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Davis E, Townsend E, Cavalier A, Chen YF, Edwards-Hart D, Kitsiou S, Kowalczyk W, Mansur I, Okpara E, Powell K, Press VG, Ramirez T, Salvo D, Sharp LK, Wright B, Nyenhuis SM. Physical Activity Intervention for Urban Black Women With Asthma: Protocol for a Randomized Controlled Efficacy Study. JMIR Res Protoc 2024; 13:e55700. [PMID: 38324365 PMCID: PMC10882465 DOI: 10.2196/55700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Black women experience a higher prevalence of poor asthma outcomes and physical inactivity than their White counterparts. Black women comprise a particularly vulnerable group of patients with asthma, with some of the highest rates of asthma in adults, high health care use (emergency department visits and hospitalizations), and the highest crude asthma mortality rate of all race or ethnicity groups. Despite recommendations to engage in regular physical activity, fewer than 15% of Black women meet the 2008 National Physical Activity Guidelines, the lowest of all racial subgroups of adults. Given the connection between physical inactivity and poor asthma outcomes, addressing physical activity among Black women with asthma is imperative. OBJECTIVE This 2-arm randomized controlled trial aims to (1) determine the efficacy of a lifestyle walking intervention on asthma control compared to an education (control) group over 24 weeks, (2) examine the maintenance effects of the lifestyle walking intervention on asthma control at 48 weeks, (3) explore the behavioral mediators (eg, self-efficacy, social support, self-regulation, and daily physical activity levels) and contextual moderators (eg, baseline asthma severity, neighborhood environment, comorbid conditions, and social determinants of health) that contribute to treatment responsiveness, and (4) assess the reach and implementation potential of the intervention. METHODS The proposed study (ACTION [A Lifestyle Physical Activity Intervention for Minority Women with Asthma]) delivers a 24-week lifestyle walking intervention designed for and by urban Black women with asthma. Participants (n=224) will be recruited through 2 urban health care systems that care for a diverse Black population. Patients will be randomized to one of two groups: (1) ACTION intervention (group sessions, physical activity self-monitoring-Fitbit, and text-based support for step goal setting) or (2) education control (an individual asthma education session and SMS text messages related to asthma education). Outcome assessments will take place at baseline, 12, 24, and 48 weeks. The primary outcome is a change in asthma control from baseline to week 24 as assessed by the asthma control questionnaire-6 (ACQ-6). Secondary outcomes include asthma-related quality of life, health care use, and asthma exacerbations and behavioral outcomes such as self-efficacy, self-regulation, social support, and physical activity. RESULTS This study was funded by the National Institute of Minority Health Disparities in August 2022. We pilot-tested our recruitment and intervention procedures and began recruitment in April 2023, with the enrollment of our first participant in May 2023. The anticipated completion of the study is April 2027. CONCLUSIONS This study will deliver a new approach to physical activity interventions in Black women with asthma and help to provide guidance for addressing physical activity within this subgroup. This study will also provide a potential framework for future studies in minoritized populations with other disease conditions associated with low levels of physical activity. TRIAL REGISTRATION ClinicalTrials.gov NCT05726487; https://clinicaltrials.gov/study/NCT05726487. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55700.
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Affiliation(s)
- Ellen Davis
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Elizabeth Townsend
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Aero Cavalier
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Yi-Fan Chen
- Center for Research on Health Care Data Center, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dameka Edwards-Hart
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Wiktoria Kowalczyk
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Iliana Mansur
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Ebere Okpara
- Department of Pharmacy, Systems, Outcomes and Policy, University of Illinois Chicago, Chicago, IL, United States
| | - Karen Powell
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Valerie G Press
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Toni Ramirez
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Deborah Salvo
- People, Health and Place Lab, Department of Kinesiology and Health Educations, University of Texas Austin, Austin, TX, United States
| | - Lisa K Sharp
- Department of Biobehavioral Nursing Science, University of Illinois Chicago, Chicago, IL, United States
- Office of Research Facilitation, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Brittani Wright
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Sharmilee Maria Nyenhuis
- Section of Allergy and Immunology, Department of Pediatrics, University of Chicago, Chicago, IL, United States
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Moore Hubbell A, Schafer Astroth K, Henry Jenkins S, Mann Woith W. Influences on Long-Term Physical Activity in African American Women: A Scoping Review. West J Nurs Res 2023; 45:953-962. [PMID: 37542382 DOI: 10.1177/01939459231191598] [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] [Indexed: 08/06/2023]
Abstract
African American women experience a disparity of preventable long-term illness than non-Hispanic White, non-Hispanic Asian, and Hispanic women. Participation in routine physical activity (PA) is recommended to prevent and manage long-term illness, yet African American women are the least physically active. There is a paucity of literature addressing long-term PA in this population; therefore, a scoping review of the literature was conducted to assess what is known about physically active African American women who successfully participate in regular forms of long-term PA. The Socioecological Model was used to organize a synthesis of factors influencing PA at the individual, social, environmental, and political levels. A search of 7 electronic databases and reference lists produced 7 studies published in English between 2000 and 2022. Participants shared perspectives of influences at multiple levels. At the individual level, modeling PA behaviors was noted as a means for changing the cultural perspective of PA; future interventions that engage physically active African American women as advocates and promoters of PA may be useful. Social level influences were the most impactful and served as a channel for belonging and attachment while performing PA; culturally appropriate interventions may include supporting a sense of belonging. At the environmental level, financial constraints and unsafe environments for subgroups influenced the ability to perform PA; future research might consider interventions based on demographics and their impact on participants' ability to perform PA. No influences were mentioned by participants at the political level.
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Affiliation(s)
| | | | | | - Wendy Mann Woith
- Mennonite College of Nursing, Illinois State University, Normal, IL, USA
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Cunningham-Myrie C, Theall K, Younger-Coleman N, Wiggan J, McFarlane S, Francis D, Bennett N, Tulloch-Reid M, Ferguson T, Davidson T, Govia I, Guthrie-Dixon N, Aiken W, Grant A, Webster-Kerr K, Wilks R. Who moves in vulnerable Caribbean neighborhoods? Positive deviance for physical activity: Findings from the Jamaica health and Lifestyle Survey 2017 (JHLS III). Prev Med Rep 2022; 30:101998. [PMID: 36189127 PMCID: PMC9519374 DOI: 10.1016/j.pmedr.2022.101998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022] Open
Abstract
Decreased physical activity (PA) has been associated with residents living in neighborhoods perceived as being disordered or having high crime levels. What is unknown are the characteristics of individuals who engage in moderate to vigorous levels of PA (MVPA) despite living in these vulnerable neighborhoods, or who may be referred to as positive deviants (PD). We examined the factors associated with PD for PA among Jamaicans. Between 2016 and 2017 the Jamaica Health and Lifestyle Survey, a cross-sectional nationally representative survey (n = 2807), was conducted on individuals aged 15 years and older. Regression analyses were performed to identify associations with PD, defined using engagement in MVPA among persons living in vulnerable neighborhoods (N = 1710). Being female (odds ratio [OR]a = 0.64 (0.48, 0.86); p = 0.003), obese while living in an urban area (ORa = 0.39; 95 % CI = 0.26, 0.59; p < 0.0001), unemployed (ORa = 0.53; 95 % CI = 0.39, 0.73; p < 0.0001), or a student (ORa = 0.62; 95 % CI = 0.39, 0.98); p = 0.041) was associated with a significantly lower likelihood of PD, while having a personal medical history of at least one chronic disease significantly increased likelihood (ORa = 1.43; 95 % CI = 1.08, 1.90; p = 0.014). Taking a PD approach may be one angle to consider in trying to determine what is working and for whom, so that this may be harnessed in policy, prevention and intervention programming to increase PA.
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Affiliation(s)
- C. Cunningham-Myrie
- Department of Community Health & Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - K.P. Theall
- Departments of Social, Behavioral, and Population Sciences and Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - N. Younger-Coleman
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - J. Wiggan
- Ministry of Health & Wellness, Jamaica
| | - S. McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - D. Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
| | - N. Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - M. Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - T.S. Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - I. Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - N. Guthrie-Dixon
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - W. Aiken
- Department of Surgery, Radiology, Anaesthesia & Intensive Care, University of the West Indies, Mona, Kingston, Jamaica
| | - A. Grant
- Ministry of Health & Wellness, Jamaica
| | | | - R. Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
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Affuso O, Kinsey AW, Whitt-Glover MC, Segar M, Bowen P. Social Environments and Physical Activity Among Active Black Women. Am J Health Promot 2022; 36:1275-1283. [PMID: 35580614 DOI: 10.1177/08901171221102139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE To explore the social context of physical activity (PA) among active Black women, we examine the patterns of PA engagement and the benefits of social support in PA maintenance. DESIGN A cross-sectional study design and descriptive phenomenological approach were used to examine social support and lived experiences of active Black women. SETTING The study setting was an online survey of active Black women, ages 21 to 71 years who were recruited from across the United States. PARTICIPANTS This secondary data analysis was conducted among a sample of 187 active Black women who maintained PA for ≥6 months. The mean age was 41 ± 12.3 years, 83.4% completed some college, 37.7% were married, and 30.0% had children. MEASURES Participants self-reported 'with whom' they engaged in PA and provided qualitative responses about their strategies for PA maintenance. Descriptive statistics were used to examine between-group differences among demographic characteristics and PA variables by category of PA engagement using SAS 9.4. Descriptive phenomenology was used to explore social support themes across and within categories of PA engagement. RESULTS On average, the active Black women in this study reported engaging in 57.0 ± 18.9 minutes of moderate intensity leisure-time PA per session. Most engaged in PA alone (n = 87), with a group (n = 72), or with another individual (n = 28). Social context themes within categories included: alone - self-management, groups - motivation and accountability, family - values health, and friends - shared interests in PA. Subthemes across social context categories included: who? - people, what and how? - types of social support, and where? - place of social support. CONCLUSIONS Our findings suggest that some Black women may need added social support from others beyond family and friends, while other Black women may prefer additional self-management skills. Nonetheless, this study provides data for developing hypotheses about the mechanisms by which social context may facilitate PA maintenance among Black women. Therefore, intervention studies targeting PA maintenance among Black women should include an in-depth query of social support needs.
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Affiliation(s)
- Olivia Affuso
- Department of Epidemiology, 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amber W Kinsey
- Division of Preventive Medicine, 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Michelle Segar
- Sport, Health, and Activity Research and Policy Center, 1259University of Michigan, Ann Arbor, MI, USA
| | - Pamela Bowen
- Department of Acute, Chronic, and Continuing Care, 9968University of Alabama at Birmingham, Birmingham, AL, USA
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Atkins R, Deatrick JA, Gage GS, Earley S, Earley D, Lipman TH. Partnerships to Evaluate the Social Impact of Dance for Health: A Qualitative Inquiry. J Community Health Nurs 2020; 36:124-138. [PMID: 31291771 DOI: 10.1080/07370016.2019.1630963] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: The purpose of this study is to determine the social impact and meaning of "Dance for Health" for participants who attended this community driven, intergenerational, physical activity dance program. Methods:This study employed a descriptive, qualitative design and utilized a participatory action research approach to obtain pilot data on fourteen participants between the ages 18 to 75. One focus group discussion with 13 participants and an individual interview with a female participant was conducted. Data collection took place in the community where intervention sessions were held. Audiotapes from one focus group discussion and one in depth individual interview were transcribed by a professional transcription service. The NVIVO computer program was used to organize the data. Directed content analysis of the data took place utilizing primary and secondary coding, category and theme development. Results: Three broad themes emerged representing the social impact of Dance for Health and included: (1) Enhancing the Well-being of the Individual, (2) Fostering Interpersonal Relationships and Connections, (3) Fostering Connections with the Community. Conclusion: A participatory action research approach facilitates successful collaborations between community organizations and academic institutions and can be used to evaluate the impact of physical activity programs on urban community residents. Participants experienced interpersonal and social benefits from regular attendance at the "Dance for Health" program, subsequently contributing to program sustainability. Focused attention to social determinants of physical activity participation can improve physical activity maintenance in residents who reside in under-resourced communities.
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Affiliation(s)
- Rahshida Atkins
- a Rutgers The State University School of Nursing-Camden , Camden , NJ , USA
| | - Janet A Deatrick
- b Professor Emerita of Nursing , University of Pennsylvania School of Nursing , Philadelphia , PA , USA
| | - Gale S Gage
- c Department of Nursing , Essex County College , Newark , NJ , USA
| | | | | | - Terri H Lipman
- e Assistant Dean for Community Engagement, Miriam Stirl Endowed Term Professor of Nutrition, Professor of Nursing of Children , University of Pennsylvania School of Nursing , Philadelphia , PA , USA
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Hubbell AM, Hardy EC, Astroth KS, Jenkins SH, Woith WM, Mallory C. A qualitative study of influences on long-term physical activity in physically active African American women. Nurs Forum 2019; 55:227-235. [PMID: 31858625 DOI: 10.1111/nuf.12420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Performing routine physical activity (PA) is one of several measures that may be taken to prevent chronic illness; however, African American (AA) women are among the least physically active groups in the United States. The purpose of this study was to gain perspectives of AA women who are physically active and understand how they continue long-term PA. In this qualitative descriptive study, we interviewed 14 AA women using researcher-developed open-ended questions. Transcription was analyzed through content analysis. The socioecological model guided the organization of themes that emerged from the data. Individual level themes were: managing my health and lifestyle to remain physically active. Social level themes were: incorporating PA in social exchanges with family, friends, and coworkers and establishing mutual support of PA among family and friends. Environmental level themes were: using the neighborhood and work environments as venues encouraging PA. There were no emerging themes at the political level; however, there were findings at the environmental level that could be interpreted as policy-level issues. Knowing specific factors that influence long-term PA may help us with the development of interventions to increase PA in AA women.
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Affiliation(s)
| | - Elaine C Hardy
- College of Nursing, University of Illinois-Chicago, Peoria, Illinois
| | - Kim S Astroth
- Mennonite College of Nursing, Illinois State University, Normal, Illinois
| | - Sheryl H Jenkins
- Mennonite College of Nursing, Illinois State University, Normal, Illinois
| | - Wendy M Woith
- Mennonite College of Nursing, Illinois State University, Normal, Illinois
| | - Caroline Mallory
- Department of Nursing, College of Health and Human Sciences, Indiana State University, Terre Haute, Indiana
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Bernard R, Cheney M, Wilkerson A, Karki I, Maness SB. Utilizing Social Determinants of Health to Elicit Perceived Control Beliefs About Physical Activity Among African Americans. J Racial Ethn Health Disparities 2019; 7:336-344. [PMID: 31732888 DOI: 10.1007/s40615-019-00662-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 10/25/2022]
Abstract
This qualitative study explored African Americans' perceived behavioral control (PBC) beliefs about how social determinants of health (SDoH) impact their physical activity behavior. Thirty semi-structured interviews were conducted with African Americans aged 30-50 in Oklahoma. Interviews were audio recorded, transcribed, coded, and analyzed for themes by two independent coders. Economic stability themes represented beliefs that financial status facilitates physical activity, yet, employment duties impede physical activity. SES barriers to physical activity did not emerge within this relatively high SES sample. Neighborhood and built environment themes represented beliefs that accessibility facilitates physical activity, while inclement weather impedes physical activity. Although not a part of the question path, motivation emerged as a theme and represented beliefs about how motivation impacts physically active behavior in the absence of other SDoH barriers. This research can inform interventions developed to promote physical activity among African American adults in the central US.
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Affiliation(s)
| | - Marshall Cheney
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, Oklahoma, 73019, USA
| | - Amanda Wilkerson
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, Oklahoma, 73019, USA
| | - Ishu Karki
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, Oklahoma, 73019, USA
| | - Sarah B Maness
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, Oklahoma, 73019, USA.
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Spiteri K, Broom D, Bekhet AH, de Caro JX, Laventure B, Grafton K. Barriers and Motivators of Physical Activity Participation in Middle-aged and Older-adults - A Systematic Review. J Aging Phys Act 2019; 27:929-944. [PMID: 31141447 DOI: 10.1123/japa.2018-0343] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Identifying the difference in barriers and motivators between middle-age and older adults could contribute toward the development of age-specific health promotion interventions. The aim of this review was to synthesize the literature on barriers and motivators for physical activity in middle-aged (50-64 years) and older adults (65-70 years). The review examined qualitative and quantitative studies using the theoretical domain framework as the guiding theory. The search generated 9400 results from seven databases. A total of fifty-five articles meeting the inclusion criteria. Results indicate that barriers are comparable across the two age groups with environmental factors and resources being the most commonly identified barriers. In older adults, social influences, reinforcement and assistance in managing change were the most identified motivators. Middle-aged identified goals settings, believe that activity will be beneficial and social influences were most important. Findings can be used by professionals to encourage engagement with and adherence to physical activity.
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Affiliation(s)
- Karl Spiteri
- 1 Faculty of Health and Wellbeing, Ministry for Family, Children and Social Solidarity
| | - David Broom
- 2 Faculty of Health and Wellbeing; Sheffield Hallam University, Sheffield, UK
| | | | | | | | - Kate Grafton
- 2 Faculty of Health and Wellbeing; Sheffield Hallam University, Sheffield, UK
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Kinsey AW, Segar ML, Barr-Anderson DJ, Whitt-Glover MC, Affuso O. Positive Outliers Among African American Women and the Factors Associated with Long-Term Physical Activity Maintenance. J Racial Ethn Health Disparities 2019; 6:603-617. [PMID: 30644068 PMCID: PMC6500467 DOI: 10.1007/s40615-018-00559-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/24/2018] [Accepted: 12/26/2018] [Indexed: 12/29/2022]
Abstract
Studying positive outliers, individuals who have achieved success with long-term (> 6-month) physical activity (PA) engagement, may be an important approach for understanding strategies for improving leisure-time PA maintenance among African American (AA) women. This cross-sectional, mixed-methods study (1) examined the personal characteristics, PA patterns, and behavioral practices of positive outliers among AA women and (2) compared characteristics of those who maintain PA at recommended levels (HIGH, ≥ 150 min/week > 6 months) with those who maintain low PA volumes (LOW, < 150 min/week > 6 months). A large sample of positive outliers completed this study (n = 290), and most became physically active on their own (76.2%). These AA women were committed to maintaining an active lifestyle, accumulated 249.7 ± 105.8 min of PA/week, and engaged in a variety of activities. Their behavioral practices included scheduling PA during the week (85.9%), goal-setting (82.4%), engaging in PA with others (55.9%), self-monitoring (78.3%), and having a backup plan for missed sessions (54.8%). HIGH maintainers (84.9%) made up most of the sample, and these women were characteristically similar to LOW maintainers with few differences. HIGH maintainers have been active longer, achieved higher commitment scores, and engaged in PA at a higher frequency, duration, and intensity, resulting in higher weekly PA volume compared to LOW maintainers (273.8 ± 96.1 vs. 114.4 ± 24.3 min per week, p ≤ 0.001). Our findings identify factors that may be important for successful PA maintenance among AA women and may help to inform the development of effective behavioral interventions to promote sustained, long-term PA engagement in this population.
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Affiliation(s)
- Amber W Kinsey
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, 35294-3360, USA.
| | - Michelle L Segar
- Sport, Health, and Activity Research and Policy Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Melicia C Whitt-Glover
- Gramercy Research Group, Winston-Salem, NC, USA
- Winston-Salem State University, Winston-Salem, NC, USA
| | - Olivia Affuso
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, 35294-3360, USA
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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University⁻Community Partnerships Using a Participatory Action Research Model to Evaluate the Impact of Dance for Health. Behav Sci (Basel) 2018; 8:bs8120113. [PMID: 30558171 PMCID: PMC6316364 DOI: 10.3390/bs8120113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/05/2018] [Accepted: 12/09/2018] [Indexed: 01/02/2023] Open
Abstract
Little is known about fostering sustainable, collaborative community-academic partnerships that effectively improve physical activity and health in residents of under resourced communities using Participatory Action Research (PAR) driven models. The purpose of this PAR study was to evaluate the impact of an urban, intergenerational, and physical activity dance program by identifying community preferred measurable outcomes that promote program participation and sustainability. A descriptive, qualitative design was employed using semi-structured interview guides to facilitate discussions for two adult focus groups and one youth focus group. Exactly 19 community-residing adults and six youth who lived in urban neighborhoods in West Philadelphia participated in the discussions. The audiotapes were transcribed and analyzed using directed content analysis. Five outcome themes emerged and included: (1). Enhancing the psychological and emotional well-being of the individual, (2). Enhancement of social well-being and management of interpersonal relationships and responsibilities (3). Enhancing and promoting physiologic well-being (4). Changes in health promoting behaviors and skill acquisition, and (5). Concerns about accessibility of dance for health and other physical activity programs in the community. Focused attention to measuring community preferred outcomes can promote sustainability of Dance for Health and possibly other urban-based physical activity dance programs.
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Williams WM, Yore MM, Whitt-Glover MC. Estimating physical activity trends among blacks in the United States through examination of four national surveys. AIMS Public Health 2018; 5:144-157. [PMID: 30094277 PMCID: PMC6079057 DOI: 10.3934/publichealth.2018.2.144] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 05/23/2018] [Indexed: 11/19/2022] Open
Abstract
Physical activity is essential for overall good health and aids in the prevention and reduction of many diseases. In 2008, the U.S. Department of Health and Human Services (DHHS) issued the Physical Activity Guidelines for Americans to foster appropriate levels of physical activity at various ages of development. Despite these guidelines and the known benefit to being physically active; physical activity levels are significantly lower in Blacks, contributing to higher prevalence of poor health outcomes. Therefore, the purpose of this paper was to look at four national datasets [Youth Risk Behavior Survey (YRBS), Behavioral Risk Factor Surveillance System (BRFSS), The National Health and Nutrition Examination Survey (NHANES), and National Health Interview Survey (NHIS)] to identify any patterns and trends that could be used to improve physical activity behavior within this population. These national datasets were used to estimate the proportion of Black adults and youth meeting national physical activity recommendations overall-stratified by age, gender and other demographic characteristics, to help identify patterns. The proportion of Black youth reporting regular physical activity ranged from 33% to 52%; and of Black adults, 27% to 52%. Physical activity was highest among men, younger age groups, highest education and income groups, and those who were employed or married. Trends were consistent across surveys. Among Black youth, physical activity decline with increasing grade level, and improvements over the past 10 years have been minimal. The percentage of Black adults achieving physical activity guidelines has improved slightly over the last ten years, but physical activity participation is still low and continues to decline with age. Trends identified from examining these national datasets can be used to inform development of physical activity interventions aimed at promoting and maintaining regular physical activity behavior among high risk subgroups across the life span.
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Brown CS, Masters KS, Huebschmann AG. Identifying Motives of Midlife Black Triathlete Women Using Survey Transformation to Guide Qualitative Inquiry. J Cross Cult Gerontol 2017; 33:1-20. [PMID: 29164497 DOI: 10.1007/s10823-017-9339-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Demonstrating health disparities related to race, age, and gender, older Black women (BW) are the most sedentary demographic group in the United States. Increasing PA in mid-life is important, as it improves health as BW age into their later years. Advancing our understanding of the exercise motives of BW triathletes presents a "reverse engineering" opportunity to identify motives that could influence sedentary mid-life BW to increase their activity. The purposes of this study were to: (a) utilize an innovative survey transformation method to adapt a measure developed primarily in Caucasian males, i.e., the Motivations of Marathoners Scale for Triathletes (MOMS-T) into a qualitative interview guide for use with BW triathletes; (b) use this interview guide to identify culturally based motives for triathlon participation among BW not previously addressed by the MOMS-T and; (c) interpret the novel motivational domains of the MOMS-T discovered, in order to gain understanding and influence subsequent interventions. Purposive sampling was used to select 12 interview participants from 121 self-identified Black female US residents aged ≥36 years with recent experience completing or training for a triathlon. The interviews identified four culturally based themes, including improving body composition to become "more lean", physical attractiveness, triathlete family, and camaraderie. These novel themes were related to existing MOMS-T scales, but the current MOMS-T questions did not illuminate their culturally distinct aspects. The process of survey transformation provides a viable approach to identify important culturally based characteristics and to adapt surveys to cultural minority populations, particularly when study resources are limited.
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Affiliation(s)
- Candace S Brown
- Center for the Study of Aging and Human Development, Duke University , PO Box 3003, DUMC, Durham, NC, 27710, USA.
- Durham Veterans Administration Medical Center, 508 Fulton St., Mailstop GRECC 182, Durham, NC, 27705, USA.
| | - Kevin S Masters
- Department of Psychology, University of Colorado Denver, 1200 Larimer Street, Suite 5010C, Denver, CO, 80217-3364, USA
| | - Amy G Huebschmann
- Department of Medicine, Center for Women's Health Research and Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave., Mailstop B180, Aurora, CO, 80045, USA
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Whitt-Glover MC, Goldmon MV, Gizlice Z, Heil DP, Karanja N. Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life: A Church-Based Physical Activity Intervention - Baseline Participant Characteristics. Ethn Dis 2017; 27:257-264. [PMID: 28811737 DOI: 10.18865/ed.27.3.257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Physical activity (PA) is beneficial for health, yet most African American women do not achieve recommended levels. Successful, sustainable strategies could help to address disparities in health outcomes associated with low levels of PA. The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-based and a secular intervention for increasing PA with a self-guided control group. DESIGN SETTING AND PARTICIPANTS This cluster randomized, controlled trial was conducted from 2010 - 2011 in African American churches (n=31) in suburban North Carolina. Participants were 469 self-identified low active African American women. MEASURES Baseline data were collected on participant demographics, objective and self-reported PA, and constructs related to social ecological theory and social cognitive theory. RESULTS Complete baseline data were available for 417 participants who were aged 51.4 ± 12.9 years, with average BMI (kg/m2) 35.8 ± 9.9; 73% of participants were obese (BMI >30). Participants averaged 3,990 ± 1,828 pedometer-assessed daily steps and 23.9 ± 37.7 accelerometer-assessed minutes of daily moderate-to-vigorous PA, and self-reported 25.4 ± 45.4 minutes of weekly walking and moderate- and vigorous-intensity PA. Baseline self-reported religiosity and social support were high. CONCLUSIONS L.A.D.I.E.S. is one of the largest PA trials focused on individual behavior change in African American women. Baseline characteristics suggest participants are representative of the general population. Findings from the study will contribute toward understanding appropriate strategies for increasing PA in high-risk populations.
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Affiliation(s)
| | | | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniel P Heil
- Exercise Physiology, Montana State University, Bozeman, MT
| | - Njeri Karanja
- Center for Health Research, Kaiser Permanente, Portland, OR
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Joseph RP, Keller C, Affuso O, Ainsworth BE. Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development. J Racial Ethn Health Disparities 2017; 4:397-409. [PMID: 27178447 PMCID: PMC5107357 DOI: 10.1007/s40615-016-0240-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/20/2016] [Accepted: 04/27/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND African-American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e., 57 % are obese, 49 % have cardiovascular disease). The marked health disparities among African-American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring physical activity programs to address the sociocultural norms, values, beliefs, and behaviors of African-American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African-American women and to present a conceptual framework to guide intervention development. METHODS Development of the framework was based on our previous physical activity research with African-American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African-American culture, and key determinants of physical activity engagement among African-American women. RESULTS Three key concepts are discussed in the conceptual framework: (1) Developmental milestones and life stage transitions of African-American women; (2) Historical, social, and cultural influences associated with physical activity engagement; and (3) Intervention delivery strategies. DISCUSSION Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African-American women.
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Affiliation(s)
- Rodney P. Joseph
- College of Nursing and Health Innovation, Arizona State University, 500 N. 3 Street, Phoenix, AZ 85004, Phone: 602-496-0772, Fax: 602-496-0448,
| | - Colleen Keller
- College of Nursing and Health Innovation, Arizona State University, 500 N. 3 Street, Phoenix, AZ 85004,
| | - Oliva Affuso
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1720 2 Ave South, Birmingham, AL 35294-0022,
| | - Barbara E. Ainsworth
- School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, 550 N. 3 Street, Phoenix, AZ 85004,
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Dlugonski D, Martin TR, Mailey EL, Pineda E. Motives and Barriers for Physical Activity among Low-Income Black Single Mothers. SEX ROLES 2016. [DOI: 10.1007/s11199-016-0718-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Reese JM, Joseph RP, Cherrington A, Allison J, Kim YI, Spear B, Childs G, Simpson T, Durant NH. Development of Participant-Informed Text Messages to Promote Physical Activity Among African American Women Attending College: A Qualitative Mixed-Methods Inquiry. J Transcult Nurs 2016; 28:236-242. [PMID: 27093904 DOI: 10.1177/1043659616644959] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to develop a participant-informed technology-based physical activity (PA) promotion tool for young overweight and obese African American (AA) women. A mixed-method 3-phase study protocol design was used to develop text messages to promote PA in AA women attending the University of Alabama at Birmingham during the Spring of 2013. Nominal focus groups and a 2-week pilot were used to generate and test participant-developed messages. Participants ( n = 14) had a mean age of 19.79 years ( SD = 1.4) and mean body mass index of 35.9 ( SD = 5.926). Focus group data identified key themes associated with the use of text messages to promote PA including message frequency, length, tone, and time of day. Participants preferred text messages that were brief, specific, and time sensitive. Results showed that text messaging was a feasible and acceptable strategy to promote PA in overweight and obese AA women in a university setting.
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Personalized Weight Management Interventions for Cardiovascular Risk Reduction: A Viable Option for African-American Women. Prog Cardiovasc Dis 2016; 58:595-604. [PMID: 26908050 DOI: 10.1016/j.pcad.2016.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 02/14/2016] [Indexed: 12/11/2022]
Abstract
Obesity is an independent contributor to cardiovascular disease (CVD) and a major driving force behind racial/ethnic and gender disparities in risk. Due to a multitude of interrelating factors (i.e., personal, social, cultural, economic and environmental), African-American (AA) women are disproportionately obese and twice as likely to succumb to CVD, yet they are significantly underrepresented in behavioral weight management interventions. In this selective review we highlight components of the limited interventions shown to enhance weight loss outcomes in this population and make a case for leveraging Web-based technology and artificial intelligence techniques to deliver personalized programs aimed at obesity treatment and CVD risk reduction. Although many of the approaches discussed are generally applicable across populations burdened by disparate rates of obesity and CVD, we specifically focus on AA women due to the disproportionate impact of these non-communicable diseases and the general paucity of interventions targeted to this high-risk group.
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Huebschmann AG, Campbell LJ, Brown CS, Dunn AL. "My hair or my health:" Overcoming barriers to physical activity in African American women with a focus on hairstyle-related factors. Women Health 2015; 56:428-47. [PMID: 26495938 DOI: 10.1080/03630242.2015.1101743] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Physical activity disparities among African American (AA) women may be related to sociocultural barriers, including difficulties with restyling hair after exercise. We sought to identify physical activity barriers and facilitators in AA women with a focus on sociocultural factors related to hairstyle maintenance. Participants (n = 51) were AA women aged 19-73 years who completed valid surveys and participated in structured focus groups, stratified by age and physical activity levels, from November 2012 to February 2013. The Constant Comparison method was used to develop qualitative themes for barriers and facilitators. The most frequently reported general physical activity barrier among exercisers was "lack of money" (27%) and among non-exercisers was "lack of self-discipline" (57%). A hairstyle-related barrier of "sweating out my hairstyle" was reported by 7% of exercisers and 29% of non-exercisers. This hairstyle-related barrier included the need for extra time and money to restyle hair due to perspiration. Hairstyle-related facilitators included: prioritizing health over hairstyle and high self-efficacy to restyle hair after perspiration. Participants were interested in resources to simplify hairstyle maintenance. AA women whose hairstyle is affected by perspiration may avoid physical activity due to time and financial burdens. Increasing self-efficacy to restyle hair after perspiration may help to overcome this barrier.
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Affiliation(s)
- Amy G Huebschmann
- a Department of Medicine , Center for Women's Health Research, University of Colorado School of Medicine , Aurora , Colorado , USA.,b Division of General Internal Medicine, Department of Medicine , University of Colorado School of Medicine , Aurora , Colorado , USA
| | | | - Candace S Brown
- d Center for Gerontology , Western Kentucky University , Bowling Green , Kentucky , USA
| | - Andrea L Dunn
- e ALDunn Health Consulting, LLC , Loveland , Colorado , USA
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