Virtual Advisors for Physical Activity Promotion in Aging Latino Communities BACKGROUND: Aging Latino adults suffer disproportionately from a number of chronic conditions (e.g., diabetes, obesity) improved by increased physical activities (PA) such as walking. Due to language, education, computer, and health literacy barriers, older Latino adults often cannot readily access typical health promotion programs offered in-person or online in U.S. communities. Lay health advisors ("promoters" in Spanish) offer a nationally recognized, culturally tailored and cost-efficient health behavior change model for Latino communities. However, as with all "human" delivered health programs, they impose constraints on participant schedules, and, even with careful intervention fidelity procedures in place, some variability in program delivery across advisors is inevitable. Computer-based culturally tailored physical activity advisor programs can potentially reduce human- to-human scheduling and fidelity constraints and extend program reach. In a recently completed 4- month experiment, a computer-based bilingual Virtual Advisor with touch-screen interactivity (no keyboard or mouse needed) was housed in a community center and programmed to tailor PA advice to the needs and preferences of low-income, aging Latino adults. The Virtual Advisor program successfully increased regular walking levels in participants compared to a health education control. OBJECTIVE: The primary study aim is to conduct a comparative effectiveness trial evaluating the 12- month impacts of the community-based Virtual Advisor PA program relative to a proven Lay Advisor program in a broader population of aging Latino adults. The secondary aim is to determine the comparative cost effectiveness of the Virtual vs. Lay Advisor programs. DESIGN: The 12-month randomized trial will enroll inactive Latino adults ages 55 years and older living near 16 neighborhood community centers (n=265/arm;530 total). The primary outcome is minutes of walking per week, and additional outcomes of interest include BMI, sedentary behavior, functional performance, and health- related quality of life. Additional areas of investigation are to evaluate theoretically based and empirically supported moderators and mediators of intervention success and determine the potential generalizability of the interventions. IMPACT: The study seeks to demonstrate that a computer-based Virtual Advisor tailored to the needs of aging Latino adults can provide an effective and potentially cost-efficien alternative to Lay Advisors in community settings frequented by this population. The potential extended reach of such programs for use in a range of community settings (e.g., clinics, pharmacies, libraries) provides substantial promise for positively impacting the current health disparities gap.

Public Health Relevance

While there has been an explosion of computerized health promotion programs to increase regular physical activity-a key health behavior linked with the prevention and control of our nation's major killers--few have been adapted to the needs and preferences of low-income Latino adults. This research aims to evaluate the effectiveness of a computer-based 'virtual lay advisor'relative to a proven human lay advisor program-both delivered at local community centers--in promoting regular walking among inactive midlife and older Latino adults. The Virtual Advisor program represents a potentially low-cost alternative to person-delivered health promotion programs that could be translated for use in a range of community settings (e.g., clinics, pharmacies, libraries).

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL116448-01A1
Application #
8503069
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Boyington, Josephine
Project Start
2013-08-15
Project End
2017-06-30
Budget Start
2013-08-15
Budget End
2014-06-30
Support Year
1
Fiscal Year
2013
Total Cost
$750,675
Indirect Cost
$178,995
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305