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Monroe CM, Zosel K, Stansbury M, Younginer N, Davis RE, Dutton G, Newton RL, Cai B, West DS. A focus group study among insufficiently physically active African American adults regarding technology-delivered team-based gamification for physical activity promotion. Mhealth 2024; 10:3. [PMID: 38323152 PMCID: PMC10839515 DOI: 10.21037/mhealth-23-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/16/2023] [Indexed: 02/08/2024] Open
Abstract
Background Gamification represents a promising approach for facilitating positive social interactions among groups of individuals and is increasingly being leveraged in physical activity (PA) interventions to promote enhanced intervention engagement and PA outcomes. Although African American (AA) adults experience disparities associated with health conditions that can be ameliorated with increased PA, little is known about how best to culturally target PA gamification strategies for this population. The purpose of this study was to gather perspectives from AA adults residing in the Southeast United States and subsequently identify themes to help inform the cultural adaptation of an existing electronic and mobile health (e/mHealth) gamification- and theory-based PA intervention for teams of insufficiently active AA adults. Methods An AA moderator facilitated six online focus groups among AA adults (n=42; 93% female; 45.09±9.77 years; 34.40±57.38 minutes/week of reported moderate-intensity equivalent PA), using a semi-structured focus group guide. Drawing from a content analysis approach, transcripts were coded and salient themes were identified. Results The focus groups revealed the following seven themes: (I) motivation (team-based gamification motivating); (II) accountability (team-based gamification promotes accountability); (III) competition (competitive elements attractive); (IV) weekly challenges (prefer to choose weekly PA challenges); (V) leaderboard feedback (preference for viewing steps and active minutes via a leaderboard); (VI) cultural relevancy (prefer elements reflective of their race and culture that promote team unity); (VII) teammate characteristics (mixed preferences regarding ideal sociodemographic characteristics and starting PA level of teammates). Conclusions Integrating team-based gamification in an e/mHealth-based PA intervention may be acceptable among AA adults. The identification of specific design preferences and perceptions of the value of the social environment points to the need to consider surface-level and deep structure cultural targeting when developing and further exploring best practices regarding gamified PA interventions for insufficiently active AAs.
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Affiliation(s)
- Courtney M. Monroe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kristen Zosel
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Melissa Stansbury
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nicholas Younginer
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Rachel E. Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Gareth Dutton
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert L. Newton
- Population and Public Health, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Bo Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Delia Smith West
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Monroe CM, Cai B, Edney S, Jake-Schoffman DE, Brazendale K, Bucko A, Armstrong B, Yang CH, Turner-McGrievy G. Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot. Int J Behav Nutr Phys Act 2023; 20:129. [PMID: 37924083 PMCID: PMC10623775 DOI: 10.1186/s12966-023-01530-1] [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: 06/04/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The use of health technologies and gamification to promote physical activity has increasingly been examined, representing an opportunistic method for harnessing social support inherent within existing social ties. However, these prior studies have yielded mixed findings and lacked long-term follow-up periods. Thus, a pilot cluster randomized controlled trial was conducted to gauge the feasibility and preliminary efficacy of a digital gamification-based physical activity promotion approach among teams of insufficiently active adults with existing social ties. METHODS Teams (N = 24; 116 total participants) were randomized to either a 12-week intervention (Fitbit, step goals, app, feedback; TECH) or the same program plus gamification (TECH + Gamification). Mixed effects models were used to compare group differences in treatment adherence, and changes in social support, steps, and moderate-to-vigorous physical activity at 12 weeks and 52 weeks from baseline, adjusted for sociodemographic characteristics and team size. RESULTS TECH had a lower mean number of days of Fitbit self-monitoring versus TECH + Gamification during the intervention (adjusted difference: -.30; 95% CI, -.54 to -.07; P = .01). Post-intervention, TECH had 47% lower odds of self-monitoring 7 days per week versus TECH + Gamification (.53; 95% CI, .31 to .89; P = .02). No differences were observed between TECH + Gamification and TECH in increases in social support (0.04; 95% CI, -.21 to .29; P = .76), ActiGraph-measured daily steps (-425; 95% CI, -1065 to 215; P = .19), or moderate-to-vigorous physical activity minutes (-3.36; 95% CI, -8.62 to 1.91; P = .21) from baseline to 12 weeks or in the regression of these improvements by 1 year (Ps > .05). Although not significant in the adjusted models (Ps > .05), clinically meaningful differences in Fitbit-measured daily steps (TECH, 7041 ± 2520; TECH + Gamification, 7988 ± 2707) and active minutes (TECH, 29.90 ± 29.76; TECH + Gamification, 36.38 ± 29.83) were found during the intervention. CONCLUSIONS A gamified physical activity intervention targeting teams of adults with existing social ties was feasible and facilitated favorable, clinically meaningful additive physical activity effects while in place but did not drive enhanced, long-term physical activity participation. Future investigations should explore optimal team dynamics and more direct ways of leveraging social support (training teams; gamifying social support). TRIAL REGISTRATION Clinicaltrials.gov ( NCT03509129 , April 26, 2018).
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Affiliation(s)
- Courtney M Monroe
- Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1 Building, Suite 403G, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Bo Cai
- Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Discovery 1 Building, Room 460, 915 Greene Street, Columbia, SC, 29208, USA
| | - Sarah Edney
- Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building (Block MD1), 12 Science Drive 2, #11-01, Singapore, 117549, Singapore
| | - Danielle E Jake-Schoffman
- College of Health and Human Performance, Department of Health Education and Behavior, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Keith Brazendale
- College of Health Professions and Sciences, Department of Health Sciences, University of Central Florida, HS II, Room 210A, 12805 Pegasus Drive, Orlando, FL, 32816, USA
| | - Agnes Bucko
- College of Health and Human Services, University of North Carolina-Charlotte, 8844 Craver Road, Charlotte, NC, 28223, USA
| | - Bridget Armstrong
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Public Health Research Center, Room 132, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Chih-Hsiang Yang
- Arnold School of Public Health, Department of Exercise Science, University of South Carolina, Discovery 1 Building, Room 403E, 915 Greene Street, Columbia, SC, 29208, USA
| | - Gabrielle Turner-McGrievy
- Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1 Building, Room 552, 915 Greene Street, Columbia, SC, 29208, USA
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Foster AJ, Marshall ML, Jefferson WK, Ard QY, Spivey S. Collaboration With African American Faith-Based Organizations to Promote Physical Activity: Lessons Learned From a Process Evaluation of a Shared-Use Agreements Program. Health Promot Pract 2022; 23:55S-66S. [DOI: 10.1177/15248399221117160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic diseases are disproportionately high among African Americans, often caused by social determinants of health (e.g., access to physical activity opportunities), as stated by the Centers for Disease Control and Prevention. Several studies have examined practices and policies of shared-use in school-based and other settings. There is still a gap in the literature regarding how faith-based shared-use programs, practices, and policies are implemented in a virtual or hybrid setting. This evaluation reviewed program activities and partnerships and assessed program needs for quality improvement. Focus groups ( n = 2) were conducted with program participants and site coordinators from five faith-based shared-use sites. A 12-question discussion guide was developed based on topics of interest predetermined by the project team to understand participant perceptions about participation, satisfaction, and recommendations. Focus group audio recordings were transcribed verbatim and reviewed using thematic analysis. The evaluators reviewed transcripts separately to confirm final coding and ensured intercoder reliability. The analysis yielded six themes and eight subthemes. Findings indicated that the program was rewarding and achievable, with suggestions for improvement. Social support was developed as a result of the program, health improvements were observed by participants, and networked partnerships were formed to promote health and wellness. The virtual platform presented limited access; therefore, adopting a hybrid approach could offer greater flexibility and reach broader audiences. It may be helpful for public health agencies to partner with faith-based organizations to jointly open their facilities. Agencies, like local health departments, may consider establishing agreements to expand shared-use to local faith-based settings.
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Onyishi CN, Ilechukwu LC, Victor-Aigbodion V, Eseadi C. Impact of spiritual beliefs and faith-based interventions on diabetes management. World J Diabetes 2021; 12:630-641. [PMID: 33995850 PMCID: PMC8107980 DOI: 10.4239/wjd.v12.i5.630] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | | | - Vera Victor-Aigbodion
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
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Farmer O, Cahill K, O’Brien W. Gaelic4Girls-The Effectiveness of a 10-Week Multicomponent Community Sports-Based Physical Activity Intervention for 8 to 12-Year-Old Girls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6928. [PMID: 32971964 PMCID: PMC7557379 DOI: 10.3390/ijerph17186928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/01/2022]
Abstract
Girls are less active than boys throughout childhood and adolescence, with limited research focusing on female community sports-based programs. This study aims to assess the effectiveness of a multi-component, community sports-based intervention for increasing girl's physical activity (PA) levels, fundamental movement skill (FMS) proficiency, and psychological wellbeing, as relative to a second treatment group (the traditionally delivered national comparative program), and a third control group. One hundred and twenty female-only participants (mean age = 10.75 ± 1.44 years), aged 8 to 12 years old from three Ladies Gaelic Football (LGF) community sports clubs (rural and suburban) were allocated to one of three conditions: (1) Intervention Group 1 (n = 43) received a novel, specifically tailored, research-informed Gaelic4Girls (G4G) intervention; (2) Intervention Group 2 (n = 44) used the traditionally delivered, national G4G program, as run by the Ladies Gaelic Football (LGF) Association of Ireland; and (3) Control Group 3 (n = 33) received no G4G intervention (group 1 or 2) conditions and were expected to carry out their usual LGF community sports activities. Primary outcome measurements (at both pre- and 10-week follow up) examining the effectiveness of the G4G intervention included (1) PA, (2) FMS and (3) Psychological correlates (enjoyment levels, self-efficacy, peer and parental support). Following a two (pre to post) by three (intervention group 1, intervention group 2, and control group 3) mixed-model ANOVA, it was highlighted that intervention group 1 significantly increased in PA (p = 0.003), FMS proficiency (p = 0.005) and several psychological correlates of PA (p ≤ 0.005). The findings demonstrate that the 10-week, specifically tailored, research-informed G4G intervention is a feasible and efficacious program, leading to a positive effect on the physical and psychological wellbeing of pre-adolescent Irish girls, relative to the traditionally delivered national G4G comparative program and control group conditions.
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Affiliation(s)
- Orlagh Farmer
- Sports Studies and Physical Education Program, School of Education, 2 Lucan Place, Western Road, 0000 Cork, Ireland;
| | - Kevin Cahill
- School of Education, Postgraduate Diploma in Special Educational Needs, University College Cork, 0000 Cork, Ireland;
| | - Wesley O’Brien
- Sports Studies and Physical Education Program, School of Education, 2 Lucan Place, Western Road, 0000 Cork, Ireland;
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Haughton J, Takemoto ML, Schneider J, Hooker SP, Rabin B, Brownson RC, Arredondo EM. Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program. Implement Sci Commun 2020; 1:51. [PMID: 32885207 PMCID: PMC7427873 DOI: 10.1186/s43058-020-00043-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women. Methods We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers' behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: (1) health behavior change training for pastors and staff, (2) tailored messaging, (3) developing community collaborations, and (4) gaining denominational support. Conclusions While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.
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Affiliation(s)
- Jessica Haughton
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA
| | | | - Jennifer Schneider
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA USA
| | - Borsika Rabin
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO USA.,Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO USA
| | - Elva M Arredondo
- School of Public Health, San Diego State University, San Diego, CA USA
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