This research study will investigate the independent effects of an environmental intervention (E only), an individual-level eHealth phone program intervention (I only), or both (E+I) on changes in moderate intensity physical activity. A cluster randomized design will be implemented whereby all residents of one of 12 of Boston's public housing developments (PHDs) will be randomized to one of the four study groups (E only, I only, E+I, or control). The activities with this multilevel design include: * Screening/enrollment/baseline assessment activities * Environmental components to promote moderate intensity walking and other physical activity at the PHDs * Changing the environment surrounding the development making it more amenable to walking through the creation of walking trails and walking maps; and advocating for changes to the built environment * Healthy Living Advocates (HLA)-led walking groups within the community * Individual level components to increase motivation and self-efficacy for physical activity * eHealth program, an automated telephone-based physical activity program * 12-month and 24-month follow up assessment activities The investigators hypothesize that the participants living in the PHDs in any of the three intervention groups (E only, I only, and E+I combined) will increase minutes of moderate intensity physical activity more than participants in control group developments at 24-month follow up. It is further expected that delivery of an intervention package targeting environmental and social cues to become active, combined with an individual level intervention, will improve overall physical activity levels to recommended guidelines at the development level. The findings will inform future health promotion efforts among residents in public housing developments.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
543
The automated eHealth phone program uses text to speech technology to deliver educational content to increase awareness, confidence, and motivation for physical activity.
The environment surrounding the PHDs will be changed to make it more amenable to walking by creating walking trails and walking maps and using Healthy Living Advocates (HLA)-led walking groups within the community. Also advocating for changes to the built environment.
Tufts Medical Center
Boston, Massachusetts, United States
Change in minutes of light, moderate, and vigorous intensity physical activity per day at 12 months
Assessed by (1) evaluating the proportion of accelerometers distributed and returned, (2) downloading the data from the devices, (3) processing the data (e.g., removing outliers), and (4) examining the proportion that have valid data (i.e., minimum 3 days of wear).
Time frame: baseline, 12 months
Change in minutes of light, moderate, and vigorous intensity physical activity per day at 24 months
Assessed by (1) evaluating the proportion of accelerometers distributed and returned, (2) downloading the data from the devices, (3) processing the data (e.g., removing outliers), and (4) examining the proportion that have valid data (i.e., minimum 3 days of wear).
Time frame: baseline, 24 months
Evaluate the mediator effects of motivation
This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.
Time frame: baseline, 12 months, 24 months
Evaluate the mediator effects of self-efficacy
This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.
Time frame: baseline, 12 months, 24 months
Evaluate the mediator effects of neighborhood walkability
This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.
Time frame: baseline, 12 months, 24 months
Evaluate the mediator effects of support from HLAs
This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.
Time frame: baseline, 12 months, 24 months
Evaluate the mediator effects fidelity to the interventions
This outcome will be assessed by analyzing participants' responses to relevant questions in an Investigator developed questionnaire.
Time frame: baseline, 12 months, 24 months
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