Caminemos! Trial to Increase Walking Among Sedentary Older Latinos

Regular physical activity contributes to the health and quality of life of older adults, but unfortunately only 20% of men and 25% of women aged 65 years and greater meet the minimal national guidelines for physical activity. Older Latinos have higher rates of diseases that are most likely to benefit from physical activity, but have disproportionately high rates of sedentary lifestyle. To address this major public health problem, this study will implement and evaluate a multifaceted intervention to raise and sustain walking levels among older Latinos.

A total of 600 sedentary older Latinos will be recruited from community-based senior centers in the greater Los Angeles region. The specific aims of the study are to test the effect of the intervention on:

• the change in steps per week measured by digital pedometer from baseline to 1, 12, and 24-month follow-up;
• self-reported physical activity level and intervening constructs (including expectations regarding aging and self-efficacy expectations for physical activity);
• psychosocial health constructs, physical performance measures, and clinical health outcomes.

The core of the intervention consists of a series of 4 weekly 1-hour group discussion sessions that utilize attribution retraining techniques from the field of motivational psychology in combination with behavioral strategies based in social cognitive theory. Discussion sessions will be conducted at senior centers and led by a bilingual health educator; each session will be followed by a 1-hour exercise class aimed at increasing strength, flexibility and endurance. During the discussion sessions, the health educator will administer a structured culturally-tailored curriculum in which participants are taught to raise their expectations for physical activity with aging and not to attribute being sedentary to "old age." The 4 weekly sessions will be followed by monthly sessions for 11 months, and sessions every 2 months for the following 12 months (total intervention duration = 24 months). Participants will be randomized to 1 of 2 arms:

• intervention arm: receiving the discussion session and the exercise class;
• control arm: receiving just the exercise class with the same frequency and duration as the intervention group.

Inclusion criteria

• Aged 60 years or older
• Self-identifying as Latino/Hispanic
• Not currently participating in 20 minutes or more of physical activity 3 times a week
• Willingness to take brief physical activity screening test and if do not pass, provide the name of a physician who has seen the patient in the recent past

Exclusion criteria

• Plans to move from the area in the next 24 months
• Unable to participate in 1-hour group discussion
• Unable to walk
• Physician stating that patient is not medically able to participate
• Family member already participating
• Substantial cognitive impairment (determined by a screening test)