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Figueroa CA, Aguilera A, Hoffmann TJ, Fukuoka Y. The Relationship Between Barriers to Physical Activity and Depressive Symptoms in Community-Dwelling Women. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:242-249. [PMID: 38516653 PMCID: PMC10956528 DOI: 10.1089/whr.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 03/23/2024]
Abstract
Background Women are less physically active, report greater perceived barriers for exercise, and show higher levels of depressive symptoms. This contributes to high global disability. The relationship between perceived barriers for physical activity and depressive symptoms in women remains largely unexplored. The aims of this cross-sectional analysis were to examine the association between physical activity barriers and depressive symptoms, and identify types of barriers in physically inactive community-dwelling women. Methods Three hundred eighteen physically inactive women aged 25-65 years completed the Barriers to Being Active Quiz (BBAQ) developed by the Centers for Disease Control and Prevention, and the Center for Epidemiological Studies Depression Scale at the baseline visit of the mobile phone-based physical activity education trial. The BBAQ consists of six subscales (lack of time, social influence, lack of energy, lack of willpower, fear of injury, lack of skill, and lack of resources). We used multivariate regression analyses, correcting for sociodemographics. Results Higher physical activity barriers were associated with greater depressive symptoms scores (linear effect, estimate = 0.75, 95% confidence interval [CI]: 0.39-1.12, p < 0.001). This effect appeared to taper off for the higher barrier scores (quadratic effect, estimate: -0.02, 95% CI: -0.03 to -0.01, p = 0.002). Exploratory analyses indicated that these associations were most driven by the social influence (p = 0.027) and lack of energy subscales (p = 0.017). Conclusions Higher depression scores were associated with higher physical activity barriers. Social influence and lack of energy were particularly important barriers. Addressing these barriers may improve the efficacy of physical activity interventions in women with higher depressive symptoms. Future research should assess this in a randomized controlled trial. Trial Registration ClinicalTrialsgov# NCTO1280812 registered January 21, 2011.
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Affiliation(s)
- Caroline A. Figueroa
- Department Engineering Systems and Services, Faculty of Technology, Policy, and Management, Delft University of Technology, Delft, The Netherlands
- School of Social Welfare, University of California, Berkeley, California, USA
| | - Adrian Aguilera
- School of Social Welfare, University of California, Berkeley, California, USA
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, California, USA
| | - Thomas J. Hoffmann
- School of Social Welfare, University of California, Berkeley, California, USA
- Department of Epidemiology and Biostatistics, and Office of Research, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Yoshimi Fukuoka
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, USA
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Garland M, Wilbur J, Schoeny M, Reed M, Semanik P, Halloway S, Waters T. Determinants of Physical Activity Among Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:172-184. [PMID: 38072009 DOI: 10.1016/j.jogn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN Longitudinal cohort. SETTING Medical center obstetric clinic. PARTICIPANTS Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.
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Kim SJ, Blesoff JR, Tussing-Humphrys L, Fitzgibbon ML, Peterson CE. The association between neighborhood conditions and weight loss among older adults living in a large urban city. J Behav Med 2023; 46:882-889. [PMID: 37000323 PMCID: PMC10544679 DOI: 10.1007/s10865-023-00410-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 03/12/2023] [Indexed: 04/01/2023]
Abstract
To elucidate the role of neighborhood walkability and crime on weight loss, we examined data from older adults residing in Chicago who participated in a randomized controlled trial lifestyle intervention. Controlling for individual demographic characteristics and the intervention assignment, the neighborhood homicide rate was significantly associated with weight change. Participants who resided in neighborhoods above the 50th percentile of homicide rate actually gained weight between pre- and post-intervention. On the other hand, there was no significant relationship between the level of walkability and weight loss. Our findings suggest that the social environment related to neighborhood crime may play a more important role in weight loss than the built environment, such as walkability. Urban characteristics related to walkability, such as sidewalks, may increase physical activity, however, interventions aiming to increase physical activity to promote weight loss will benefit by addressing the neighborhood social environment that determines how people navigate space.
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Affiliation(s)
- Sage J Kim
- School of Public Health, Division of Health Policy & Administration, University of Illinois at Chicago, 1603 W. Taylor St. #781, Chicago, IL, 60612, USA.
| | - Jamine R Blesoff
- School of Public Health, Division of Health Policy & Administration, University of Illinois at Chicago, 1603 W. Taylor St. #781, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphrys
- College of Applied Health Sciences, Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, USA
| | - Marian L Fitzgibbon
- Pediatrics and Health Policy and Administration, Associate Director for Population Science, University of Illinois at Chicago, UI Cancer Center, Chicago, USA
| | - Caryn E Peterson
- School of Public Health, Division of Epidemiology & Biostatistics, University of Illinois at Chicago, Chicago, USA
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Allen J. The indirect effects of food insecurity on obesogenic environments. Front Public Health 2023; 10:1052957. [PMID: 36685001 PMCID: PMC9853452 DOI: 10.3389/fpubh.2022.1052957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction The Centers for Disease Control and Prevention (CDC) estimates 39.8% of United States (US) residents have obesity. This study examined obesity-related factors at the county-level to determine the indirect effects on physical inactivity, insufficient sleep duration, income inequality, food insecurity, on obesity rates. Methodology Using the 2018 Robert Wood Johnson Foundation (RWJF) County Health Rankings data set, a multiple regression analysis was conducted to measure the percentage of the obesity rate explained by physical inactivity, insufficient sleep duration, food insecurity, and income inequality via geographically weighted county means. RWJF combines US federal and state datasets to produce a composite dataset comprised of information primarily from adults over the age of 18 from the 3,143 counties found within US borders. The aggregate county-level data serves as the unit of measure (N = 3,143). The indirect relationships (the product of two direct relationships) between obesity-related variables and obesity were measured and illustrated through a path analysis model. Results This study found the combination of independent variables explained 53% of the obesity rates in the US, R 2 = 0.53, p < 0.001, two-tailed. This study also found that food insecurity has both a direct and indirect effect on obesity, physical inactivity, and insufficient sleep duration. Physical inactivity has a direct effect on obesity and insufficient sleep duration, along with an indirect effect on obesity. Insufficient sleep duration has a direct effect on obesity. Conclusion This analysis found that food insecurity indirectly impacts an obesogenic environment and drives county-level BMI averages. The dataset used for analysis predates the COVID-19 pandemic but presents the effect of food insecurity during a normative year. The findings, though interesting, provide an opportunity for future research.
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Affiliation(s)
- Jeffrey Allen
- Department of Health Science and Public Health, St. Bonaventure University, Allegany, NY, United States
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Obi OC, Nnonyelu AC, Onobrakpeya A, Ogundele OJ. Benefits and barriers to physical activity among African women: A systematic review. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 5:59-66. [PMID: 36994171 PMCID: PMC10040374 DOI: 10.1016/j.smhs.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
Black women have always been likened to being a less physically active group compared to women of other races/ethnicity, with reports of a high prevalence of obesity and other cardiometabolic diseases among them. The purpose of this study is to examine the health benefits of physical activity on women of color, as well as barriers that inhibit their participation. We searched PubMed and Web of Science databases for relevant research articles. Included articles were: Published in the English Language from 2011 to February 2022; conducted predominantly on black women, African women, or African American women. Articles were identified, screened, and data extracted following the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) guidelines. The electronic search produced 2 043 articles, and 33 articles were reviewed after meeting the inclusion criteria. 13 articles focused on the benefits of physical activity while 20 articles addressed the barriers to physical activity. It was found that physical activity has various benefits for black women participants but they are being hindered from participation by some factors. These factors were grouped into four themes, namely Individual/Intrapersonal barriers, Socio-economic barriers, Social barriers, and Environmental barriers. Various studies have examined the benefits and barriers of physical activity among women of different racial and ethnic backgrounds, but there have been very few studies of African women, with the majority focusing on one geographical area. In addition to exploring these benefits and barriers, this review offers recommendations on the areas researchers should focus on to promote physical activity in this population.
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Loughman TM, Flaherty GT, Houlihan A, Dunne D. A Cross-Sectional Analysis of Physical Activity Patterns, Aerobic Capacity and Perceptions about Exercise among Male Farmers in the Mid-West Region of Ireland. J Agromedicine 2021; 27:87-97. [PMID: 33775220 DOI: 10.1080/1059924x.2021.1879699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In Ireland, farmers have been identified as a high-risk population, with higher rates of cardiovascular disease (CVD) and overall mortality, compared with the general population. Farming has always been considered a physically active lifestyle. However, in recent times, with the increased use of technology and machinery, farmers may not be completing as much physical activity as before. There is a lack of research on physical activity patterns, fitness, and perception about exercise among farmers. Physical activity patterns were assessed using ActivPAL₃ micro monitors for a duration of 7 consecutive days. Aerobic capacity was measured using a validated sub-maximal exercise test to calculate Metabolic Equivalent Task (MET) levels. The Exercise Benefits and Barriers Scale (EBBS) questionnaire was used to explore perceived benefits and barriers towards exercise. Farmers completed a mean (standard deviation) of 16,452 (5,170) steps and 124 (43) minutes of moderate-vigorous intensity physical activity (MVPA) daily. The volume of weekly MVPA was largely accumulated in bouts lasting <10 minutes, with only 17.89% completing bouts of ≥10 minutes. Daily sitting time was 8.26 hours. Farmers are fit, have positive perceptions about exercise, and complete large quantities of physical activity, but not in a CVD protective pattern. CVD risk can be reduced in this population by encouraging them to sit less and engage in MVPA in bouts of ≥10 minutes, in line with current guidelines.
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Affiliation(s)
- Trisha M Loughman
- National Institute for Prevention and Cardiovascular Health, Croi Heart and Stroke Centre, Galway, Ireland
| | - Gerard T Flaherty
- National Institute for Prevention and Cardiovascular Health, Croi Heart and Stroke Centre, Galway, Ireland.,School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Ailish Houlihan
- National Institute for Prevention and Cardiovascular Health, Croi Heart and Stroke Centre, Galway, Ireland
| | - Denise Dunne
- National Institute for Prevention and Cardiovascular Health, Croi Heart and Stroke Centre, Galway, Ireland
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Hair Maintenance and Chemical Hair Product Usage as Barriers to Physical Activity in Childhood and Adulthood among African American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249254. [PMID: 33322020 PMCID: PMC7762987 DOI: 10.3390/ijerph17249254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 01/01/2023]
Abstract
Qualitative studies have identified haircare practices as important culturally specific barriers to physical activity (PA) among Black/African American (AA) women, but quantitative investigations are lacking. Using the Study of Environment, Lifestyle and Fibroids data among 1558 Black/AA women, we investigated associations between hair product usage/hair maintenance behaviors and PA during childhood and adulthood. Participants reported childhood and current chemical relaxer and leave-in conditioner use. Self-reported PA included childhood recreational sports participation, leisure-time PA engagement during adulthood, and, at each life stage, minutes of and intensity of PA. Adjusting for socioeconomic and health characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each PA measure for more vs. less frequent hair product use/hair maintenance. Thirty-four percent reported ≥twice/year chemical relaxer use and 22% reported ≥once/week leave-in conditioner use at age 10 years, and neither were associated with PA at age 10 years. In adulthood, ≥twice/year chemical relaxer users (30%) were less likely (PR = 0.90 [95% CI: 0.79-1.02]) and ≥once/week leave-in conditioner users (24%) were more likely (PR = 1.09 [95% CI: 0.99-1.20]) to report intense PA compared to counterparts reporting rarely/never use. Hair product use/maintenance may influence PA among Black/AA women and impact cardiometabolic health disparities.
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Rosselli M, Ermini E, Tosi B, Boddi M, Stefani L, Toncelli L, Modesti PA. Gender differences in barriers to physical activity among adolescents. Nutr Metab Cardiovasc Dis 2020; 30:1582-1589. [PMID: 32605880 DOI: 10.1016/j.numecd.2020.05.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Great attention is now being paid to effective policies and programs to promote physical activity among adolescents, girls consistently found to be less active than boys. The aim of this study was to assess gender differences in perceived barriers for physical activity practice and their relationship with physical activity levels and physical condition among adolescents. METHODS AND RESULTS A cross-sectional study was conducted in February-April 2017 among students (n = 368) in the last year of two state high schools in Florence (Italy). Participants underwent the measurements of anthropometric parameters (height, weight, waist, and hip circumferences), blood pressure and administration of 3 standardized questionnaires (International Physical Activity Questionnaire, Mediterranean Diet Score Quiz, and Barriers to Being Active Quiz). Gender differences were assessed using a multivariate logistic regression model (adjusted for age and body mass index). The prevalence of participants who reached recommended levels was lower among girls compared to boys (OR 0.27; 95% CI 0.17-0.43). The number of perceived barriers to physical activity was higher among girls than among boys (OR 1.52; 95% CI 1.29-1.79), lack of energy for exercise and lack of willpower being the two barriers most frequently reported by girls. At multivariable adjusted logistic regression analysis, gender (female), and positivity of at least one perceived barrier (score ≥ 5) were independently selected as the main determinants of non-compliance with WHO criteria for physical activity. CONCLUSIONS Exercise professionals should be aware of the barriers that young girls can face during exercise prescription and be able to contrast them with useful individual strategies.
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Affiliation(s)
- Martina Rosselli
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy
| | - Elena Ermini
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy
| | - Benedetta Tosi
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy
| | - Maria Boddi
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy
| | - Laura Stefani
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy
| | - Loira Toncelli
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy
| | - Pietro A Modesti
- Department of Medicina Sperimentale e Clinica, School of Medicine, University of Florence, Florence, Italy.
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Zenk SN, Tarlov E, Wing C, Slater S, Jones KK, Fitzgibbon M, Powell LM. Does the built environment influence the effectiveness of behavioral weight management interventions? Prev Med 2019; 126:105776. [PMID: 31330154 PMCID: PMC6878977 DOI: 10.1016/j.ypmed.2019.105776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/01/2019] [Accepted: 07/14/2019] [Indexed: 11/28/2022]
Abstract
Outcomes of behavioral lifestyle interventions for promoting weight loss vary widely across participants. The effectiveness of a weight management intervention may depend on a person's environmental context. This study compared short- and longer-term effects of a structured nationwide weight management program for people living in neighborhoods with different levels of walkability and different access to recreational places (parks, fitness facilities). Drawing on the health production model, we tested competing hypotheses for whether treatment effects of the program complement environmental supports or substitute for environmental constraints. We studied the US Department of Veterans Affairs (VA) MOVE! weight management program using VA electronic heath record data (2009-2014) and a difference-in-differences design with an inverse propensity score matched comparison group. A total of 114,256 program participants and 498,494 non-participants comprised the sample. Built environment features were measured within one-mile of each person's home. We estimated program effects on body mass index (BMI) for subgroups with different built environments at 6-, 12-, 18-, and 24-month follow-up using linear regressions with person and year fixed effects. At 6 months, the program reduced BMI by 0.4-0.6 kg/m2 among men and 0.3-0.5 kg/m2 among women. The effect diminished at 12, 18, and 24 months. The program effect did not vary significantly across subgroups with different walkability, park access, or fitness facility access. The MOVE! program was not sensitive to environmental context. Results did not lend support to either hypothesis that the MOVE! program complements or substitutes for a person's built environment to affect weight management outcomes.
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Affiliation(s)
- Shannon N Zenk
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA.
| | - Elizabeth Tarlov
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA; Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA.
| | - Coady Wing
- Indiana University School of Public and Environmental Affairs, Bloomington, IN 47405, USA.
| | - Sandy Slater
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA; University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
| | - Kelly K Jones
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA.
| | - Marian Fitzgibbon
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL 60612, USA; University of Illinois at Chicago Department of Pediatrics, Chicago, IL 60612, USA.
| | - Lisa M Powell
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL 60612, USA; University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
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Physical Activity After Breast Cancer Surgery: Does Depression Make Exercise Feel More Effortful than It Actually Is? Int J Behav Med 2019; 26:237-246. [PMID: 30820922 DOI: 10.1007/s12529-019-09778-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prior to treatment, breast cancer patients are less physically fit compared to peers; during cancer treatment, their fitness typically declines. Depressive symptoms are associated with reduced activity up to 5 years post-treatment, but research has not identified mechanisms linking depression and lower activity. The current study assessed relationships among breast cancer patients' depression and perceived exertion during exercise as well as heart rate, an objective indicator of exertion. METHODS Participants were 106 breast cancer patients, stages I-IIIA, who completed surgery but had not started adjuvant treatment. Heart rate and self-rated exertion, measured using the Borg Scale of Perceived Exertion, were assessed every 2 min during a graded exercise test. Depression was assessed using the CES-D and a structured clinical interview. RESULTS Compared to women below the CES-D clinical cutoff, women with significant depressive symptoms reported steeper increases in exertion during the exercise test (p = .010) but had similar heart rates (p = .224) compared to women below the cutoff. Major depression history was unrelated to perceived exertion (ps > .224) and heart rate (ps > .200) during exercise. CONCLUSIONS Women with currently elevated depressive symptoms experienced exercise as more difficult compared to women below the CES-D cutoff, but these self-perceptions did not reflect actual heart rate differences. Depression may make exercise feel more demanding, which could ultimately decrease patients' likelihood of engaging in regular exercise. Results support the use of depression screening tools following breast cancer surgery to identify and intervene on individuals at risk for decreased physical activity during survivorship.
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Hayes T, Sharma M, Shahbazi M, Sung JH, Bennett R, Reese-Smith J. The evaluation of a fourth-generation multi-theory model (MTM) based intervention to initiate and sustain physical activity. Health Promot Perspect 2019; 9:13-23. [PMID: 30788263 PMCID: PMC6377703 DOI: 10.15171/hpp.2019.02] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 12/24/2018] [Indexed: 01/20/2023] Open
Abstract
Background: The United States Department of Health and Human Services (USDHHS)recommends that adults achieve 150 minutes per week of moderate-intensity aerobic activity.Most African American women do not meet these guidelines. The purpose of this study was to determine the efficacy of an intervention based on the fourth generation, multi-theory model (MTM) of health behavior change for initiating and sustaining physical activity among African American women when compared to a first generation, knowledge-based intervention. Methods: The randomized controlled trial (RCT) utilized a pre-test, post-test and 6-week followup evaluation with an experimental (n=25) group and a comparison group (n=23). Process evaluation for satisfaction and program fidelity was conducted along with impact evaluation for changes in MTM constructs, intent to initiate and sustain physical activity, minutes of physical activity, body mass index (BMI), waist circumference and blood pressure in hypertensives. Results:The MTM-based intervention proved significantly efficacious in increasing the minutes of physical activity from pre-test mean of 37 minutes to 172 minutes at follow-up (mean difference135.08 minutes, 95% CI: 106.04 to 164.13, P<0.0001), reducing waist circumference from pretest mean of 39 inches to 38 inches at follow-up (mean difference -1.12 inches, 95% CI: -1.70 to-0.545, P<0.001) and modifying the MTM construct of changes in physical environment from a mean of 7 units at pre-test to 9 units at follow-up (mean difference 2.08 units, 95% CI: 0.73 to 3.43, P<0.004) when compared to the knowledge-based intervention over time. Conclusion: There were directional improvements in the mean scores for most of the study variables over time for the MTM intervention group and statistically significant improvement in minutes of physical activity and waist circumference.
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Affiliation(s)
- Traci Hayes
- Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Mohammad Shahbazi
- Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Jung Hye Sung
- Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Russell Bennett
- Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
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Stillman CM, Erickson KI. Physical activity as a model for health neuroscience. Ann N Y Acad Sci 2018; 1428:103-111. [DOI: 10.1111/nyas.13669] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/06/2018] [Accepted: 02/13/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Chelsea M. Stillman
- Western Psychiatric Institute and Clinic; University of Pittsburgh Medical Center; Pittsburgh Pennsylvania
| | - Kirk I. Erickson
- Western Psychiatric Institute and Clinic; University of Pittsburgh Medical Center; Pittsburgh Pennsylvania
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Predicting Physical Activity Behavior in African American Females: UsingMulti Theory Model. J Res Health Sci 2018. [PMCID: PMC7204419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Despite physical activity having several benefits, a considerable number of Americans donot engage in sufficient exercise. Among the high-risk groups are African American women. A recenttheory, multi theory model (MTM) for health behavior change can be used to develop effectiveinterventions. The objective of this research was to test MTM in its ability to predict physical activitybehavior in African American women. Study design: A cross-sectional study. Methods: African American women aged 18 yr and older were recruited at various locations (primarilychurches) of Jackson, a large city in Central Mississippi instead of southern Mississippi to participate inthis cross-sectional study in 2016. The valid and reliable survey was administered to a G*Power calculatedquota sample of 156 women either in person or via a Qualtrics link sent through an e-mail. Results: The regression analysis revealed that 32.7% of the variance in initiating physical activity behaviorwas predicted by participatory dialogue, behavioral confidence, and changes in physical environment.Sustenance of physical activity behavior was predicted up to 38.8% by emotional transformation andchanges in social environment. Conclusions: MTM appears to be a robust theory in its application for changing physical activity behaviorin African American women. This theory must be reified and empirically tested with this population.
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Saelens BE, Arteaga SS, Berrigan D, Ballard RM, Gorin AA, Powell-Wiley TM, Pratt C, Reedy J, Zenk SN. Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain. Obesity (Silver Spring) 2018; 26 Suppl 2:S35-S44. [PMID: 29575779 PMCID: PMC5875459 DOI: 10.1002/oby.22159] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/31/2018] [Accepted: 02/12/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. OBJECTIVES The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. SIGNIFICANCE Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance.
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Affiliation(s)
- Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle Washington, USA
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - S Sonia Arteaga
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel M Ballard
- Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Amy A Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Tiffany M Powell-Wiley
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Charlotte Pratt
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jill Reedy
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shannon N Zenk
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
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15
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Craven MR, Keefer L, Rademaker A, Dykema-Engblade A, Sanchez-Johnsen L. Social Support for Exercise as a Predictor of Weight and Physical Activity Status Among Puerto Rican and Mexican Men: Results From the Latino Men's Health Initiative. Am J Mens Health 2018; 12:766-778. [PMID: 29451072 PMCID: PMC6131447 DOI: 10.1177/1557988318754915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Social support is an important factor in increasing positive health outcomes and
positive health behaviors across a variety of disease states including obesity.
However, research examining the relationship between social support for exercise
and weight and physical activity status, particularly among Latino men, is
lacking. This paper examined whether social support for exercise predicted
weight and physical activity status and whether the direction of these
relationships differ as a function of Hispanic/Latino background (Puerto
Rican/Mexican). Participants were 203 men who participated in a National
Institutes of Health (NIH)-funded study addressing culture- and obesity-related
variables. Both family participation social support and
family rewards and punishment social support predicted
higher weight status (p < .005 and p <
.05, respectively). Friend participation social support did not
predict weight status. The direction of the relationship between weight status
and family participation social support, family rewards and punishment
social support, and friend participation social
support did not significantly differ as a function of
Hispanic/Latino background. The direction of the relationship between physical
activity status and family participation social support, family rewards
and punishment social support, and friend participation
social support did not significantly differ as a function of
Hispanic/Latino background. Findings suggest that increased social support for
exercise from family members may be focused on those who need it most—overweight
and obese participants. Additional research is needed to explore sociocultural
factors that may promote social support, physical activity, and weight loss and
maintenance in Puerto Rican and Mexican men.
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Affiliation(s)
- Meredith R Craven
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Laurie Keefer
- 2 Department of Gastroenterology, The Mount Sinai Hospital, New York, NY, USA
| | - Alfred Rademaker
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Lisa Sanchez-Johnsen
- 4 Departments of Psychiatry and Surgery, University of Illinois at Chicago, Chicago, IL, USA
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16
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Barriers to Physical Activity in Low Back Pain Patients following Rehabilitation: A Secondary Analysis of a Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6925079. [PMID: 29209630 PMCID: PMC5676355 DOI: 10.1155/2017/6925079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 12/02/2022]
Abstract
Background Promoting health-enhancing physical activity following rehabilitation is a well-known challenge. This study analysed the barriers to leisure time activity among low back pain patients. Methods A subset of 192 low back pain patients who participated in a randomized controlled trial promoting physical activity was analysed. Physical activity, barriers, and sociodemographic and indication-related variables were assessed by a questionnaire. Differences in barriers between active and inactive participants were tested by Pearson's chi squared test. A logistic regression model was fitted to identify influencing factors on physical activity at six months following rehabilitation. Results Inactive and active participants differed significantly in nine of the 19 barriers assessed. The adjusted regression model showed associations of level of education (OR = 5.366 [1.563; 18.425]; p value = 0.008) and fear of pain (OR = 0.612 [0.421; 0.889]; p value = 0.010) with physical activity. The barriers included in the model failed to show any statistically significant association after adjustment for sociodemographic factors. Conclusions Low back pain patients especially with a low level of education and fear of pain seem to need tailored support in overcoming barriers to physical activity. This study is registered at German Clinical Trials Register (DRKS00004878).
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