PROJECT SUMMARY
Latinos are at an elevated risk for medical undertreatment of chronic spine pain (CSP) due to having a lower
socioeconomic status, inconsistent access to healthcare, limited English proficiency, comorbid conditions, high
prevalence of occupational injuries, and systemic prejudicial discrimination. Physical activity (PA) has been
widely accepted as an effective non-pharmacological pain management strategy, yet many Latinos with pain
do not engage in PA. Latinos with CSP face distinct challenges to engaging in PA that may be influenced by
multiple levels of the socioecological model including intrapersonal (e.g., social identities, pain or PA-related
beliefs), interpersonal (e.g., social support), and environmental factors (e.g., neighborhood walkability). These
multilevel factors may also intersect to influence PA engagement in Latinos with CSP. Considering the
complexity of PA behavior, integrating the socioecological model and intersectional framework support the
assessment of how predictors intersect to influence PA. Furthermore, there are time-varying elements of PA
(e.g., pain, social support, and environment) among Latinos with CSP that can be triggered by a specific event
or at random. Thus, assessing momentary fluctuations in the relationships between multilevel factors with PA
and identifying specific environmental contexts that facilitate or impede PA engagement is warranted. The
proposed study aims to conduct a secondary analysis of baseline data from an ongoing clinical trial near the
US-Mexico border to assess how multilevel factors intersect to influence PA (Aim 1). A mixed methods
approach will then be conducted to first explore what multilevel factors have the potential to influence
momentary PA and second, use Ecological Momentary Assessment (EMA) to assess how these real-time
factors intersect to form person-specific networks predicting free-living PA among Latinos with CSP (Aim 2).
Both aims will conduct an intersectional sub-analysis that evaluates subgroups that may be at a greater
disadvantage for physical activity opportunities. Findings from this study are expected to shed light on PA
disparities among Latinos with CSP while setting the foundation for the applicant’s future research goals of
developing momentary and personalized behavioral interventions targeting this population. Through this F31
mechanism, the applicant will gain advanced interdisciplinary training in the fields of physical activity, pain, and
digital health that will significantly contribute to the applicant’s long-term goal of being an independent, public
health researcher.
