The Seamos Saludables Study

Abstract

Background Latinas in the U.S. are less physically active than non-Latino white women, and also report higher levels of diabetes, obesity, and other conditions related to inactivity. Interventions are needed to address disparities in this high-risk group. Purpose To evaluate the efficacy of a culturally adapted, Spanish-language, individually tailored, computer expert system–driven physical activity print-based intervention for adult Latinas. Design RCT. Setting/participants Participants were 266 inactive adult Latinas who participated between 2009 and 2012. Intervention Participants were randomized to one of two treatment arms: a 6-month tailored physical activity intervention condition or wellness contact control. For both conditions, print materials were delivered by mail. Main outcome measures The main outcome measure was change in weekly moderate to vigorous physical activity (MVPA) measured by the 7-Day Physical Activity Recall interview, which was administered at baseline and post-intervention (6 months). Participants also wore accelerometers for a week at baseline and follow-up. Analyses were conducted in 2013. Results Increases in minutes/week of MVPA measured by the 7-Day PAR were significantly greater in the intervention group compared to the control group (mean difference=41.36, SE=7.93, p<0.01). This difference was corroborated by accelerometer readings (rho=0.44, p<0.01). Further, results indicate that intervention participants had greater increases in self-efficacy, cognitive processes and behavioral processes at 3 months compared to control paricipants (p’s<0.05). Conclusions The tailored Spanish-language intervention was effective in increasing MVPA among predominantly low-income, less-acculturated Latinas. Such print-based interventions are poised for widespread dissemination, and thus may help address health disparities.

Long-term Surveillance of Physical Activity Habits of Latinas Enrolled in a 12-Month Physical Activity Intervention

“…19,20 Adult women (aged 18 to 65 years) who self-identified as Hispanic or Latina, could read and write in Spanish, and were underactive (<60 minutes of MVPA/week) were recruited for participation in the trial. A total of 132 participants (mean age = 41.6 + 10.1 years; mean body mass index = 25.6+4.3 kg/m 2 ) were randomized to a 12 month print-based physical activity intervention.…”

“…19,20 In an effort to more clearly understand the impact of individual components of the intervention, all participants were asked to wear a physical activity monitor (Omron HJ 720-ITC, Omron Health Care, Inc.) every day for 12 months that measured total steps and moderate intensity aerobic steps (100+ steps/minute) at both hourly and daily intervals. This detailed, longitudinal surveillance data will allow us to examine individual variability of physical activity over the course of an entire year.…”

Twelve-Month Physical Activity Outcomes in Latinas in the Seamos Saludables Trial

“…Six-month main trial MVPA outcomes and a description of the protocol are reported elsewhere. 15,16 Intervention participants ( n =132) received materials through the mail 11 times during the first 6 months, then booster doses at 8, 10, and 12 months, with a final assessment at 12 months. Spanish-language materials were individually tailored based on participants’ responses to monthly questionnaires about their thoughts, feelings, and behaviors surrounding MVPA, and were culturally adapted for Latinas based on extensive formative research (e.g., translation/back-translation, focus groups on barriers/intervention preferences for Latinas, cognitive interviews to ensure translation of key intervention messages, adaption of materials for low literacy levels 17 .…”

“…Nearly half (46%) had some college education, 25% did not finish high school, and 53.6% had a yearly family income <$20,000. A full description of the study sample is published elsewhere (Pekmezi et al, 16 Marcus and colleagues 15 ). Of the 266 randomized participants, 215 (81%) provided data at 12 months.…”

“…15 After 6 months, those randomized to the intervention condition reported significantly more MVPA than a contact control group. Following the main trial, completion of the program was tapered, with participants receiving doses of intervention until a final 12-month assessment.…”