Does Difference in Physical Activity Between Blacks and Whites Vary by Sex, Income, Education, and Region of Residence? Results from 2008 to 2017 National Health Interview Surveys

Physical activity engagement among Black African-born immigrant women in the United States: Results from the 2011 to 2018 National Health Interview Surveys

INTRODUCTION

Black women in the US, including Black African immigrant women, have the lowest rates of physical activity (PA). This study aimed to identify sociodemographic, anthropometric, and health characteristics associated with PA engagement among African-born Black women immigrants.

METHODS

The sample consisted of 736 Black African-born women respondents the 2011-2018 National Health Interview Surveys. The outcomes of interest were aerobic activity, strengthening activity, and combined aerobic and strengthening activity. Independent variables of interest included sociodemographic characteristics, health behaviors, and anthropometrics. Descriptive statistics and multivariable adjusted logistic regression analyses were performed.

RESULTS AND DISCUSSION

Of the 736 women, 43.1 % were sufficiently active in aerobic activities and 17.4 % met the strengthening activity guidelines. Overall, only 15.7 % of the participants met the guidelines for total PA (aerobic and strength), while 55 % did not meet any guidelines. Participants who consumed alcohol were more likely to be sufficiently active in aerobic activity compared to those who abstained (AOR = 3.54, 95 % CI [2.43,5.16]). Factors negatively associated with sufficient aerobic activity were smoking (AOR = 0.42, 95 % CI [0.19,0.92] and having obesity (AOR = 0.50, 95 % CI [0.33,0.75]). The odds of meeting strengthening activity guidelines were greater among those with high school education (AOR = 2.94, 95 % CI [1.20, 7.20]) and more than high school (AOR = 2.54, 95 % CI [1.09,5.95]) than among those with less than high school education, Additionally, being in the US 15 years or more (AOR = 2.15, 95 % CI [1.18-3.91]). and a current drinker (AOR = 2.14, 95 % CI [1.22-3.75]) was positively associated with meeting strength guidelines.

IMPLICATIONS

Findings provide missing information about Black African immigrant women's participation in PA and suggest that more research is needed to understand how African immigrant women make decisions about PA. The findings join calls to disaggregate data and health related research on Africans.

Racial/Ethnic Differences in Physical Activity in a Low-Income Sample in Texas

INTRODUCTION

National data reveal that the age-adjusted prevalence of leisure-time physical inactivity is higher among Blacks and Hispanics compared with Whites. However, these estimates do not consider nonleisure physical activity (PA). Also, race/ethnicity in these findings may by confounded by socioeconomic status disparities in PA. Here, we examine racial/ethnic differences in multiple measures of PA within a lower socioeconomic status sample.

METHODS

Participants in the current cross-sectional study (n = 1526 adults, aged ≥ 18 y) were recruited from Supplemental Nutrition Assistance Program-Education classes (nutrition education classes that target low-income people) in Texas. Self-report data were obtained using survey questionnaires in spring and fall 2018. PA outcomes of 4 different intensities were assessed: mean daily time spent walking, engaging in moderate and vigorous PA, and sitting. Additional PA-related measures included use and awareness of community PA resources. Linear regression models examined racial/ethnic differences in the 4 PA outcomes after adjusting for participant gender, age, household composition measures, and various socioeconomic status measures.

RESULTS

In this low-income sample, Hispanic and Black participants spent 6 to 9 more minutes per day walking and engaging in moderate and vigorous PA compared with White/other participants (P < .05 for each measure). Conversely, White/other participants reported spending 82 more minutes sitting per day than Black and Hispanic participants (P < .01). Overall, Black participants were most likely to utilize community PA resources and report ease of engaging in exercise.

DISCUSSION

Together, these results reveal greater engagement in PA by racial/ethnic minorities in low-income communities compared with Whites. Our results have implications for tailoring PA programming to these communities.

Exercise Self-efficacy Improvements During Cardiac Rehabilitation: IMPACT OF SOCIAL DISPARITIES

PURPOSE

The objective of this study was to determine exercise self-efficacy improvements during cardiac rehabilitation (CR) and identify predictors of exercise self-efficacy change in CR participants.

METHODS

Patients with coronary heart disease at four metropolitan CR sites completed the Exercise Self-efficacy Scale at entry and completion. A general linear model identified independent predictors of change in exercise self-efficacy.

RESULTS

The mean age of patients (n = 194) was 65.9 ± 10.5 yr, and 81% were males. The majority (80%) were married or partnered, 76% were White, and 24% were from an ethnic minority background. Patients received CR in-person (n = 91, 47%) or remote-delivered (n = 103, 54%). Exercise self-efficacy mean scores improved significantly from 25.2 ± 5.8 at CR entry to 26.2 ± 6.3 points at completion ( P = .025). The majority of patients (59%) improved their self-efficacy scores, 34% worsened, and 7% had no change. Predictors of reduced exercise self-efficacy change were being from an ethnic minority (B =-2.96), not having a spouse/partner (B =-2.42), attending in-person CR (B =1.75), and having higher exercise self-efficacy at entry (B =-0.37) (adjusted R2 = 0.247).

CONCLUSIONS

Confidence for self-directed exercise improves in most, but not all, patients during CR. Those at risk for poor improvement (ethnic minorities, single patients) may need extra or tailored support, and screening for exercise self-efficacy at CR entry and completion is recommended. Differences identified from CR delivery mode need exploration using robust methods to account for complex factors.

The Impact of COVID-19 on Maintaining Physical Activity and Its Associated Factors among Medical Students

BACKGROUND

Stay-home orders and the shutdown of university campuses and fitness centers have greatly influenced health behaviors, resulting in a widespread reduction in physical activity. This study aimed to identify factors associated with maintaining physical activity among Jazan University medical students during the COVID-19 shutdown.

METHODS

An official Arabic short form of the International Physical Activity Questionnaire was used to assess physical activity before and during the COVID-19 home quarantine. Differences between groups were examined using chi-square analyses and the Mann-Whitney U test. Multinomial logistic regression was used to test whether certain demographic and exercise-related variables were significant predictors of maintaining physical activity levels during the COVID-19 pandemic.

RESULTS

More than half of the participants (53%) reported no change or increased physical activity level. Several factors were significantly related to physical activity heterogeneity including income (p = 0.04), fitness center membership (p < 0.01), usage of fitness tracker devices (p < 0.01), and the purchase of physical activity equipment during the COVID-19 pandemic (p < 0.01). The odds of maintaining physical activity were higher among those who tracked their physical activity (AOR = 6.160; 95% CI = 3.782-10.032, p < 0.001). Similarly, the odds of maintaining physical activity were higher among those who purchased home-exercise equipment during the pandemic (AOR = 2.243; 95% CI = 1.386-3.632, p = 0.001).

CONCLUSIONS

Understanding the factors affecting physical activity behaviors is an essential step toward addressing the reduction in physical activity. This could help maintain physical activity levels during a potential future pandemic-related shutdown.

Racial, Ethnic, and Nativity Disparities in Physical Activity and Sedentary Time among Cancer Prevention Study-3 Participants

PURPOSE

Understanding racial/ethnic and nativity disparities in physical activity (PA) is important, as certain subgroups bear a disproportionate burden of physical inactivity-related diseases. This descriptive study compared mean leisure-time moderate-to-vigorous intensity physical activity (LTMVPA) by race/ethnicity and nativity.

METHODS

The Cancer Prevention Study-3 (78.1% women; age, 47.9 ± 9.7 yr) includes 4722 (1.9%) Asian/Pacific Islander; 1232 (0.5%) Black/Indigenous (non-White) Latino; 16,041 (6.5%) White Latino; 9295 (3.8%) non-Latino Black; 2623 (1.1%) Indigenous American; and 210,504 (85.7%) non-Latino White participants across the United States and Puerto Rico. Participants completed validated LTMVPA and 24-h time use surveys at enrollment (2006-2013). Differences in LTMVPA across race/ethnicity and nativity were examined by ANCOVA with paired Tukey tests adjusting for age and sex. The proportion of time spent sitting, sleeping, and on PA by race/ethnicity was also compared.

RESULTS

There were significant differences in LTMVPA by race/ethnicity (race main effect, P < 0.001; nativity, P = 0.072; interaction, P < 0.001). Pairwise comparisons showed that White participants born abroad were the most active (23.8 MET-h·wk-1) and non-White Latino participants born abroad were the least active (17.9 MET-h·wk-1). Among Latinos, participants born in Puerto Rico were 6.6-7.3 MET-h·wk-1 less active than participants born in Mexico, the United States/Canada, or other countries. There were variations in time use by race/ethnicity, with the largest difference in time spent sitting while watching TV. Black participants spent 14.8% of the day (~3.5 h) sitting watching TV, which was 78 min longer than Asian/Pacific Islander participants.

CONCLUSIONS

This study suggests that there are differences in LTMVPA accumulation by race, ethnicity, and nativity. Results can be used to identify demographic groups that may benefit from culturally tailored PA interventions.

Factors Protecting against a Decline in Physical Activity during the COVID-19 Pandemic

PURPOSE

The spread of COVID-19 and the associated stay-at-home orders and shutdowns of gyms and fitness centers have drastically influenced health behaviors leading to widespread reductions in physical activity (PA). The recent Call to Action from the American College of Sports Medicine has promoted "innovative strategies to promote PA during the COVID-19 pandemic." We aimed to identify individual-level factors that protected against declines in PA levels amid the COVID-19 restrictions.

METHODS

We used the Pennington Biomedical COVID-19 Health Behaviors Survey for our analyses and used mixed-effect linear and generalized linear models to estimate the effects of individual-level factors on changes in PA levels during the COVID-19 restrictions.

RESULTS

Participants (n = 4376) provided information on PA behaviors before and during the COVID-19 shutdown. Overall, PA levels declined by a mean ± SD of 112 ± 1460 MET·min·wk-1 during the COVID-19 shutdown; however, changes in PA were heterogeneous, with 55% of the participants reporting increases in or maintenance of PA during that time. Several social and demographic factors were significantly related to declines in PA, including high prepandemic PA levels, living alone (difference = 118 MET·min·wk-1), low household income (difference between the highest and the lowest income group = 363 MET·min·wk-1), COVID-19-related changes in income (difference = 110 MET·min·wk-1), and loss of employment (difference = 168 MET·min·wk-1). The substitution of prepandemic gym attendance with the purchase and use of home exercise equipment or exercise through virtual fitness platforms promoted increases in PA during the COVID-19 shutdown.

CONCLUSIONS

While promoting PA through the COVID-19 pandemic, it is important to consider demographic factors, which greatly influence health behaviors and implementation of, and access to, replacement behaviors. The promotion of such strategies could help maintain PA levels during potential future stay-at-home orders.

Understanding of Physical Activity in Social Ecological Perspective: Application of Multilevel Model

In the social ecological model, personal characteristics are important determinants of health behaviors, however, multi-dimensional approaches that consider social and physical environments must be utilized to gain a broader picture. Accordingly, this study examines the effects of personal, social, and physical environment variables as factors affecting levels of physical activity (METs). Our findings are based on 72,916 responses from the 2015 Community Health Survey in South Korea. Individual characteristics considered included sex, education level, marital status, age, and income. The social environment variables considered were trust between neighbors and the social network with neighbors. The physical environment variables were satisfaction with living environment and satisfaction with public transportation. The analysis was conducted using a multilevel model in order to accurately consider the characteristic differences of the variables. Regarding personal characteristics, sex, education level, and age have a significant effect on physical activity. Of the social and physical environment variables, social network with neighbors and satisfaction with public transportation have a significant effect on physical activity. This study confirms that a macroscopic understanding is needed to explain individual levels of physical activity; the results of this study will be helpful for public health interventions concerning physical activity.