Promoting Physical Activity in a Spanish-Speaking Latina Population of Low Socioeconomic Status With Chronic Neurological Disorders: Proof-of-Concept Study (Preprint)

Abstract

BACKGROUND Physical activity is known to improve quality of life as well as reduce mortality and disease progression in individuals with chronic neurological disorders. However, Latinas are less likely to participate in recommended levels of physical activity due to common socioeconomic barriers including limited resources and access to exercise programs. Therefore, we developed a community-based intervention with activity-monitoring and behavioral coaching to target these barriers and facilitate sustained participation in an exercise program promoting physical activity. OBJECTIVE To determine the feasibility and efficacy of a community-based intervention to promote physical activity (PA) through self-monitoring via a Fitbit and behavioral coaching in Latina participants with chronic neurological disorders. METHODS We conducted a proof-of-concept study in 21 Spanish-speaking Latina participants recruited from the Los Angeles County/ University of Southern California (LAC/USC) neurology clinic and enrolled in the 16-week intervention at The Wellness Center at The Historic General Hospital. Demographic data was assessed at baseline. Feasibility was defined by participant attrition and Fitbit adherence. Physical activity promotion was determined by examining change in time spent performing moderate-vigorous physical activity (MVPA) over the 16-week period. The effect of behavioral coaching was assessed by quantifying the difference in MVPA on days coaching occurred vs. days without coaching. Change in psychometric measures (baseline vs. post-intervention) and medical center visits (16-weeks pre-intervention vs. during intervention) were also examined. RESULTS Participants were of low socioeconomic status and acculturation. 19 participants completed the study (attrition 9.5%) with high Fitbit wear adherence (90.31%). Time performing moderate-vigorous physical activity (MVPA) significantly increased throughout the study (P<0.001). Behavioral coaching enhanced intervention effectiveness as evidenced by a higher time spent in MVPA on days coaching occurred. Participants’ illness perception (Effect Size g=.30), self-rated quality-of-life (Effect Size g=.32), and medical center visit frequency (Effect Size r =.44) improved. CONCLUSIONS Self-monitoring with behavioral coaching is a feasible community-based intervention for PA promotion in low socioeconomic Latinas with chronic neurological conditions. PA is known to be important in brain health in neurological conditions but remains relatively unexplored in minority populations. CLINICALTRIAL Clinicaltrials.gov; NCT04820153