ABSTRACT Research demonstrates the health-related benefits of participation in daily physical activity (PA), including prevention and treatment of chronic diseases. Despite this knowledge, the majority of US adults, particularly black women, do not achieve recommended levels of PA and, consequently, have higher rates of related chronic disease. An efficacy study led by the proposed Principal Investigator developed and tested an in person, 10-month group-based faith-integrated (FI) or secular (SEC) PA intervention, compared with a self- guided control (SG) for black women. Both FI and SEC were superior to SG for increasing daily steps after 10 months, and FI was superior to SG for increasing daily steps 12 months post intervention. Barriers to program participation noted by participants included childcare and work responsibilities and proximity to the group meeting location. The 2018 PA Guidelines Advisory Committee Scientific Report highlighted the need for effective strategies to promote PA, including internet-delivered interventions which have demonstrated strong evidence for effectiveness at increasing PA levels. Limited data exist regarding the efficacy of internet- delivered interventions in racial/ethnic minority groups. Online delivery of our evidence-based program may increase reach and address known barriers to PA program participation in black women. We therefore propose to explore strategies for adapting the program for web-based delivery of the existing curriculum. R21 phase aims are: Aim 1: Solicit input from individuals representative of the population of focus to inform the translation of the FI curriculum for online use; Aim 2: Use the knowledge gathered in Aim 1 to adapt existing FI and SG curricula for online use; Aim 3: Assess acceptability of the online curricula in an advisory group similar to the target population. We will conduct focus groups with black women to understand factors that would influence online delivery of the curriculum. We will identify a group of a 12 member advisory group to assist with developing materials/strategies to adapt the curriculum for online delivery. In an iterative approach where material is tested, refined, and retested until complete, we will engage the advisory group in feasibility testing of the online curriculum. Data collected from the R21 phase will be used to inform the R33 phase that will: Aim 4: Conduct a randomized pilot intervention to field test the modified online curricula in a sample (n=60) representative of participants who would meet eligibility criteria for enrollment in a full scale trial. We will assess change in PA, acceptability of the modified interventions including intervention delivery methods, online materials, recruitment, enrollment, and data collection methods, online engagement, and clinical markers of disease. The proposed project is directly responsive to PAR-18-307. The intervention is informed by the socio- ecological model and addresses PA at the intrapersonal (individual) and interpersonal (social support through online group-based interaction) levels. The project will further enhance our current knowledge of successful strategies to increase PA and reduce inactivity in high risk populations.

PUBLIC HEALTH RELEVANCE The results will have an important public health impact, as significant changes in PA can reduce the risk of coronary heart disease, hypertension, type 2 diabetes, and stroke by 15-40%, avoid 263,000 deaths each year, and result in life expectancy gains of 1.5-3.5 years in this population.