Background Physical activity (PA) is known to improve quality of life (QoL) as well as reduce mortality and disease progression in individuals with chronic neurological disorders. However, Latina women are less likely to participate in recommended levels of PA due to common socioeconomic barriers, including limited resources and access to exercise programs. Therefore, we developed a community-based intervention with activity monitoring and behavioral coaching to target these barriers and facilitate sustained participation in an exercise program promoting PA. Objective The aim of this study was to determine the feasibility and efficacy of a community-based intervention to promote PA through self-monitoring via a Fitbit and behavioral coaching among Latina participants with chronic neurological disorders. Methods We conducted a proof-of-concept study among 21 Spanish-speaking Latina participants recruited from the Los Angeles County and University of Southern California (LAC+USC) neurology clinic; participants enrolled in the 16-week intervention at The Wellness Center at The Historic General Hospital in Los Angeles. Demographic data were assessed at baseline. Feasibility was defined by participant attrition and Fitbit adherence. PA promotion was determined by examining change in time spent performing moderate-to-vigorous PA (MVPA) over the 16-week period. The effect of behavioral coaching was assessed by quantifying the difference in MVPA on days when coaching occurred versus on days without coaching. Change in psychometric measures (baseline vs postintervention) and medical center visits (16 weeks preintervention vs during the intervention) were also examined. Results Participants were of low socioeconomic status and acculturation. A total of 19 out of 21 (90%) participants completed the study (attrition 10%), with high Fitbit wear adherence (mean 90.31%, SD 10.12%). Time performing MVPA gradually increased by a mean of 0.16 (SD 0.23) minutes per day (P<.001), which was equivalent to an increase of approximately 18 minutes in MVPA over the course of the 16-week study period. Behavioral coaching enhanced intervention effectiveness as evidenced by a higher time spent on MVPA on days when coaching occurred via phone (37 min/day, P=.02) and in person (45.5 min/day, P=.01) relative to days without coaching (24 min/day). Participants improved their illness perception (effect size g=0.30) and self-rated QoL (effect size g=0.32). Additionally, a reduction in the number of medical center visits was observed (effect size r=0.44), and this reduction was associated with a positive change in step count during the study period (P.=04). Conclusions Self-monitoring with behavioral coaching is a feasible community-based intervention for PA promotion among Latina women of low socioeconomic status with chronic neurological conditions. PA is known to be important for brain health in neurological conditions but remains relatively unexplored in minority populations. Trial Registration ClinicalTrials.gov NCT04820153; https://clinicaltrials.gov/ct2/show/NCT04820153
BACKGROUND Physical activity is known to improve quality of life as well as reduce mortality and disease progression in individuals with chronic neurological disorders. However, Latinas are less likely to participate in recommended levels of physical activity due to common socioeconomic barriers including limited resources and access to exercise programs. Therefore, we developed a community-based intervention with activity-monitoring and behavioral coaching to target these barriers and facilitate sustained participation in an exercise program promoting physical activity. OBJECTIVE To determine the feasibility and efficacy of a community-based intervention to promote physical activity (PA) through self-monitoring via a Fitbit and behavioral coaching in Latina participants with chronic neurological disorders. METHODS We conducted a proof-of-concept study in 21 Spanish-speaking Latina participants recruited from the Los Angeles County/ University of Southern California (LAC/USC) neurology clinic and enrolled in the 16-week intervention at The Wellness Center at The Historic General Hospital. Demographic data was assessed at baseline. Feasibility was defined by participant attrition and Fitbit adherence. Physical activity promotion was determined by examining change in time spent performing moderate-vigorous physical activity (MVPA) over the 16-week period. The effect of behavioral coaching was assessed by quantifying the difference in MVPA on days coaching occurred vs. days without coaching. Change in psychometric measures (baseline vs. post-intervention) and medical center visits (16-weeks pre-intervention vs. during intervention) were also examined. RESULTS Participants were of low socioeconomic status and acculturation. 19 participants completed the study (attrition 9.5%) with high Fitbit wear adherence (90.31%). Time performing moderate-vigorous physical activity (MVPA) significantly increased throughout the study (P<0.001). Behavioral coaching enhanced intervention effectiveness as evidenced by a higher time spent in MVPA on days coaching occurred. Participants’ illness perception (Effect Size g=.30), self-rated quality-of-life (Effect Size g=.32), and medical center visit frequency (Effect Size r =.44) improved. CONCLUSIONS Self-monitoring with behavioral coaching is a feasible community-based intervention for PA promotion in low socioeconomic Latinas with chronic neurological conditions. PA is known to be important in brain health in neurological conditions but remains relatively unexplored in minority populations. CLINICALTRIAL Clinicaltrials.gov; NCT04820153
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