ABSTRACT
Physical activity (PA), including regular exercise, prevents weight gain, delays functional
limitations, and improves cardiovascular function, yet one in three Americans is inactive. PA
measurement and promotion in underserved populations, such as low-income race/ethnic
minority communities, is especially challenging. Inadequate cultural adaptation contributes to
substantial measurement error between self-administered and continuously-monitored (e.g.,
device-based) PA assessments. Identification of the determinants of PA, within the context of
sociocultural and geographic norms, is a central component of developing sustainable and cost-
effective PA promotion strategies. Emerging evidence suggests that culturally-adapted PA
promotion strategies, such as those that use community health workers, can provide cultural
interpretation and adaptation of measurement and intervention, sensitivity to sociocultural
norms, and increase treatment adherence and social support of intervention activities. However,
these interventions are difficult to scale. Mobile health (mHealth) technology, including text
messaging, has shown great promise for behavioral interventions and disease self-
management, but common concerns include the impersonalized nature of texts and uncertainty
regarding effective frequency and content. Culturally-adapted health coaching and social
support provided by community health workers, combined with frequent contact via text
messaging, may be an effective, scalable PA promotion tool, but the feasibility is not well
understood among underserved communities. This career development award will provide
me with training in health behavior theories, PA measurement strategies, and peer support and
mHealth intervention development and evaluation. We propose to conduct an analysis of PA in
the longitudinal Study of Women’s Health Across the Nation, a diverse sample of women
that have been followed for 20 years, and recruit a sample of 60 Mexican-heritage Latina
women from a federally-qualified health center to compare self-administered and device-based
PA data among multiple race/ethnic groups (Aim 1). Then, we will develop (Aim 2) and pilot
(Aim 3) a PA behavioral intervention using community health workers and mHealth tools to
increase social support and PA among Latina participants. The goal of this Mentored Research
Scientist Development Award (K01) is to prepare Dr. Kelly Ylitalo to become an independent
investigator with expertise in innovative PA promotion throughout the lifecourse, with a specific
emphasis on culturally-adapted measurement and intervention, to support the long-term goal of
preventing or delaying functional limitations and aging-related disability in priority populations.