In the U.S., Latinas report high rates of inactivity and related conditions (obesity, diabetes). Effective interventions that leverage state-of-the-art theory and methods are needed to address such health disparities. We recently conducted a randomized controlled trial of a culturally/linguistically adapted, print-based, mail- delivered physical activity (PA) intervention for Latinas (Seamos Saludables, R01 NR011295), in which participants (N=266) received either individually tailored PA intervention materials based on the Transtheoretical Model and Social Cognitive Theory, or printed wellness materials. Changes in moderate to vigorous PA (MVPA) were significantly greater in the intervention arm from baseline to six months (1.87 min/week to 73.37 min/week) than the control arm (3.02 min/week to 32.98 min/week). These increases were maintained at 12 months and mediated by changes in psychosocial constructs targeted by the intervention. A renewal of R01NR011295 is proposed to replicate these findings in Mexican Americans (who comprised only 5% of the original sample but most of US Latino population), explore its clinical potential in preventing and managing chronic disease, and to improve the intervention's effectiveness by incorporating participant feedback (desire for increased interactivity and accountability), further targeting SCT constructs that were overall not influenced by the original intervention yet improved amongst the most successful participants (social support and outcome expectancies), and responding to changing trends and technology use in the Latino population (adding text messaging). In the proposed study, 250 Mexican American women will be randomized to either 1) the original, empirically supported Seamos Saludables tailored print intervention or 2) the technology and theory-enhanced version of the Seamos Saludables intervention. Data will be collected at baseline, 6 months (post-treatment), and 12 months (maintenance) using well-established objective (accelerometers) and subjective (7 Day PAR) PA measures, as well as a comprehensive set of psychosocial questionnaires. We hypothesize that at the end of treatment (month six) the Enhanced Tailored Intervention participants will report significantly more minutes/week of MVPA than the Original Tailored Intervention participants. We will also examine changes in cardiovascular and metabolic biomarkers (fasting blood glucose, HbA1c, triglycerides, LDL, HDL, HS-CRP), maintenance of treatment effects at 12 months, costs of delivering the enhanced vs. original intervention programs, potential mediators and moderators of the intervention- physical activity relationship, and will also compare the efficacy of the original Seamos Saludables program in Mexican American women to results in the original population (who were mostly Dominican, Colombian, and Puerto Rican). Such high-reach, low-cost strategies for promoting physical activity have great potential for adoption on a larger scale and could have a large impact on reducing health disparities.

Public Health Relevance

Latinas report high rates of inactivity and related health conditions, and are in need of high reach, low burden, culturally and linguistically adapted physical activity interventions. The proposed study will strengthen the power and reach of an existing physical activity intervention for Latinas by increasing the intervention's efficacy, incorporating new technology, expanding its reach by replicating it in Mexican American women, and exploring its clinical potential by measuring changes in cardiovascular and metabolic biomarkers. The proposed high reach, low cost strategy for increasing physical activity has great potential for adoption on a larger scale and thereby positively impacting public health and eliminating health disparities.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
Project #
Application #
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Roary, Mary
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California, San Diego
Family Medicine
Schools of Medicine
La Jolla
United States
Zip Code
Marquez, Becky; Dunsiger, Shira I; Pekmezi, Dori et al. (2016) Social support and physical activity change in Latinas: Results from the Seamos Saludables trial. Health Psychol 35:1392-1401
Carr, Lucas J; Dunsinger, Shira; Marcus, Bess H (2016) Long-term Surveillance of Physical Activity Habits of Latinas Enrolled in a 12-Month Physical Activity Intervention. J Phys Act Health 13:740-6
Larsen, Britta; Gilmer, Todd; Pekmezi, Dori et al. (2015) Cost effectiveness of a mail-delivered individually tailored physical activity intervention for Latinas vs. a mailed contact control. Int J Behav Nutr Phys Act 12:140
Dominick, Gregory M; Dunsiger, Shira I; Pekmezi, Dorothy W et al. (2015) Moderating Effects of Health Literacy on Change in Physical Activity Among Latinas in a Randomized Trial. J Racial Ethn Health Disparities 2:351-7
Daiello, Lori A; Gongvatana, Assawin; Dunsiger, Shira et al. (2015) Association of fish oil supplement use with preservation of brain volume and cognitive function. Alzheimers Dement 11:226-35
Marcus, Bess H; Dunsiger, Shira I; Pekmezi, Dorothy W et al. (2013) The Seamos Saludables study: A randomized controlled physical activity trial of Latinas. Am J Prev Med 45:598-605
Pekmezi, Dori; Dunsiger, Shira; Gans, Kim et al. (2012) Rationale, design, and baseline findings from Seamos Saludables: a randomized controlled trial testing the efficacy of a culturally and linguistically adapted, computer- tailored physical activity intervention for Latinas. Contemp Clin Trials 33:1261-71
Wen, Xiaozhong; Chen, Weiqing; Gans, Kim M et al. (2010) Two-year effects of a school-based prevention programme on adolescent cigarette smoking in Guangzhou, China: a cluster randomized trial. Int J Epidemiol 39:860-76