# Primary Care Referrals to a Remotely Delivered Physical Activity Intervention for Latina Teens

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2024 · $691,299

## Abstract

PROJECT SUMMARY
Latina adolescents report especially low activity,2,3 being less than half as likely to meet physical activity
guidelines as Latino boys. Compared to non-Latino White girls, Latina adolescents have 50% higher rates of
overweight/obesity and 60% higher rates of metabolic syndrome4,5 and these disparities continue into
adulthood.6,7 Effective physical activity counseling delivered through Federally Qualified Health Centers could
have broad impacts on Latina teens, yet it is estimated that only 50% of pediatric visits include any discussion
of physical activity. Due to constraints on provider time and expertise, referrals to exterior programs may be
necessary. Through iterative research, including pilot trials (R03NR014329), interviews, design workshops,
and beta testing with a youth advisory board, we have developed a theory-based multi-technology MVPA
intervention for Latina teens, Chicas Fuertes, which is currently being tested in a fully powered trial with a
healthy community sample (R01NR017876). Intervention content is delivered via web, Fitbits, individually
tailored text messages, and Instagram; preliminary data show high engagement and excellent retention
(>90%). Given the use of scalable mobile technologies to deliver the intervention, an adapted version of the
intervention that focuses on guideline adherence has good potential for a referral system; effectiveness or
implementation of such interventions in clinical settings has never been tested. Therefore, we will conduct a
hybrid type 1 effectiveness-implementation trial of FQHC referrals to an augmented, EMR-integrated, remotely
delivered version of the intervention (Chicas Fuertes 2). In the proposed study, providers at Family Health
Centers of San Diego, the largest FQHC in San Diego County, will refer N=200 adolescent Latinas (age 13-17)
to receive a wearable tracker integrated into EMR; they will be randomized 1:1 to receive no other intervention
(comparison arm) or to receive the Chicas Fuertes 2 intervention. We will build a bidirectional data sharing
system in EMR which allows for referral to the program and documentation of MVPA back to EMR as a vital
sign. Adherence to guidelines will be measured at six and 12 months via accelerometers. We will also evaluate
change over time in physical and mental health measures (e.g., BMI, blood pressure, depression), and
examine daily guideline adherence throughout the course of the intervention using data from wearables
(Fitbits). Finally, we will conduct a thorough mixed methods analysis of facilitators, barriers, and outcomes of
implementation guided by the PRISM framework to inform future scale-up across FQHC’s and future
sustainability, including staff time needed to run the intervention and potential to integrate tasks into existing
staff roles. The proposed study will build a foundation for broad implementation, using existing clinical systems
and widespread technologies to shift health behaviors across the life course...

## Key facts

- **NIH application ID:** 10977986
- **Project number:** 1R01HL171807-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Britta Larsen
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $691,299
- **Award type:** 1
- **Project period:** 2024-08-01 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10977986

## Citation

> US National Institutes of Health, RePORTER application 10977986, Primary Care Referrals to a Remotely Delivered Physical Activity Intervention for Latina Teens (1R01HL171807-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10977986. Licensed CC0.

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