Positive Action for Today's Health

Study Overview
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Brief Summary
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Regular moderate and vigorous intensity physical activity (PA) is inversely related with obesity, however, few adults are successful in incorporating sufficient PA into their daily lives. Minority and lower-income adults have among the highest obesity rates and lowest levels of regular PA. Increasing environmental supports for safe and convenient places for PA is an emerging public health strategy for PA interventions. Preliminary data by Wilson (PI) and colleagues has revealed through focus groups that low-income minority adults would like to increase the safe places for PA (areas free from crime, containment of stray dogs, increased police patrol) and access to PA (sidewalks/trails and expand opportunities for PA) in their community. In addition, the results of the investigators' preliminary studies suggest that African Americans had psychosocial barriers to PA that included lack of self-motivation, cultural body image issues, and lack of time due to family obligations. The present proposal is innovative in that it specifically tests the efficacy of an intervention that includes both patrolled-walking and social marketing elements to increase PA in low-income African Americans. Three communities will be randomized to receive one of three programs: a police patrolled-walking program plus social marketing intervention, a police patrolled-walking only intervention, or no walking intervention (general health education only; N=390; 130/group). The 24-month intervention will focus on increasing safety (training community leaders to serve as walking captains, hiring off-duty police officers to patrol the walking program, and containing stray dogs), increasing access for PA (marking a walking route), and will include a tailored social marketing campaign for increasing PA (in one intervention community). The investigators will collect data for PA (7-day accelerometer estimates, 4-week PA history), body composition, blood pressure, psychosocial measures, and perceptions of environmental supports for safety and access for PA at baseline, 6-,12-,18-, and 24-months. The primary hypotheses are that the patrolled-walking plus social marketing intervention will result in greater increases in moderate and vigorous PA as compared to a patrolled walking only intervention or no-intervention by 12-months and that these effects will be maintained at 18-month and 24-month assessments.

Official Title
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Improving Safety and Access for Physical Activity

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Police Patrolled Walking plus Social Marketing
* Behavioral: Police Patrolled Walking Program Only
* Behavioral: General Health Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: African American (3 of 4 grandparents are of African Descent) Lives in designated census area No plans to move in the next two years Has no medical condition that would limit participation in moderate intensity exercise including life-threatening illness (e.g., immobile, severely disabled, or bed ridden) Available and able to participate in measures and intervention activities over the next 2 years Exclusion Criteria: Extreme Blood Pressure and/or Blood Glucose levels Unable to take a brisk, 30-minute walk

Ages Eligible for Study
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Minimum Age: 18 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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Full Intervention<br>Police Patrolled Walking Program plus Social Marketing Intervention | Behavioral: Police Patrolled Walking plus Social Marketing<br>* Identify walking route, hire walking leaders and police support, maintain route and monitor stray dogs PLUS grass-roots social marketing campaign to promote walking on the route<br>|
| Experimental: Walking Only<br>Police Patrolled Walking Only Intervention | Behavioral: Police Patrolled Walking Program Only<br>* Identify walking route, hire walking leaders and police support, maintain route and monitor stray dogs<br>|
| Active Comparator: General Health<br>General Health Education Intervention | Behavioral: General Health Education<br>* Host community events for chronic disease education<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Activity (Accelerometer) |  | 0, 6, 12, 18, 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood Pressure |  | 0, 6, 12, 18, 24 months | 
| Body Mass Index (BMI) |  | 0, 6, 12, 18, 24 months |