Sedentary lifestyle is directly associated with disease and reduced quality of life. While the general United States population is suffering from an epidemic of sedentary lifestyle, Latinos are even more sedentary than their non-Hispanic white counterparts. Notably, Latinos suffer from greater rates of morbidity and mortality of conditions associated with being sedentary than non-Hispanic whites. One concern is that due to cultural artifacts, socioeconomic circumstances, and language barriers, Latinos have limited access to public health interventions that promote active lifestyles. Modern behavioral informatics interventions that use theory-based computer-run expert systems show great promise to provide more effective interventions for hard-to-reach populations at lower cost. The present application is in response to PA-04-153, 'Health Disparities Among Minority and Underserved Women.' We aim to both culturally and linguistically modify an evidence-based, inidvidually tailored intervention, founded on the Transtheoretical Model and Social Cognitive Theory, to target sedentary Latinas. This print-based, expert system intervention has been developed and tested by Dr. Bess Marcus and her team, who have spent 18 years developing programs to increase physical activity in sedentary adults. The study will involve two phases: 1) a formative research period in which 100 Latinas will be recruited to provide data on how to modify the current tailored intervention to be culturally congruent and 2) a pilot randomized trial with 80 recruited Latinas to test the modified intervention against off-the-shelf bilingual health educational materials for Latinas. The formative research phase will involve an iterative process of qualitative data collection and intervention modification, with: 1) translation from English to Spanish; 2) an initial round of exploratory focus groups to obtain data on unique themes to include in the modified intervention; 3) a second round of confirmatory focus groups to examine responses to modified intervention materials; and 4) a series of intensive individual cognitive interviews to examine readability and comprehension, consistency of perception of materials with theory, and conceptual integrity of the intervention materials across English and Spanish. The pilot study will provide data on feasibility as well as on effect size of the modified intervention to inform a future clinical trial. Secondary analyses will explore differences in intervention effect based on levels of acculturation and of ethnic identity. ? ? ? ?
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