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Latino men in the United States report low physical activity (PA) levels and related health conditions (eg, diabetes and obesity). Engaging in regular PA can reduce the risk of chronic diseases and yield many health benefits; however, there is a paucity of interventions developed exclusively for Latino men.
To address the need for culturally relevant PA interventions, this study aims to develop and evaluate Hombres Saludables, a 6-month theory-based, tailored web- and text message-based PA intervention in Spanish for Latino men. This protocol paper describes the study design, intervention, and evaluation methods for Hombres Saludables.
Latino men aged 18-65 years were randomized to either the individually tailored PA internet intervention arm or the nutrition and wellness internet control arm. The PA intervention included 2 check-in phone calls; automated SMS text messages; a pedometer; a 6-month gym membership; access to a private Facebook group; and an interactive website with PA tracking, goal setting, and individually tailored PA content. The primary outcomes were feasibility, acceptability, and efficacy (minutes per week of total moderate-to-vigorous PA assessed via the ActiGraph GT3X+ accelerometer worn at the waist and 7-day physical activity recall at baseline and 6 months). Secondary outcomes examined potential moderators (eg, demographics, acculturation, and environmental variables) and mediators (eg, self-efficacy and cognitive and behavioral processes of change) of treatment effects at 6 months post randomization.
This study was funded in September 2016. Initial institutional review board approval was received in February 2017, and focus groups and intervention development were conducted from April 2017 to January 2018. Recruitment for the clinical trial was carried out from February 2018 to July 2019. Baseline data collection was carried out from February 2018 to October 2019, with a total of 43 participants randomized. Follow-up data were collected through April 2020. Data cleaning and analysis are ongoing.
We developed and tested protocols for a highly accessible, culturally and linguistically relevant, theory-driven PA intervention for Latino men. Hombres Saludables used an innovative, interactive, web- and text message–based intervention for improving PA among Latino men, an underserved population at risk of low PA and related chronic disease. If the intervention demonstrates feasibility, acceptability, and preliminary efficacy, we will refine and evaluate it in a larger randomized control trial.
Clinicaltrials.gov: NCT03196570; https://clinicaltrials.gov/ct2/show/NCT03196570
DERR1-10.2196/23690
Engaging in regular physical activity (PA) exerts health benefits, including decreases in all-cause mortality, obesity, and risk for other chronic diseases, such as cardiovascular disease, type 2 diabetes, certain cancers, obesity, hypertension, osteoporosis, osteoarthritis, depression, and dementia [
Although several studies have demonstrated the efficacy of culturally and linguistically appropriate, individually tailored PA interventions for Latina women [
This study addresses the scarcity of interventions designed to increase PA specifically for diverse Latino men and uses technology to improve reach and accessibility. Computer-based, expert system–driven, theory-based interventions use participant-supplied data to generate messages tailored to the individual needs of each participant [
Recent meta-analyses (and a comprehensive review) have described the impact of web-based interventions on PA and have found small to moderate positive effect sizes [
The purpose of this protocol paper is to describe the study design, intervention, and evaluation methods for Hombres Saludables, an internet- and text-based tailored Spanish language intervention designed for an ethnically diverse population of Latino men (ie, Caribbean and Central and South American origin) to increase total PA. This intervention was adapted from our culturally and linguistically appropriate, internet-based PA intervention for Latina women, Pasos Hacia la Salud [
Hombres Saludables is a 6-month randomized controlled trial (RCT) for Latino men comparing an individually tailored, internet- and text-based PA intervention with a control group that received an attention-matched intervention about nutrition and wellness. The primary aims of the study are to determine the feasibility, acceptability, and preliminary efficacy of the intervention, as well as the recruitment, implementation, and evaluation protocols. Secondary aims include examining potential moderators (eg, demographics, acculturation, and environmental variables such as the neighborhood and socioeconomic environments) and mediators (eg, self-efficacy and cognitive and behavioral processes of change) of treatment effects at 6 months post randomization. The targeted sample size for this pilot trial is 50 Latino men.
To inform the design of this study, we conducted 8 focus groups with 38 Latino men in Rhode Island. We asked their opinions on potential design elements of this study, including website functionality, use of text messages, email and social media, and content for both the intervention and control arms of the study. All focus groups were audio-recorded, and the recordings were transcribed, translated, and subjected to several stages of analytic coding using ethnographic methods by 2 graduate students. Transcripts were initially read as texts to isolate obvious themes and then subjected to open coding to identify additional themes and actions that are relevant for further analysis. Next, transcripts were subjected to focused coding using the subdomains identified in the earlier stages. Following coding, we worked with the coded data set and the texts to create a componential analysis that identified patterns and themes. Focus group findings were discussed with the research team and used to adapt and refine recruitment and intervention materials to be culturally appropriate for the diverse target audience. Focus group results will be discussed in another paper; however, briefly, participants expressed interest in the use of text messages rather than email to deliver information and reminders during the intervention. Focus group participants also recommended the use of a private Facebook group as a forum to post intervention content for study participants and allow them to comment and post among themselves. Focus group participants expressed strong interest in a gym membership, stating that it would help with barriers of cost and motivation to exercise.
Inclusion criteria were as follows: (1) self-identification as Hispanic or Latino; (2) self-identification as male; (3) age between 18 and 65 years; (4) self-reported 60 min or less of total MVPA a week; (5) had an adequate literacy level to read study materials in Spanish, that is, scored more than 16 on the Spanish language version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA) [
Exclusion criteria were as follows: (1) history of myocardial infarction or angina, insulin-dependent diabetes, or hospitalization for diabetes in the past year; (2) stroke, osteoarthritis, osteoporosis, orthopedic problems, or exercise-induced asthma; (3) any other medical condition that would make MVPA unsafe; (4) hospitalization because of a psychiatric disorder in the past 3 years; (5) BMI >45; (6) planned surgery or hospitalization in the next 6 months; and (7) intake of medication that may impair PA tolerance or performance. Any questions about medical eligibility were sent to the study physician to determine eligibility. Participants who reported another family member already enrolled in another PA study being conducted concurrently by our research team were yoked during randomization to the same study arm to prevent the possibility of cross-treatment contamination.
The computer-based, expert system–driven, individually tailored intervention was based on social cognitive theory (SCT) [
Theoretical constructs of social cognitive theory and the transtheoretical model targeted by intervention components.
Construct (theory) | Intervention component |
Self-regulation (SCTa) |
Website goal setting and PAb tracking feature allow participants to log their weekly PA goals and daily activity, including minutes of MVPAc, and to view a graph of how their actual PA compares with their goals. Participants receive a pedometer to track their daily step count |
Outcome expectations (SCT) |
Web-based daily and weekly exercise tips provide information about the benefits of PA. Text messages about PA benefits |
Stages of change and processes of change, for example, consciousness raising, social supports, and reinforcement management (TTMd) |
Participants complete monthly web-based questionnaires (stages of change and processes of change) and then receive computer-based, expert system–driven, individually tailored reports for increasing their PA based on their responses |
Self-efficacy (SCT and TTM) |
Participants complete monthly web-based questionnaires and then receive computer-based, expert system–driven, individually tailored reports |
Observational learning (SCT) |
Exercise videos in Spanish (led by diverse Latino men) let men observe peers leading exercises and allow practice, which leads to an increase in self efficacy |
Behavioral capability (SCT) |
Text reminders to access websites, log activity, and set goals; knowledge and skills information in concise tips, detailed tip sheets, text messages, and Facebook posts. Exercise videos in Spanish (led by diverse Latino men) teach skills that help participants learn to be more physically active. |
Reciprocal determinism (SCT) |
Information provided about the built environment: list on website of places to be active near participants’ home; Facebook messages about community PA events |
Outcome expectations and self-efficacy and perceived barriers (SCT) |
Share motivational and culturally relevant information about benefits and how to address barriers in concise tips, detailed tip sheets, text messages, and Facebook posts. Exercise videos to promote self-efficacy. |
Social support (SCT) |
Provide social interaction and support through the online community discussion forum or on Facebook where participants can write messages and interact with each other. Concise tips, detailed tip sheets, text messages, and Facebook encourage exercising with family, spouse, friends, and coworkers |
aSCT: social cognitive theory.
bPA: physical activity.
cMVPA: moderate-to-vigorous physical activity.
dTTM: transtheoretical model.
Draft intervention logic model.
Study materials were culturally adapted for a diverse population of Latino men. We enhanced cultural appropriateness through the following strategies using the frameworks described by Kreuter et al [
Peripheral or structural: We include appropriate physical activities, illustrations, role models, etc that are targeted for Latino men.
Evidential: We enhance perceived relevance by presenting evidence of the impact of a sedentary lifestyle for Latino men.
Constituent involving: We employ project staff who are Latino, including 1 Latino male research assistant.
Linguistic: We translate all study materials into Spanish that is appropriate for the Latino subgroups (eg, Dominican and Puerto Rican) in New England.
Sociocultural or deep structure: We incorporate cultural values and beliefs to provide context and meaning (eg, content about gender role expectations, conflicts with family time, and partner support) [
In designing intervention materials (eg, the web-based interface), we integrated components of the cultural dimensions theory by Hofstede, a framework for cross-cultural communication that shows the effects of the culture of a society on the values of its members and how these values relate to behavior [
Cultural adaptations for the Hombres Saludables physical activity intervention.
Theme | Intervention modification | |
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Activity preferences | Focus intervention on gender-neutral and male-associated activities (eg, soccer and hiking) | |
Language | Translate intervention into appropriate Spanish for the diverse Latino audience | |
Literacy | Use qualitative methods (eg, focus groups with Latino men to review intervention materials) and low-literacy strategies (eg, Flesch Kincaid grade level less than eighth grade) to modify measures and materials to better match educational experience of participants | |
Role models | Provide videos, photos, and stories of diverse Latino men and families from the target population on a website | |
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Gender role expectations | Emphasize the need for the head of family to set a good example by being active and protect family members by exercising with them; highlight benefits of aerobic activities for men’s health | |
Not wanting to spend money on fitness when that money should be used for family needs | Reframe PAa to include behaviors that do not require gym membership or special equipment, distribute information on low- or no-cost PA resources in the community (eg, hiking and walking trails, recreation centers, and pickup soccer games), offer a list of free Spanish or bilingual smartphone apps that provide access to exercise resources, and provide a 6-month gym membership | |
Perceived lack of access to culturally appropriate PA | Provide tailored community guides identifying places to do PA, including information and schedules for free and low-cost team sports at local recreation centers and community or social sports leagues; include Spanish exercise videos that are appropriate for Latino men; offer a list of free Spanish or bilingual smartphone apps that provide access to exercise resources; and provide a 6-month gym membership | |
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Stress reduction | Provide information on PA and stress reduction for stressors commonly experienced by Latino men | |
PA conflicts with work schedule | Provide tips for exercising at work or for transportation and on finding time with a hectic schedule; highlight low-cost local sports and activities that occur on nights and weekends | |
Lack of time and conflicts with family time | Augment existing content on this topic with examples that are familiar to Latino men (planning PA around family and work commitments); share Spanish exercise videos that are appropriate for Latino men; and provide membership to a gym that is open for extended hours, which helps men find time to exercise around work schedules. Provide tips and texts for getting children and family involved in PA and include specific suggestions regarding family-friendly activities (eg, easy hiking trails) | |
Partner support | Provide tips on eliciting social support from friends and family | |
Need for accountability | Provide pedometer, emphasize monthly personal reporting and feedback based on participant’s reported PA (steps or minutes), provide normative feedback comparing their progress with others, send regular text messages asking about recent activity and reminding participants to log activity and answer monthly surveys, and offer private Facebook group to post progress and request support |
aPA: physical activity.
Participants in the tailored PA internet intervention group received access to the Hombres Saludables study website. All website content was published in Spanish and adapted to be culturally and linguistically relevant for Latino men. The website was developed to be mobile phone friendly. Participants in this study arm were asked to log their minutes of MVPA each day. They were also asked to set a weekly PA goal and log it on the website. The website offered a goal setting and tracking feature to allow participants to view graphs of their actual level of PA compared with the goals they set each week. Participants were asked to complete monthly questionnaires on the study website, assessing key theoretical components of SCT and the TTM. Answers from these questions generated their individually tailored PA reports. These reports were published on the website automatically upon completion of each monthly survey. The reports used a bank of more than 300 messages from the computer-based, expert system and offered feedback on (1) the current stage of motivational readiness for PA, (2) self-efficacy, and (3) cognitive and behavioral strategies associated with PA.
The computer-based, expert system also provided feedback on how the participant compared with individuals who are physically active based on American College of Sports Medicine guidelines [
Other website features included resources to promote PA. Participants could access city guides containing useful information on where to be active in their city (eg, parks, bike paths, gyms, and local recreation centers), a list of free PA promotion apps participants could download on their smartphones, a series of Spanish language exercise videos found on YouTube, and concise daily and weekly tips published on the website throughout the 6-month intervention as well as detailed 2- to 3-page
Throughout the 6 months of the intervention, participants received text messages 4 to 6 times per week. These included prompts to access new information posted on the website, such as their tailored tip sheets; reminders to log their minutes, set a weekly goal, and complete their monthly questionnaire; and texts that were informational and motivational, for example, suggestions to overcome barriers and enlist social support. Examples of the latter included: “Is lack of time a problem for you? Try waking up 15 minutes earlier to take a short 15-minute walk, and then another 15 minutes at lunchtime or in the afternoon for a second walk;” “There are many exercise videos on YouTube and in mobile apps. Look in the ‘Ways to Be Active’ section on the website for our recommendations for exercise videos and apps;” and “Remember that physical activity burns calories, improves sleep, increases your energy, and reduces stress.”
Participants were also given the option to join a private Facebook group where study staff posted weekly to the group with tips, quizzes, events, and information related to PA. Participants were encouraged to engage with the content, submit questions, and post comments. Each month, a random participant who had engaged with the Facebook content won a US $25 incentive.
Participants also received a voucher for a free 6-month membership worth US $60 to a local gym franchise with multiple locations. Participants who did not live in the surrounding Rhode Island or Massachusetts area received US $60 toward the costs of a gym membership.
One week after enrolling in this study, intervention participants received a phone call from the study staff. The 5 to 10 min call ensured that all aspects of the website, Facebook, and text message alerts were functioning well, and the study staff answered any participant questions. After 1 month, the participants completed another 10 to 15 min call with study staff to review their progress and answer any study questions. A staff member supported the participants in creating a new goal for the second month of the study. If any barriers to PA arose, the staff member assisted the participants in developing solutions.
Participants randomized into the control arm received access to a Spanish language website with information on nutrition and men’s health and wellness topics unrelated to PA. The study staff guided participants through the website and set up their account. The website featured healthy recipes; app suggestions for healthy eating; and weekly tips on topics such as eating more fruits and vegetables, healthy drink choices, reducing salt intake, sleep health, prostate care, information about cholesterol, and supplements. Tip sheets on similar topics were also regularly posted on the website throughout the intervention on the same schedule as the intervention arm. Participants were asked to complete a monthly survey on the website on the same schedule as the PA arm. Survey questions asked about diet, sleep, and wellness habits. Participants completed the first survey during the baseline visit. Control arm participants also received text message alerts 3 to 4 times per week with reminders of new information on the website and helpful tips. Participants also received access to a private Facebook group that offered additional information on nutrition- and wellness-related topics. This group also received a check-in call from the study staff 1 week and 1 month after enrollment (
Hombres Saludables study flow diagram. C: control group; I: intervention group; PAR: physical activity recall; STOHFLA: Short Test of Functional Health Literacy in Adults.
We used various recruitment strategies in Rhode Island, Connecticut, and Massachusetts as well as nationally. Locally in Rhode Island, Connecticut, and Massachusetts, we advertised on Craigslist and posted flyers in local community organizations and businesses (eg, restaurants, barbershops, grocery stores, and laundromats). We worked extensively with the local library systems and presented at local high school equivalency certificate, citizenship, and English language classes. We also attended local church groups, elementary schools, Latino men’s groups, and community organizations working with the Latino population. We visited worksites of companies with high Latino employment and posted information in college campus student centers and on student listservs at various local colleges. We also ran paid radio ads on a local Spanish language FM radio station, performed a guest stint on a Latino radio talk show, and left study flyers and brochures with doctors’ offices and health clinics. Due to a slower recruitment rate than anticipated, we also expanded recruitment efforts nationally by publishing paid ads on Facebook and Craigslist pages for different towns and cities, mainly focusing on the East Coast. Use of web-based recruitment, particularly the use of Facebook, has been shown to be an effective approach for recruiting participants in health research [
A summary of the study and flow diagram is shown in
For participants attending visit 1 in person, the bilingual and bicultural research staff gave an overview of this study, described study steps and rights of participation, and answered participant questions. The participant then underwent measures to further assess eligibility, including height, weight, and waist circumference measurements; the S-TOFHLA literacy questionnaire; a brief 7-day physical activity recall (PAR) [
For visit 1,
In-person participants returned for a second visit approximately 8 days after the first visit. They brought the accelerometer and the wear-time log form to the visit. Any participant with insufficient wear time (<3000 min over 4 days or <5 days of 600 min each) was asked to rewear the accelerometer, and the visit was rescheduled. Participants with sufficient wear time completed a 10-min treadmill walk to demonstrate moderate-intensity PA (3-4 miles per hour). Heart rate and rate of perceived exertion were documented throughout the treadmill walk by the study staff. The goal of the walk was to help improve the accuracy of participants’ self-report of their PA by providing a real-time demonstration of a 10-min bout of moderate-intensity PA with no breaks. The protocol for this demonstration was developed by Dr Marcus and has been used in earlier studies [
Participants were then randomized to 1 of the 2 Spanish language internet and text message–based conditions: tailored PA intervention arm or nutrition and wellness control arm. Group assignment was determined using a permuted block randomization procedure with small randomly sized blocks. Randomization was stratified by the TTM stage of change [
At the end of visit 2, the study staff helped participants in the tailored PA intervention arm to set up their personalized website account. The study staff also set up a bookmark to the page on the participant’s smartphone to aid easy access to the website and then provided thorough instructions on using all sections of the website. In the final phase of the visit, the study staff helped the participants set a personalized exercise goal and create a detailed PA plan for their first week. The staff members and the participants discussed potential barriers to completing this goal and how to overcome those barriers. The staff members walked the participants through these goal-setting steps and how to record their minutes of MVPA and goal on the website to ensure that the participants were able to complete these steps independently throughout the 6-month intervention.
At the end of the visit, the staff members reviewed the study goals and expectations and asked the participants to do the following:
Try to do MVPA for at least 10 min at a time, with no breaks.
Track how much exercise they perform each day and log the time on the website.
Wear the pedometer every day and log the steps on the website.
Review and revise the exercise goal each week to work up to 150 min of MVPA each week by the end of 6 months in the study.
Complete the monthly questionnaire on the website.
For participants traveling to our office for in-person visits, we offered a US $10 incentive to aid with the cost of transportation and a monthly US $5 incentive to aid with cell phone and data costs. Participants were also compensated for their time at evaluation time points, receiving US $25 for completing their second visit and US $50 for completing the 6-month assessment visit. In addition, participants received US $10 for returning their accelerometer at visit 2 and at the 6-month visit. Each time the participants completed a monthly web-based questionnaire, they also received a US $10 incentive. Local participants received a voucher for a free 6-month gym membership worth US $60, and distance participants received US $60 toward the cost of a gym membership. Those in the PA intervention arm received the gym membership at the start of the study, whereas those in the control arm received the membership (or financial equivalent) at the 6-month follow-up.
At the end of the 6-month intervention, participants were contacted again to set up their final assessment visit. Participants were mailed an ActiGraph accelerometer and asked to wear it for 7 complete days, following the baseline protocol. Participants were scheduled for their assessment visit on day 8 after they started wearing their monitor.
At the start of the visit, the study staff reviewed the ActiGraph wear data to ensure that it was worn for sufficient time. Any participant with insufficient wear time was asked to rewear the accelerometer, and the visit was rescheduled. Participants then completed the same survey measures from the baseline assessment, with some additional process evaluation questions. Height, weight, and waist circumference were recorded again, followed by a 10-min treadmill walk (for in-person participants) and the PAR assessment. Finally, after the 6-month visit, the study staff conducted brief semistructured qualitative interviews with study participants who agreed to complete this interview.
Demographic questions at baseline assessed age, education, race, ethnicity, income, employment status, marital status, household size, country of birth, Hispanic subgroup, and years lived in the United States. In addition,, the Brief Acculturation Scale [
The primary outcome measure is total PA, as measured by an accelerometer (ActiGraph wGT3X-BT). All participants were asked to wear an accelerometer for 7 days to measure their movement and intensity of activity. The minimum acceptable wear time is 5 days, with at least 600 min daily, or 4 days, with at least 3000 min total. The daily and weekly minutes of MVPA were calculated with Actilife software, using a minimum cutoff point of 1952 [
A self-reported measure of total weekly PA was also included as an outcome measure of MVPA. Using the 7-day PAR [
Readiness to change, self-efficacy, and processes of change were also assessed as psychosocial constructs related to PA. The 5-item PA stages of change questionnaire determines whether a participant is in the precontemplation, contemplation, preparation, action, or maintenance stage of PA change. This measure has demonstrated reliability and concurrent validity with measures of self-efficacy and current activity levels [
Additional psychosocial measures related to PA included social support, PA enjoyment, perceived stress, and perceived quality of life. The social support measure (social support for exercise) [
Measures of neighborhood safety, neighborhood social cohesion, neighborhood police attitudes, and fear of police were also administered. Neighborhood safety was assessed with a single item [
To assess built environment factors that influence PA, including land use characteristics, sidewalks, shoulders and bike lanes, street characteristics, and quality of the pedestrian environment, we used Objective Neighborhood Audits using Google Street View [
For the nutrition and wellness control arm, a wellness questionnaire assessed knowledge regarding the men’s wellness topics presented in the control materials. We also assessed pre and post fruit and vegetable intake using the National Cancer Institute's
Standardized protocols were used in training staff to conduct all study visits. All PAR questionnaires were reviewed for errors before data entry. To ensure receipt of treatment, phone calls were conducted 1 week and 1 month post randomization to ensure proper use of the pedometer and self-monitoring on the website. Participants who were not completing their PA logs or their monthly web-based questionnaires were also contacted. To measure fidelity and dose of treatment implementation—and to provide insight into participant usage—the website captured the number of log-ins and views of each page or link; how much time participants spent on the website; and what participants entered on the website, that is, goals, discussion board posts,
Our main feasibility measure is a participant retention rate of 80% or more. To inform a future study, we also measured time to recruit 50 participants, what proportion of recruited participants were eligible and reasons for ineligibility, the yield of various recruitment methods, and baseline process data (proportion of eligible participants who completed study visits, length of visits, time range from initial recruitment to randomization, visits attempted and completed on different days, duration of visit, refusals, and interviewer notes on surveys). Six-month visit process data included duration of the visit, the proportion of randomized participants completing the study, and those who refused or were dropped from the study along with reasons for dropping as well as participants we were unable to reach for follow-up.
In the 6-month follow-up survey, participants completed questions regarding their overall level of satisfaction with the intervention (
Our sample size estimates were based on results from 2 of our completed studies with accelerometer data for Latina participants [
The primary aim of this study is to determine the feasibility, acceptability, and preliminary efficacy of the tailored PA intervention. We will consider the intervention feasible if at least 80% of the randomized participants are retained at the 6-month follow-up. The intervention will be considered acceptable if at least 80% of participants completing the 6-month follow-up respond favorably (
As a preliminary step, we will assess potential between-group differences in baseline characteristics (demographics and baseline PA level) using graphical methods and nonparametric and parametric tests as appropriate (eg, the Wilcoxon rank sum test for skewed data,
Modeling is performed using a likelihood or quasi-likelihood–based approach and, thus, makes use of all available data (intent-to-treat sample) to produce consistent estimates of the regression parameters. Our goal is to estimate effect sizes, rather than strict statistical hypothesis tests. A similar modeling strategy will be used to estimate effects on self-reported minutes per week of MVPA.
Potential moderators will be examined using a similar analytic approach to that described earlier. For example, the total PA at 6-month follow-up (as measured by the accelerometer) will be regressed simultaneously on each moderator (eg, neighborhood PA environment profiles), as determined by latent class analysis, treatment assignment, and the interaction between the 2. If the interaction term is nonzero, we will conclude that there is evidence for a potential moderator. Models will also control for potential confounders of the association, including baseline PA and any variables unbalanced between arms. Our interest is in estimating effect sizes for conditional effects rather than strict statistical hypothesis testing.
This study was funded in September 2016. Initial institutional review board approval was received in February 2017. Focus groups and intervention development were conducted from April 2017 to January 2017. Recruitment for the clinical trial was carried out from February 2018 to July 2019. Baseline data collection was carried out from February 2018 to October 2019, with a total of 43 participants randomized. Follow-up data were collected through April 2020. Data cleaning and analysis are ongoing, and we expect study results to be published in summer 2021.
PA is a critical health behavior known to promote health and prevent the onset of chronic diseases and mortality [
The Hombres Saludables study leverages theories of behavior change and low-cost, technology-based intervention delivery mechanisms that demonstrate high reach with Latinos, most of whom use the internet and own a cell phone [
With regard to the intervention dose and components of the study design, literature findings indicate that interventions averaging 12.7 weeks in duration (ranging from 2 to 52 weeks) yield small but significant increases in PA [
In addition, achieving the study aims will provide evidence for potential mediators and moderators of PA, which remain underexamined in Latino men. The mediators in this study are based on theoretical constructs (eg, self-efficacy and social support) associated with increases in PA among Latina women and other racial or ethnic subgroups [
Although the intervention focuses mostly on changing the psychological, behavioral, and economic barriers to PA, we will explore potential moderating effects of individual and environmental factors on PA. At the individual level, we will examine whether important demographics (eg, age, country of origin, marital status, and education), acculturation, or baseline stage of change (based on TTM) impact changes in PA among Latino men. At the neighborhood level, we will explore walkability and social conditions, which have not been reported in PA intervention studies with Latino men. Although many studies explore associations of neighborhood walkability with PA (including studies with Latinos) or as a potential moderator of intervention efficacy [
Although the strengths of this study are numerous, a few potential challenges exist. Recruitment and retention of Latinos in PA interventions are often challenging [
Screenshots of the Hombres Saludables website.
Peer review of study grant proposal.
Active Neighborhood Checklist
moderate-to-vigorous physical activity
physical activity
physical activity recall
randomized controlled trial
social cognitive theory
Short Test of Functional Health Literacy in Adults
transtheoretical model
This study was funded by the National Heart Lung and Blood Institute #R34HL128067.
None declared.