Cardiovascular diseases (CVD) comprise the leading cause of mortality worldwide, accounting for 3 in 10 deaths. Individuals with certain risk factors, including tobacco use, obesity, low levels of physical activity, type 2 diabetes mellitus, racial/ethnic minority status and low socioeconomic status, experience higher rates of CVD and are, therefore, considered priority populations. Technological devices such as computers and smartphones are now routinely utilized in research studies aiming to prevent CVD and its risk factors, and they are also rampant in the public and private health sectors. Traditional health behavior interventions targeting these risk factors have been adapted for technology-based approaches. This review provides an overview of technology-based interventions conducted in these priority populations as well as the challenges and gaps to be addressed in future research. Researchers currently possess tremendous opportunities to engage in technology-based implementation and dissemination science to help spread evidence-based programs focusing on CVD risk factors in these and other priority populations.

Objective

To evaluate the efficacy of a brief telephone-delivered Motivational Interviewing (MI)-based intervention to facilitate engagement in evidence-based cessation treatment for Veterans with mental illness referred to smoking cessation treatment.

Methods

86 military Veteran smokers with mental illness were recruited from a tobacco cessation consult clinic and randomized to receive either a MI-based treatment engagement intervention (TE; n = 48) or a non-MI assessment and information control (CON; n = 38) condition. Intervention was delivered during a single brief telephone contact. Primary engagement outcomes were 1) attending a treatment session within 30 days and 2) combination treatment (attending session plus using pharmacotherapy). Cessation outcomes included self-reported 24 h cessation attempts and 7 day point abstinence at 3 months post-intervention. Outcomes were assessed at 1 and 3 months post intervention.

Results

Outcome analyses included 85 participants (47 TE, 38 CON) using an intent-to-treat analytic approach. Participants were on average 49.5 (13.4) years old, 88% Male, 59% white, 18% African American and 14% Hispanic/Latino(a). Following intervention delivery TE and CON participants did not differ on likelihood of attending a treatment session during the subsequent 30 days (47% vs 45%, respectively). A significant difference was observed when classified as utilizing combination treatment, 40% of TE versus 18% of CON reported use of smoking cessation medication and behavioral counseling (p = 0.04). No statistical differences were observed for cessation outcomes, although more TE than CON participants reported 7 day point abstinence at 3 months post-intervention (30% vs 18%).

Conclusions

The present pilot study provides initial evidence for the feasibility, acceptability and efficacy of a telephone delivered TE intervention for enhancing engagement in combinationevidence evidence-based treatment in a sample of Veteran smokers with mental illness referred to smoking cessation treatment. Smokers with mental illness typically have greater difficulty stopping smoking than those without mental illness. Increased engagement in combination treatment thus has the potential to increase quit rates and ultimately reduce the burden of tobacco use for this population.

Background

A growing literature addresses the need to reduce cigarette smoking prevalence by increasing the use of assistance when quitting. A key focus is to identify strategies for enhancing adoption of effective interventions in order to increase utilization of evidence-based treatments.

Purpose

To examine the effect of beliefs regarding ability to quit on utilization of assistance for smoking cessation. A mediation model was hypothesized whereby the relationship between smoking and use of assistance is influenced by beliefs in ability to quit.

Methods

The present study includes 474 of 1000 respondents to baseline and follow-up California Smokers Cohort surveys conducted from 2011 to 2013. Included were baseline smokers who reported a 24-h quit attempt at follow-up. Baseline variables were used to predict use of assistance when quitting.

Results

The hypothesized model was tested using a product of coefficients method, controlling for demographics. Greater heaviness of smoking and lower belief in ability to quit were significantly related to use of assistance. Quitting beliefs significantly mediated the relationship between nicotine dependence and use of assistance.

Conclusions

The present data support a mechanism whereby the effect of smoking rate on treatment utilization is mediated by beliefs in ability to quit. Greater belief in one's ability to quit may represent an obstacle to treatment utilization by reducing the likelihood of successful cessation. The present findings suggest the value of targeted messages from health care providers that normalize the need for assistance when attempting to change an addictive behavior and emphasize the difficulty of quitting without assistance.

Internet-based interventions show promise as an effective channel for promoting physical activity. However, a paucity of research has been conducted among underserved groups despite recent increases in Internet access and physical activity-related health disparities in these communities. Thus, the current randomized controlled trial will test the efficacy of an individually tailored, Internet-based physical activity intervention for Latinas. This program was culturally and linguistically adapted for the target population through extensive formative research. Two hundred eighteen sedentary Latinas were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. The Physical Activity Internet Intervention, based on Social Cognitive Theory and the Transtheoretical Model, utilizes a website with features including self-monitoring, goal setting, discussion forum, links to online resources, individually tailored and motivation-matched physical activity feedback reports, and exercise tip sheets. Participants receive regular emails over the first 6months with a tapered dose during the second 6months (maintenance phase) to alert them to new content on the website. The main outcome is differences in minutes/week of moderate to vigorous physical activity at six months as measured by the 7-Day Physical Activity Recall and accelerometer data. High reach, low cost, culturally relevant Internet-based interventions that encourage physical activity among Latinas could help reduce health disparities and thus have a substantial positive impact on public health.

Internet-based interventions show promise as an effective channel for promoting physical activity. However, a paucity of research has been conducted among underserved groups despite recent increases in Internet access and physical activity-related health disparities in these communities. Thus, the current randomized controlled trial will test the efficacy of an individually tailored, Internet-based physical activity intervention for Latinas. This program was culturally and linguistically adapted for the target population through extensive formative research. Two hundred eighteen sedentary Latinas were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. The Physical Activity Internet Intervention, based on Social Cognitive Theory and the Transtheoretical Model, utilizes a website with features including self-monitoring, goal setting, discussion forum, links to online resources, individually tailored and motivation-matched physical activity feedback reports, and exercise tip sheets. Participants receive regular emails over the first 6months with a tapered dose during the second 6months (maintenance phase) to alert them to new content on the website. The main outcome is differences in minutes/week of moderate to vigorous physical activity at six months as measured by the 7-Day Physical Activity Recall and accelerometer data. High reach, low cost, culturally relevant Internet-based interventions that encourage physical activity among Latinas could help reduce health disparities and thus have a substantial positive impact on public health.

Latinas report disproportionately low physical activity (PA) levels and related health conditions. Reducing chronic disease in Latinas requires interventions to increase and maintain health-enhancing PA levels; yet limited intervention studies have examined PA maintenance among Latinas. The present study evaluated the efficacy during the maintenance phase (months 6-12) of the Enhanced PA intervention for Latina adults in Seamos Activas II compared to the Original PA Intervention. Seamos Activas II was conducted in San Diego, California from 2015 to 2020. Underactive adult Latina women (N = 199), mainly of Mexican descent (89%) were randomized to the original intervention or a theory- and technology-enhanced intervention. Their PA was measured objectively (via accelerometers) and via self-report at baseline, 6, and 12 months. Quantile regression models assessed treatment effects on min/week of moderate to vigorous PA (MVPA) at 12 months. Generalized linear models examined treatment effects on indicators of meeting 2008 National PA Guidelines. Both groups maintained the significant gains in MVPA they had made during the first 6 months of the intervention, neither increasing nor decreasing their MVPA over the maintenance period, with no significant between-group differences. At 12 months, 46.3% of Enhanced Intervention participants were meeting self-reported PA guidelines (vs 35.6 % of the Original PA Intervention arm, p = .02). Even with minimal contact throughout the maintenance phase, participants maintained their MVPA, which underscores the importance of continued use of evidence-based behavior change tools and techniques to reinforce newly established habits. Theoretical and technological enhancements may help Latinas to continue meeting PA guidelines during maintenance periods.

The study purpose is to explore adolescent and adult women's experiences, perceptions, beliefs, knowledge and behaviors related to bladder health across the life course using a socioecological perspective. Lower urinary tract symptoms affect between 20-40% of young adult to middle-aged women, with symptoms increasing in incidence and severity with aging. There is limited evidence to address bladder health promotion and prevention of dysfunction. This first study of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium is designed to address gaps in existing qualitative research in this area. This focus group study will be implemented across seven geographically diverse United States research centers using a semi-structured focus group guide informed by a conceptual framework based on the socioecological model. The study was approved in July 2017. A total of 44 focus groups composed of 6-8 participants representing six different age categories (ranging from 11 to over 65 years) will be completed. We aim to recruit participants with diverse demographic and personal characteristics including race, ethnicity, education, socioeconomic status, urban/rural residence, physical/health conditions and urinary symptom experience. Up to 10 of these focus groups will be conducted in Spanish. Focus group transcripts will undergo content analysis and data interpretation to identify and classify themes and articulate emerging themes. This foundational qualitative study seeks to develop an evidence base to inform future research on bladder health promotion in adolescent and adult women. This study has the potential to provide new insights and understanding into adolescent and adult women's lived experience of bladder health, the experience of lower urinary symptoms and knowledge and beliefs across the life course. This article is protected by copyright. All rights reserved.

Introduction

Latino men experience disproportionately high rates of diseases related to low physical activity, yet they are poorly represented in physical activity intervention trials. Efforts to promote physical activity in Latina women show promising results, yet such interventions are yet to be extended to Latino men. This study tested a computer expert system‒tailored, text messaging-supported physical activity intervention for underactive Spanish-speaking Latino men compared with a control group matched for contact time. Potential predictors of intervention success were also explored.

Study design

Randomized trial. Participants were randomized to receive a Tailored Physical Activity Intervention (Intervention) or a Wellness Control (Control). Data were collected in 2015-2017 and analyzed in 2018-2019.

Setting/participants

Insufficiently active Latino men (n=46).

Intervention

Intervention participants received a baseline counseling session and then, individually tailored print materials and text messages on a tapered schedule for 6 months. Control participants received printed wellness materials and text messages on the same schedule.

Main outcome measures

Primary outcome was a change in weekly moderate to vigorous physical activity from baseline to 6 months measured by accelerometers. Self-reported moderate to vigorous physical activity measured by the 7-day Physical Activity Recall Interview was a secondary outcome.

Results

For Intervention participants, median accelerometer-measured moderate to vigorous physical activity increased from 10.0 minutes/week at baseline to 57.5 minutes/week at 6 months, whereas for Control participants, it increased from 21.0 minutes/week at baseline to 23.0 minutes/week at 6 months (p<0.05). Similar results were found for self-reported moderate to vigorous physical activity. At 6 months, 47% of Intervention participants met national guidelines of 150 minutes/week versus 25% of Control participants (p=0.15, not significant).

Conclusions

Findings suggest that an individually tailored intervention can successfully increase moderate to vigorous physical activity in underactive Latino men. Such technology-supported interventions have the potential for broad dissemination.

Trial registration

This study is registered at www.clinicaltrials.gov NCT02512419.