Caminemos! Trial to Increase Walking Among Sedentary Older Latinos

Study Overview
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Brief Summary
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The purpose of this study is to examine the efficacy of a multifaceted behavioral intervention aimed at raising walking levels among sedentary older Latinos.

Detailed Description
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Regular physical activity contributes to the health and quality of life of older adults, but unfortunately only 20% of men and 25% of women aged 65 years and greater meet the minimal national guidelines for physical activity. Older Latinos have higher rates of diseases that are most likely to benefit from physical activity, but have disproportionately high rates of sedentary lifestyle. To address this major public health problem, this study will implement and evaluate a multifaceted intervention to raise and sustain walking levels among older Latinos. A total of 600 sedentary older Latinos will be recruited from community-based senior centers in the greater Los Angeles region. The specific aims of the study are to test the effect of the intervention on: the change in steps per week measured by digital pedometer from baseline to 1, 12, and 24-month follow-up; self-reported physical activity level and intervening constructs (including expectations regarding aging and self-efficacy expectations for physical activity); psychosocial health constructs, physical performance measures, and clinical health outcomes. The core of the intervention consists of a series of 4 weekly 1-hour group discussion sessions that utilize attribution retraining techniques from the field of motivational psychology in combination with behavioral strategies based in social cognitive theory. Discussion sessions will be conducted at senior centers and led by a bilingual health educator; each session will be followed by a 1-hour exercise class aimed at increasing strength, flexibility and endurance. During the discussion sessions, the health educator will administer a structured culturally-tailored curriculum in which participants are taught to raise their expectations for physical activity with aging and not to attribute being sedentary to old age. The 4 weekly sessions will be followed by monthly sessions for 11 months, and sessions every 2 months for the following 12 months (total intervention duration = 24 months). Participants will be randomized to 1 of 2 arms: intervention arm: receiving the discussion session and the exercise class; control arm: receiving just the exercise class with the same frequency and duration as the intervention group.

Official Title
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Trial to Increase Walking Among Sedentary Older Latinos

Conditions
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Aging, Sedentary Lifestyle

Intervention / Treatment
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* Behavioral: The Lifetime Fitness Program
* Behavioral: Exercise class


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 60 years or older Self-identifying as Latino/Hispanic Not currently participating in 20 minutes or more of physical activity 3 times a week Willingness to take brief physical activity screening test and if do not pass, provide the name of a physician who has seen the patient in the recent past Exclusion Criteria: Plans to move from the area in the next 24 months Unable to participate in 1-hour group discussion Unable to walk Physician stating that patient is not medically able to participate Family member already participating Substantial cognitive impairment (determined by a screening test)

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>discussion session and exercise class | Behavioral: The Lifetime Fitness Program<br>* A series of 4 weekly 1-hour group discussion sessions that utilize attribution retraining techniques from the field of motivational psychology in combination with behavioral strategies based in social cognitive theory; weekly for 4 weeks, monthly for 11 months, then every two months for 12 months (total duration = 24 months<br>Behavioral: Exercise class<br>* 1-hour exercise class aimed at increasing strength, flexibility and endurance; weekly for 4 weeks, monthly for 11 months, then every two months for 12 months (total duration = 24 months<br>|
| Active Comparator: 2<br>exercise class only | Behavioral: Exercise class<br>* 1-hour exercise class aimed at increasing strength, flexibility and endurance; weekly for 4 weeks, monthly for 11 months, then every two months for 12 months (total duration = 24 months<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of steps per week on digital pedometer |  | baseline and 1, 12, and 24-months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-reported physical activity level |  | baseline and 1, 12, and 24-months | 
| beliefs about aging |  | baseline and 1, 12, and 24-months | 
| self-efficacy |  | baseline and 1, 12, and 24-months | 
| health-related quality of life |  | baseline and 1, 12, and 24-months | 
| blood pressure |  | baseline and 1, 12, and 24-months | 
| body mass index (BMI) |  | baseline and 1, 12, and 24-months | 
| physical performance measures |  | baseline and 1, 12, and 24-months | 
| hospital days |  | baseline and 1, 12, and 24-months | 
| outpatient visits |  | baseline and 1, 12, and 24-months | 
| restricted activity days |  | baseline and 1, 12, and 24-months | 
| cognitive function |  | baseline and 1, 12, and 24-months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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behavior therapy, exercise, gait, physical activity