled 69 patients, 35 in the intervention arm and 34 in the control arm. The mean age of the cohort was 58.7 years (SD 6.82). At baseline, mean steps per week were 65,218.2 (SD 25420.8) for intervention participants compared to 71,581.26 (SD 26118.07) for control participants, P = 0.36. At 3 months, the change in mean steps per week was 31,184.6 (SD 26121.52) for participants randomized to the intervention compared to 15,370.9 (SD 22247.84) for those randomized to control, P = 0.045. Among Latino adults with one or more risk factors for CVD, there was an increase in mean steps per week among those randomized to an intervention, involving the use of smartphones, versus control.

Clinical trial registration: https://ichgcp.net/clinical-trials-registry/NCT02622282" title="See in ClinicalTrials.gov">NCT02622282.

Keywords: Atherosclerotic risk factors; Exercise behaviors; Latino adults; Text messaging.

Figures

Fig. 1
Fig. 1
Consort diagram.
Fig. 2
Fig. 2
Error bars indicate 95% Cls. a. There was a significant difference between participants randomized to the control group who did not graduate from high school versus persons in the intervention group with the same level of education (mean difference = 44,275, p-value = 0.035). Similarly, the difference in mean steps at three months was significantly different for participants randomized to the control group who did not graduate from high school compared to participants in the intervention group who graduated from high school (mean difference = 29,886, p-value = 0.042).
Fig. 3
Fig. 3
Error bars indicate 95% Cls. a. For participants whose spoken language was English, there was significant difference between those in the control group versus intervention in mean change in steps at three months (mean difference = 37,609, p-value = 0.048).

References

    1. Buchholz S.W., Wilbur J., Ingram D., Fogg L. Physical activity text messaging interventions in adults: a systematic review. Worldviews Evid.-Based Nurs. 2013;10(3):163–173.
    1. Burke B.L., Arkowitz H., Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J. Consult. Clin. Psychol. 2003;71(5):843–861.
    1. Butler C.C., Rollnick S., Cohen D., Russell I., Bachmann M., Stott N. Motivational consulting versus brief advice for smokers in general practice: a randomized trial. Br. J. Gen. Pract. 1999;49:611–616.
    1. Collins T., Petersen N., Suarez-Almazor M., Ashton C. The prevalence of peripheral arterial disease in a racially diverse population. Arch. Intern. Med. 2003;163:1469–1474.
    1. Collins T., O'Malley K., Petersen N., Suarez-Almazor M. The lifestyle and clinical survey: a pilot study to validate a medical history questionnaire. Fed. Pract. 2005;22(5):25–46.
    1. Collins T.C., Lunos S., Carlson T., Henderson K., Lightbourne M., Nelson B. Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: a randomized controlled trial. Diabetes Care. 2011;34(10):2174–2179.
    1. Collins T.C., Dong F., Ablah E., Parra-Medina D., Cupertino P., Rogers N. Text messaging to motivate exercise among Latino adults at risk for vascular disease: a pilot study, 2013. Prev. Chronic Dis. 2014;11:E192.
    1. Daviglus M.L., Talavera G.A., Aviles-Santa M.L., Allison M., Cai J., Criqui M.H. Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA. 2012;308(17):1775–1784.
    1. Dunn C., Deroo L., Rivara F.P. The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction. 2001;96(12):1725–1742.
    1. Fanning J., Mullen S.P., McAuley E. Increasing physical activity with mobile devices: a meta-analysis. J. Med. Internet Res. 2012;14(6)
    1. Fortmann A.L., Gallo L.C., Garcia M.I., Taleb M., Euyoque J.A., Clark T. Dulce digital: an mHealth SMS-based intervention improves glycemic control in Hispanics with type 2 diabetes. Diabetes Care. 2017;40(10):1349–1355.
    1. Hu J., Wallace D.C., Amirehsani K.A., McCoy T.P., Coley S.L., Wiseman K.D. Improving physical activity in Hispanics with diabetes and their families. Public Health Nurs. 2015;32(6):625–633.
    1. Joseph R.P., Royse K.E., Benitez T.J. A systematic review of electronic and mobile health (e- and mHealth) physical activity interventions for African American and Hispanic women. J. Phys. Act. Health. 2019;16(3):230–239.
    1. Lorig K, Stewart A, Ritter P, Gonzalez V, Laurent D, Lynch J. Outcome Measures for Health Education and Other Health Care Interventions. Standford Chronic Disease Self-management Study. Thousand Oaks, Calif: Sage Publications; vol. 1996: 24–5.
    1. Marcus B.H., Hartman S.J., Larsen B.A., Pekmezi D., Dunsiger S.I., Linke S. Pasos Hacia La Salud: a randomized controlled trial of an internet-delivered physical activity intervention for Latinas. Int. J. Behav. Nutr. Phys. Act. 2016;13:62.
    1. Miller W., Rollnick S. Guilord Press; New York: 1991. Motivational Interviewing: Preparing People to Change Addictive Behavior.
    1. Miller W., Rollnick S. Second ed. The Guilford Press; New York: 2002. Motivational Interviewing: Preparing People for Change.
    1. NCHS NHIS . Sample Adult Core component. 2017. January–September.
    1. Ogedegbe G., Schoenthaler A., Richardson T., Lewis L., Belue R., Espinosa E. An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: rationale and design. Contemp. Clin. Trials. 2007;28(2):169–181.
    1. Osborn C.Y., Amico K.R., Cruz N., O'Connell A.A., Perez-Escamilla R., Kalichman S.C. A brief culturally tailored intervention for Puerto Ricans with type 2 diabetes. Health Educ. Behav. 2010;37(6):849–862.
    1. Park L.G., Beatty A., Stafford Z., Whooley M.A. Mobile phone interventions for the secondary prevention of cardiovascular disease. Prog. Cardiovasc. Dis. 2016;58(6):639–650.
    1. Patrick K., Sallis J., Long B., Calfas K., Wooten W., Heath G. A new tool for encouraging activity: project PACE. Physician Sportsmed. 1994;22(11):45–52.
    1. Pew Internet. 2010.
    1. Prochaska J.O., DiClemente C.C. Stages and processes of self-change of smoking: toward an integrative model of change. J. Consult. Clin. Psychol. 1983;51(3):390–395.
    1. Resnicow K., Davis R.E., Zhang G., Konkel J., Strecher V.J., Shaikh A.R. Tailoring a fruit and vegetable intervention on novel motivational constructs: results of a randomized study. Ann. Behav. Med. 2008;35(2):159–169.
    1. Stevens L.M., Lymn C., Glass R.M. JAMA patient page. Peripheral arterial disease. JAMA. 2006;295(5):584.
    1. Unal E., Giakoumidakis K., Khan E., Patelarou E. Mobile phone text messaging for improving secondary prevention in cardiovascular diseases: a systematic review. Heart Lung. 2018;47(4):351–359.
    1. Ware J.E., Snow K.K., Kosinski M., Gandek B. Quality Metric Incorporated; Lincoln, RI: 2000. SF-36 Health Survey: Manual and Interpretation Guide.

Source: PubMed

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