Web-Based Physical Activity Intervention for Latina Adolescents: Feasibility, Acceptability, and Potential Efficacy of the Niñas Saludables Study

Background Physical activity is markedly low in Latina adolescents, yet few physical activity interventions have been attempted in this population. Web-based interventions can incorporate theory-based components, be appealing to adolescents, and have potential for low-cost dissemination. Objective This study aimed to assess the feasibility, acceptability, and potential efficacy of a Web-based physical activity intervention for Latina adolescents in a single-arm pilot trial. Methods A total of 21 Latina adolescents (aged 12-18 years) who could read and write in English and were underactive (<90 min/week) participated in a 12-week, theory-informed Web-based physical activity intervention. The intervention website was modified from a previous Web-based intervention for Latina adults. Web content was individually tailored based on the responses to monthly questionnaires. Feasibility was measured by recruitment, retention, and adherence/engagement, and acceptability was measured by satisfaction surveys. Physical activity was measured at baseline and follow-up (12 weeks) using the 7-day physical activity recall (PAR) interview and accelerometers. Results Baseline activity as measured by the 7-day PAR and accelerometers was 24.7 (SD 26.11) and 24.8 (SD 38.3) min/week, respectively. At 12 weeks, 19 participants (90%, 19/21) returned. Adherence and engagement with materials were low, but 72% (15/21) of the participants indicated that they were satisfied with the intervention. Activity at 12 weeks increased by 58.8 (SD 11.33) min/week measured by the 7-day PAR (P<.001). Accelerometer-measured activity did not increase. Activities reported at follow-up were more varied than at baseline, including some activities measured poorly by accelerometers (eg, biking and swimming). Participants suggested simplifying the website and incorporating other technologies. Conclusions Good retention and increases in self-reported activity suggest a promising approach to delivering a physical activity intervention to Latina adolescents. Incorporating other technologies, such as smartphone apps, could make the intervention more engaging, acceptable, and effective.

[1]  T. Robinson,et al.  The effects of increasing outdoor play time on physical activity in Latino preschool children. , 2007, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[2]  B. Ainsworth,et al.  The current state of physical activity assessment tools. , 2015, Progress in cardiovascular diseases.

[3]  G. Schofield,et al.  Adolescent physical activity levels: discrepancies with accelerometer data analysis , 2016, Journal of sports sciences.

[4]  Antronette K Yancey,et al.  Disparities in Physical Activity and Sedentary Behaviors Among US Children and Adolescents: Prevalence, Correlates, and Intervention Implications , 2009, Journal of public health policy.

[5]  G. Norman,et al.  Comparability and Reliability of Paper- and Computer-Based Measures of Psychosocial Constructs for Adolescent Physical Activity and Sedentary Behaviors , 2005, Research quarterly for exercise and sport.

[6]  E. Jansson,et al.  Adolescent determinants of cardiovascular risk factors in adult men and women , 2001, Scandinavian journal of public health.

[7]  G. Cardon,et al.  Physical activity levels in 10- to 11-year-olds: clustering of psychosocial correlates , 2005, Public Health Nutrition.

[8]  K. Flegal,et al.  Prevalence of obesity among adults: United States, 2011-2012. , 2013, NCHS data brief.

[9]  H. Nagaraja,et al.  Evaluation of methods to assess physical activity in free-living conditions. , 2001, Medicine and science in sports and exercise.

[10]  J. Prochaska,et al.  A review of correlates of physical activity of children and adolescents. , 2000, Medicine and science in sports and exercise.

[11]  Leena Choi,et al.  Validation of accelerometer wear and nonwear time classification algorithm. , 2011, Medicine and science in sports and exercise.

[12]  J. Sallis,et al.  Reliability and validity of self-reported physical activity in Latinos. , 1992, International journal of epidemiology.

[13]  U. Ekelund,et al.  Sedentary time in children: influence of accelerometer processing on health relations. , 2013, Medicine and science in sports and exercise.

[14]  B. Marcus,et al.  Efficacy of an individualized, motivationally-tailored physical activity intervention , 1998, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[15]  Jeannine S. Schiller,et al.  Summary health statistics for U.S. adults: National Health Interview Survey, 2002. , 2004, Vital and health statistics. Series 10, Data from the National Health Survey.

[16]  J. Bian,et al.  Efficacy and Effectiveness of Mobile Health Technologies for Facilitating Physical Activity in Adolescents: Scoping Review , 2018, JMIR mHealth and uHealth.

[17]  J. Sallis,et al.  Using accelerometers in youth physical activity studies: a review of methods. , 2013, Journal of physical activity & health.

[18]  A. Norris,et al.  Evaluation of a Generic Brief Acculturation Scale in a Sample of Male Enlisted Naval Personnel , 2008, Clinical nurse specialist CNS.

[19]  S. Griffin,et al.  Determinants of Change in Physical Activity in Children and Adolescents , 2011, American journal of preventive medicine.

[20]  Atreyi Kankanhalli,et al.  User Models for Personalized Physical Activity Interventions: Scoping Review , 2019, JMIR mHealth and uHealth.

[21]  Sheri J. Hartman,et al.  Pasos Hacia La Salud: a randomized controlled trial of an internet-delivered physical activity intervention for Latinas , 2016, International Journal of Behavioral Nutrition and Physical Activity.

[22]  A. Armstrong,et al.  Effects of video-based, online education on behavioral and knowledge outcomes in sunscreen use: a randomized controlled trial. , 2011, Patient education and counseling.

[23]  R J Shephard,et al.  Revision of the Physical Activity Readiness Questionnaire (PAR-Q). , 1992, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[24]  A. Sacker,et al.  Do adolescent leisure-time physical activities foster health and well-being in adulthood? Evidence from two British birth cohorts. , 2006, European journal of public health.

[25]  R. Poulton,et al.  Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study , 2004, The Lancet.

[26]  Gregory M Dominick,et al.  Randomized controlled trial testing an internet physical activity intervention for sedentary adults. , 2013, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[27]  Wolfgang Himmel,et al.  Video-assisted patient education to modify behavior: a systematic review. , 2014, Patient education and counseling.

[28]  W. Evans,et al.  Strategies to Increase Latino Immigrant Youth Engagement in Health Promotion Using Social Media: Mixed-Methods Study , 2018, JMIR public health and surveillance.

[29]  Sheri J. Hartman,et al.  Physical activity maintenance among Spanish-speaking Latinas in a randomized controlled trial of an Internet-based intervention , 2017, Journal of Behavioral Medicine.

[30]  L. Mâsse,et al.  Physical activity in the United States measured by accelerometer. , 2008, Medicine and science in sports and exercise.

[31]  S. Biddle,et al.  Analysis of children's physical activity and its association with adult encouragement and social cognitive variables. , 1996, The Journal of school health.

[32]  Marian Huhman,et al.  Effects of a Mass Media Campaign to Increase Physical Activity Among Children: Year-1 Results of the VERB Campaign , 2005, Pediatrics.

[33]  Bess H. Marcus,et al.  Motivational Readiness, self-efficacy and decision-making for exercise , 1992 .

[34]  B. Marcus,et al.  Twelve-month physical activity outcomes in Latinas in the Seamos Saludables trial. , 2015, American journal of preventive medicine.

[35]  Helen X. Gao,et al.  Prevalence of and trends in diabetes among adults in the United States, 1988-2012. , 2016, Journal of diabetes.

[36]  I. Janssen,et al.  Systematic review of the health benefits of physical activity and fitness in school-aged children and youth , 2010, The international journal of behavioral nutrition and physical activity.

[37]  S. Kelders,et al.  Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions , 2012, Journal of medical Internet research.

[38]  T. Poder,et al.  Social acceptance and population confidence in telehealth in Quebec , 2015, BMC Health Services Research.

[39]  C. Vandelanotte,et al.  Meta-analysis of internet-delivered interventions to increase physical activity levels , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[40]  B. Marcus,et al.  The Seamos Saludables study: A randomized controlled physical activity trial of Latinas. , 2013, American journal of preventive medicine.

[41]  M. Campbell,et al.  A tailored multimedia nutrition education pilot program for low-income women receiving food assistance. , 1999, Health education research.

[42]  J. Lucas,et al.  Summary health statistics for U.S. adults: national health interview survey, 2012. , 2014, Vital and health statistics. Series 10, Data from the National Health Survey.

[43]  S. Going,et al.  Defining accelerometer thresholds for activity intensities in adolescent girls. , 2004, Medicine and science in sports and exercise.

[44]  K. Vranizan,et al.  Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. , 1985, American journal of epidemiology.

[45]  A. King,et al.  Telephone versus print delivery of an individualized motivationally tailored physical activity intervention: Project STRIDE. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.