A multiple technology-based physical activity intervention for Latina adolescents in the USA: randomized controlled trial study protocol for Chicas Fuertes

Abstract

Background Latina adolescents in the USA report some of the lowest rates of physical activity of any demographic subgroup; this is paralleled by a markedly higher lifetime risk of obesity, type 2 diabetes, and other conditions related to inactivity. Despite this, to date, no fully powered clinical trials have tested physical activity interventions specifically for this population. High use of mobile technologies (including text messages, smartphone apps, and social media) suggests this could be an appropriate intervention channel, while also having potential for broad reach. This paper describes the protocol for Chicas Fuertes, a fully powered randomized trial of a mobile technology-based physical activity intervention for Latina adolescents. Methods We plan to recruit 200 Latina teens (age 13–18) in San Diego, CA, currently engaging in ≤ 150 min/week of moderate-to-vigorous physical activity (MVPA) to be assigned 1:1 to the intervention or control groups. Those randomly assigned to the intervention group receive a one-on-one goal setting session followed by 6 months of mobile technology-based intervention, including a personalized website, Fitbit activity tracker and app, individually tailored text messages based on Fitbit data, and daily intervention content on Instagram. Those randomized to the control group receive only a Fitbit activity tracker. The main outcome is change in weekly minutes of MVPA from baseline to 6 months, measured both objectively (ActiGraph accelerometers and Fitbit Inspire HR) and subjectively (7-Day Physical Activity Recall Interview). Additional outcomes are maintenance of activity change at 12 months and changes in psychosocial constructs, including social support and self-efficacy, engagement with mobile technology channels, and costs of intervention delivery. We are also examining the potential mediators and moderators of the intervention. The efficacy of the intervention is analyzed using a mixed effects regression model, adjusting for any potential confounders not balanced by randomization. All analyses of accelerometer measured MVPA are also adjusted for wear time. Discussion The Chicas Fuertes trial uses widely available mobile technologies to target critical health behavior, physical activity, in Latina teens, a population with a high lifetime risk of lifestyle-related diseases. The results will speak to the efficacy and acceptability of the intervention, which has the potential for broad dissemination. Trial registration ClinicalTrials.govNCT04190225. Registered on November 20, 2019

mHealth Targeting Physical Activity, Diet, Alcohol, and Smoking among Swedish High School Students : Processes and Outcomes of a Multiple Health Behavior Change Intervention (LIFE4YOUth)

“…A search in the literature revealed that multicomponent interventions with mHealth components involved school staff in a variety of ways-e.g., teacher-led online educational modules, face-to-face counseling regarding behavior change strategies, regular visits to school nurses aiming at boosting students' motivation, web-based material for school staff to learn about how to promote students' decision-making, workshops, and suggestions for environmental changes. These programs with mHealth components targeted physical inactivity, 94 smoking, 95 or a combination of behaviors such as physical activity and diet [96][97][98][99] or alcohol, smoking, sleep, and screen time. 100 Text messages and health applications (apps) were used to deliver the mHealth component; sometimes combined with fitness trackers and social media peer-groups.…”

“…100 Text messages and health applications (apps) were used to deliver the mHealth component; sometimes combined with fitness trackers and social media peer-groups. 95,97,[99][100][101][102][103] In contrast, stand-alone mHealth interventions require minimal efforts from school staff and do not interfere with teacher-led activities. Numerous stand-alone mHealth interventions were identified in the literature.…”

“…There are examples in the literature of tailoring strategies. For example, Larsen et al 101 used baseline data to tailor mHealth content targeting adolescents' MVPA to end-users' stage of motivational readiness, and Haug 175 and Brown 101 used a similar approach.…”