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Yang X, Han R, Song Y, Zhang J, Huang H, Zhang J, Wang Y, Gao L. The Mediating Role of Physical Activity Self-Efficacy in Predicting Moderate-Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes. J Midwifery Womens Health 2024; 69:403-413. [PMID: 38069454 DOI: 10.1111/jmwh.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/09/2023] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Moderate-intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate-intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown. METHODS A cross-sectional study was conducted in China. Two hundred fifty-two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables. RESULTS A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self-efficacy was significantly correlated with moderate-intensity physical activity. Physical activity self-efficacy mediated the relationship between moderate-intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate-intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self-efficacy. CONCLUSION Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self-efficacy played an important mediating role in predicting moderate-intensity physical activity. Future studies should focus on enhancing self-efficacy to improve moderate-intensity physical activity for pregnant people at high risk for GDM.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Yingli Song
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Ji Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Hui Huang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Jing Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Yan Wang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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Sillice MA, Nelson T, Jennings E, Holland CC, Bock BC. Assessing Hair Concerns and Physical Activity Measures Among African American Women: a Mixed-Method Exploratory Study. J Racial Ethn Health Disparities 2024; 11:226-237. [PMID: 36648622 PMCID: PMC10350471 DOI: 10.1007/s40615-023-01513-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Research on the association between hair concerns and physical activity (PA) constructs among African American (AA) women is lacking. Demographics such as age and income are indicated to influence hair concerns. In this study, quantitative methods were used to assess demographic differences in hair concerns and associations between hair concerns and PA. Qualitative interviewing explored AA women's views about their hair and engagement in PA. METHODS Participants (n = 48; M age = 37.57, SD = 13.72) completed a survey that included demographics, hair type and hairstyle management (HTHM), decisional balance (pros, cons), perceived benefits and perceived barriers scale, and level of physical activity. HTHM consists of six items measuring different factors related to hair concerns. 25 completed a qualitative interview. Chi-square or analysis of variance tests were conducted as appropriate. Qualitative data were analyzed using content analysis. RESULTS Proportion differences were noted between age groups (≤ 32 vs. ≥ 33) and average cost of haircare per month (p = .048). A statistically significant effect was noted for average monthly haircare cost and pros (p = .05), and for alter behavior due to hair concerns and perceived benefits to physical activity (p = .05). For level of physical activity, proportion differences were noted between exercisers and non-exercisers for average minutes spent on hair care (p = .009). Qualitative results showed few participants view hair concern as an important barrier to PA. Some participants suggested strategies for overcoming hair concerns to exercise (e.g., braids, twists). CONCLUSION Implications of findings including development of PA intervention approaches that may appeal to AA women are discussed.
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Affiliation(s)
- Marie Aline Sillice
- City University of New York School of Public & Health Policy, 55 W 125Th St, New York, NY, 10027, USA.
| | - Tamara Nelson
- Department of Psychology, Rutgers University, Camden, NJ, 08102, USA
| | - Ernestine Jennings
- Department of Psychiatry & Human Behavior at The Warren Alpert Medical School of Brown University, Providence, RI, 02906, USA
| | - Curtis C Holland
- Department of Sociology, State University of New York at Old Westbury, Old Westbury, NY, 11568, USA
| | - Beth C Bock
- Department of Psychiatry & Human Behavior at The Warren Alpert Medical School of Brown University, Providence, RI, 02906, USA
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Wippold GM, Garcia KA, Frary SG, Griffith DM. Community Health Worker Interventions for Men: A Scoping Review Using the RE-AIM Framework. HEALTH EDUCATION & BEHAVIOR 2024; 51:128-143. [PMID: 37350223 DOI: 10.1177/10901981231179498] [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: 06/24/2023]
Abstract
INTRODUCTION Community health workers (CHWs) are health promotion specialists who are trusted members of the community served and have a close understanding of the community's needs and values. CHWs are a cost-effective and scalable workforce to promote health among men through tailored approaches. The purpose of the present review was to use the RE-AIM Framework to assess design, implementation, and outcomes of CHW-implemented health promotion efforts tailored for men to provide recommendations for future efforts. METHODS The protocol was pre-registered with PROSPERO. The primary inclusion criteria were that the interventions were (a) implemented at least partially by CHWs, (b) conducted only among men, and (c) designed to improve a health-related outcome. PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Global Index Medicus were searched using a librarian-generated search strategy. In all, 1,437 articles were uploaded to Rayyan and two reviewers blindly reviewed each article for inclusion. A total of 24 articles met the inclusion criteria. RESULTS Most interventions (a) targeted men under 50 years, (b) were conducted among a subset of underserved men, (c) improved health outcomes, (d) community-based and informed, (e) atheoretical, and (f) had satisfactory retention rates. The roles and responsibilities of CHWs were varied. Attention was given to training of CHWs, but limited attention was given to how/if the CHWs were supervised. DISCUSSION CHW-implemented interventions can improve health outcomes among men. Opportunities exist to build on past interventions, such as addressing mental health and incorporating prosocial aspects of masculinity. The results have implications for designing similar interventions.
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Johnson O, Delk DW. #Wematter: Creating culturally tailored health promotion content for Black and Latina college women on Instagram. Digit Health 2024; 10:20552076241241919. [PMID: 38596403 PMCID: PMC11003336 DOI: 10.1177/20552076241241919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
Objective Although students at Minority-Serving Institutions (HBCUs, HSIs, TCUs, AAPISIs) have been found to make sound health choices as compared to their counterparts at Predominately White Institutions and have positive expectancy outcomes of physical activity engagement, it is consistently suggested that MSIs examine and bolster health enhancing avenues. Black and Latina women frequently use social media platforms to connect to content that can initiate and support lifestyle changes or improvements. Thus, establishing culturally relevant health related social media content geared toward Black and Latina College Women (BLCW) may be successful in achieving health-related goals. Therefore, the purpose of this study using social identity theory as a theoretical lens, was to identify the fundamental characteristics of culturally tailored health-related content for BLCW. Method This study employed a qualitative approach to ascertain the characteristics of culturally tailored health-related content for BLCW. Black and Latina college women were asked to provide feedback on mock culturally tailored health-related content in semi-structured focus groups. Participants discussed the authenticity and cultural relevancy of images designed to promote physical activity engagement and other healthy behaviors. Results Results indicated that at a minimum, culturally tailored health-related content should include an array of body shapes, authentic language and messaging, in relevant settings. Moreover, BLCW prefer content that is realistic, reflects their experiences, and embodies their relevant identities. Conclusion Social media content designed to attract and promote healthy lifestyles of BLCW must be comprised of imagery and language that represent the diversity of the priority group. The findings from this study can help to establish best practices when designing content intended to strengthen wellness among college students and young adults.
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Griffith DM, Jaeger EC, Pennings JS, Semlow AR, Ellison JM, Alexander LR. Tailor Made: A Pilot Virtual Weight Loss Intervention Individually Tailored for African American Men. Health Promot Pract 2023:15248399231213347. [PMID: 38050903 DOI: 10.1177/15248399231213347] [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: 12/07/2023]
Abstract
This study tests the acceptability and feasibility of the first virtual weight loss study individually tailored for middle-aged African American men. Tailor Made is a 3-month randomized controlled pilot of a weight loss intervention that included 58 overweight or obese African American men (mean age of 50.4; SD = 7.9). Control group participants received a Fitbit activity tracker and Bluetooth-enabled scale and copies of the self-led Tailor Made curriculum. Intervention group participants received the same Fitbit, Bluetooth-enabled scale, and curriculum and also participated in weekly, 45-minute virtual small group, professional-led education sessions using the Tailor Made curriculum and received three SMS text messages weekly: (a) a message individually tailored on African American Manhood that links men's values, goals, and motivation to health-promoting behavior; (b) a goal-tracking message to monitor physical activity, healthier eating, and lifestyle changes; and (c) a reminder 24 hours before their session. Participation rates in weekly small group sessions, randomization, and attendance at the assessments suggest that Tailor Made was feasible and acceptable. Only among intervention group participants, we found a small and significant decrease in BMI between baseline and final. In addition, active minutes of physical activity decreased for the control group while active minutes for the intervention group remained steady throughout the intervention. In sum, we demonstrated that a virtual, individually tailored weight loss intervention is feasible and acceptable to African American men. Participants valued the convenience of a virtual intervention, but there were a number of ways we may be able to enhance the potential benefits of this approach.
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Affiliation(s)
| | | | - Jacquelyn S Pennings
- Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University, Nashville, TN, USA
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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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Bhandari S, Dawson AZ, Kobylarz Z, Walker RJ, Egede LE. Interventions to Reduce Hospital Readmissions in Older African Americans: A Systematic Review of Studies Including African American Patients. J Racial Ethn Health Disparities 2023; 10:1962-1977. [PMID: 35913544 PMCID: PMC9889568 DOI: 10.1007/s40615-022-01378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This systematic review aims to summarize interventions that effectively reduced hospital readmission rates for African Americans (AAs) aged 65 and older. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for this review. Studies were identified by searching PubMed for clinical trials on reducing hospital readmission among older patients published between 1 January 1990 and 31 January 2020. Eligibility criteria for the included studies were mean or median age ≥ 65 years, AAs included in the study, randomized clinical trial or quasi-experimental design, presence of an intervention, and hospital readmission as an outcome. RESULTS There were 5270 articles identified and 11 were included in the final review based on eligibility criteria. The majority of studies were conducted in academic centers, were multi-center trials, and included over 200 patients, and 6-90% of participants were older AAs. The length of intervention ranged from 1 week to over a year, with readmission assessed between 30 days and 1 year. Four studies which reported interventions that significantly reduced readmissions included both inpatient (e.g., discharge planning prior to discharge) and outpatient care components (e.g., follow-ups after discharge), and the majority used a multifaceted approach. CONCLUSION Findings from the review suggest successful interventions to reduce readmissions among AAs aged 65 and older should include inpatient and outpatient care components at a minimum. This systematic review showed limited evidence of interventions successfully decreasing readmission in older AAs, suggesting a need for research in the area to reduce readmission disparities and improve overall health.
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Affiliation(s)
- Sanjay Bhandari
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Aprill Z Dawson
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Zacory Kobylarz
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Rebekah J Walker
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Leonard E Egede
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
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Griffith DM, Pennings JS, Jaeger EC. Mighty Men: A Pilot Test of the Feasibility and Acceptability of a Faith-Based, Individually Tailored, Cluster-Randomized Weight Loss Trial for Middle-Aged and Older African American Men. Am J Mens Health 2023; 17:15579883231193235. [PMID: 37608590 PMCID: PMC10467204 DOI: 10.1177/15579883231193235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
Two in five African American men have obesity, but they are underrepresented in community-based weight loss interventions. This pilot effectiveness trial examines the acceptability and feasibility of the first weight loss study for African American men that includes randomization and individual tailoring. Using a community-based, cluster-randomized, longitudinal parallel group design, four churches were randomized to a control condition or a weight loss condition. Each church received physical activity equipment, a coordinator, and small group physical activity sessions. A total of 71 African American men (mean age: 58.5) enrolled and received a Fitbit, Bluetooth-enabled scale, a t-shirt, gift cards for participation, and 45 min of small group physical activity led by a certified personal trainer. Men in the weight loss condition also received 45 min of health education and individually tailored SMS text messages. Multiple metrics suggest that Mighty Men was feasible, yet the acceptability of the intervention components was mixed. Participants in both the weight loss and control conditions lost weight between zero and 6 months (p < .001), but body fat (p = .005) and visceral fat percentage (p = .001) of men in the weight loss condition decreased while men in the control condition did not (p < .05). An increase in physical activity was seen among men in the weight loss condition (p = .030) but not among men in the control condition (p < .05). It is acceptable and feasible to conduct a 6-month weight loss intervention with African American men that includes randomization and individually tailored text messages.
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Affiliation(s)
- Derek M. Griffith
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Racial Justice Institute, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
| | - Jacquelyn S. Pennings
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily C. Jaeger
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
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Alsaleh E. Is a combination of individual consultations, text message reminders and interaction with a Facebook page more effective than educational sessions for encouraging university students to increase their physical activity levels? Front Public Health 2023; 11:1098953. [PMID: 37448659 PMCID: PMC10338000 DOI: 10.3389/fpubh.2023.1098953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/03/2023] [Indexed: 07/15/2023] Open
Abstract
Background Physical activity (PA) has been consistently reported as a crucial component of disease prevention and improvement of people's health. Nevertheless, data has evidenced a decline in physical activity levels among adults in Jordan. Although previous behavioral change interventions have documented efficacy in increasing physical activity among adults, the PA levels is low among adults. A new motivational intervention that focuses on changing behavior toward performing the recommended level of physical activity is on need. Objective This two-arm single-center randomized controlled trial aimed to measure the efficacy of a multi-component behavioral intervention (including goal setting, self-monitoring, and feed-back) for increasing physical activity levels and self-efficacy for exercise and decreasing body mass index and blood pressure among students at a Jordanian University. Setting Philadelphia University in Jordan. Methods A behavioral intervention based on individualized consultations, text messages reminders and interaction with a Facebook page was compared with educational sessions in terms of efficacy for increasing physical activity levels among students at Philadelphia University. Results The intervention and control groups were comparable at baseline. At 6 months a significant increase was seen in the moderate physical activity and walking levels of the intervention group compared with the control group. The mean change (SD) in total METs of moderate physical activity and walking was 503 (325.20) METs/week in the intervention group and 6 (271.20) METs/week in the control group. The mean change (SD) in steps/day was 3,000 (1,217) steps/day in the intervention group and 876 (1120.23) steps/day in the control group. The difference between mean change of the two groups was very significant at 2,124 (-820 to -563). Self-efficacy for exercise scale significantly increased among the intervention group compared with the control group. In addition, body mass index (BMI) declined from the baseline (Mean: 28.23, SD: 4.82) to 6 months (Mean: 25.36, SD: 5.23) for the intervention group. Conclusion Behavioral intervention through multicomponent strategies, alongside the implementation of an advanced communication strategy via phone and social media, is effective for motivating adult students to increase their physical activity levels. Clinical trial registration ISRCTN54100536.
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Affiliation(s)
- Eman Alsaleh
- School of Nursing, Philadelphia University, Amman, Jordan
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Mama SK, Soltero EG, Joseph RP. Reducing Sedentary Behavior and Increasing Physical Activity Among Low Active, Underserved Adults: A Staircase Approach. J Phys Act Health 2023:1-3. [PMID: 37279898 DOI: 10.1123/jpah.2023-0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 06/08/2023]
Affiliation(s)
- Scherezade K Mama
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX,USA
| | - Erica G Soltero
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX,USA
| | - Rodney P Joseph
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ,USA
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Sanz-Remacha M, García-González L, Sevil Serrano J, Aibar Solana A. A Qualitative Evaluation of a Community-Based Intervention on Health-Related Behaviors in Disadvantaged Women. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:272-282. [PMID: 35025722 DOI: 10.1080/02701367.2021.1971149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/13/2021] [Indexed: 06/14/2023]
Abstract
Purpose: Grounded in social ecological model and self-determination theory, the aim of this study was to qualitatively evaluate the first and second year follow-ups of a community-based healthy lifestyle programme on health-related behaviors, and outcomes in disadvantaged adult women. Methods: Eleven disadvantaged adult women (M = 37.72; SD = 8.34) (seven of them from the Roma population) participated in this community-based participatory action research. Discussion groups, semi-structured interviews, and field notes were used to assess the effects of the intervention programme on health-related behaviors and health outcomes through thematic analysis. Results: Women perceived improvements in PA-related variables, healthy eating, and other health-related outcomes throughout two years. Most women mentioned these behavior changes in the first year, while others perceived them in the second year. Conclusions: These findings highlight the importance of developing contextual and culturally tailored interventions that address the specific problems and needs that emerge from ethnic groups. Given that some of these behavior changes were only mentioned by most of these women in the second year, long-term interventions seem to be ideally required in this population.
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Kitilya B, Sanga E, PrayGod G, Kavishe BB, Ditlevsen K, Peck R, Olsen MF. Perceptions, facilitators and barriers of physical activity among people living with HIV: a qualitative study. BMC Public Health 2023; 23:360. [PMID: 36803443 PMCID: PMC9938982 DOI: 10.1186/s12889-023-15052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) have low levels of physical activity. Using the social ecological model to understand perceptions, facilitators and barriers of physical activity in this population is of importance for developing contextualised interventions to improve physical activity in PLWH. METHOD This was a qualitative sub-study conducted between august and November 2019 as part of a cohort study on diabetes and associated complications in HIV infected in Mwanza, Tanzania. Sixteen in-depth interviews and three focus groups with nine participants in each were conducted. The interviews and focus groups were audio recorded, transcribed and translated into English. The social ecological model was considered during the coding and interpretation of the results. Transcripts were discussed, coded and analyzed using deductive content analysis. RESULTS Forty-three PLWH aged 23-61 years participated in this study. The findings showed that most PLWH perceived physical activity as beneficial to their health. However, their perceptions of physical activity were rooted within existing gender stereotypes and roles in the community. Running and playing football were perceived as activities for men while household chores activities were for women. Further, men were perceived to do more physical activity than women. For women, household chores and income-generating activities were perceived as sufficient physical activity. Social support and engagement of family members and friends in physical activity were reported as facilitators of physical activity. Reported barriers of physical activity were lack of time, money, availability of physical activity facilities and social support groups, and poor information on physical activity from health care providers in HIV clinics. Human-immunodeficiency virus (HIV) HIV infection was not perceived by PLWH as a barrier for doing physical activity but most family members did not support them to do physical activity, fearing that it might worsen their condition. CONCLUSION The findings demonstrated differing perceptions, facilitators and barriers of physical activity among PLWH. Interventions addressing awareness, gender stereotypes and roles related to physical activity from individual to community level are needed. Supportive environment and infrastructures are needed to improve physical activity levels in PLWH in Tanzania.
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Affiliation(s)
- Brenda Kitilya
- Mwanza Research Centre, National Institute for Medical Research, P.O BOX 1462, Mwanza, Tanzania.
| | - Erica Sanga
- Mwanza Research Centre, National Institute for Medical Research, P.O BOX 1462, Mwanza, Tanzania
| | - George PrayGod
- Mwanza Research Centre, National Institute for Medical Research, P.O BOX 1462, Mwanza, Tanzania
| | - Bazil Baltazar Kavishe
- Mwanza Research Centre, National Institute for Medical Research, P.O BOX 1462, Mwanza, Tanzania
| | - Kia Ditlevsen
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - Robert Peck
- Mwanza Research Centre, National Institute for Medical Research, P.O BOX 1462, Mwanza, Tanzania
- Weill Bugando School of Medicine, Mwanza, Tanzania
- Weill Cornell Medicine, New York, USA
| | - Mette Frahm Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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Dodgen L, Kitzman H, Spence E, Mamun A, Walters ST, Cervantes D. What's theory got to do with it: measuring effects of theory on lifestyle behaviors and weight in the Better Me Within Randomized Trial. AMERICAN JOURNAL OF HEALTH EDUCATION 2023; 54:86-98. [PMID: 37396565 PMCID: PMC10311983 DOI: 10.1080/19325037.2022.2163007] [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: 05/15/2022] [Accepted: 09/08/2022] [Indexed: 02/19/2023]
Abstract
Background Knowing which theoretical constructs work best to design effective interventions is essential for populations with increased disease burden. African American women (AAW) experience greater prevalence of chronic diseases and fewer benefits from weight loss interventions compared to White women. Purpose To examine how theoretical constructs were associated with lifestyle behaviors and weight outcomes in the Better Me Within (BMW) Randomized Trial. Methods BMW used a tailored diabetes prevention program implemented in churches among AAW with BMI ≥ 25. Regression models assessed relationships between constructs (self-efficacy, social support and motivation), and outcomes (physical activity (PA), calories, and weight). Results Among 221 AAW (mean (SD) age 48.8 years (11.2); mean weight 215.1 pounds (50.5), several significant relationships were found including an association between change in motivation for activity and change in PA (p=.003), and change in motivation for diet and weight at follow-up (p=<.001). Discussion The clearest relationships emerged for PA with motivation for activity and weight management social support demonstrating significance in all models. Translation to Practice Self-efficacy, motivation and social support show promise to promote changes in PA and weight among church-going AAW. Opportunities to keep engaging AAW in research are essential for eliminating health inequities in this population.
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Affiliation(s)
- Leilani Dodgen
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
| | - Heather Kitzman
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
- Robbins Institute for Health Policy & Leadership, Baylor University, Waco, TX, USA
| | - Emily Spence
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Abdullah Mamun
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
- Ethicon, Raritan, NJ, USA
| | - Scott T. Walters
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Diana Cervantes
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Joseph RP, Todd M, Ainsworth BE, Vega-López S, Adams MA, Hollingshead K, Hooker SP, Gaesser GA, Keller C. Smart Walk: A Culturally Tailored Smartphone-Delivered Physical Activity Intervention for Cardiometabolic Risk Reduction among African American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1000. [PMID: 36673756 PMCID: PMC9859082 DOI: 10.3390/ijerph20021000] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
This article reports the results of Smart Walk: a randomized pilot trial of an 8-month culturally tailored, smartphone-delivered physical activity (PA) intervention for African American women with obesity. Sixty participants (age range = 24−49 years; BMI range = 30−58 kg/m2) were randomized to the Smart Walk intervention (n = 30) or a wellness comparison intervention (n = 30). Results supported the acceptability and feasibility of the intervention, as demonstrated by participant retention (85% at 4 months and 78% at 8 months), Smart Walk app use, and intervention satisfaction (i.e., 100% of PA participants completing the intervention [n = 24] reported they would recommend it to friend). Smart Walk participants also reported greater increases in moderate-to-vigorous PA (4-month between-arm difference in change [b] = 43.3 min/week; p = 0.018; Cohen’s d = 0.69; 8-month b = 56.6 min/week; p = 0.046; d = 0.63) and demonstrated clinically relevant, although not statistically significant (p-values > 0.05), baseline to 4 months improvements in cardiorespiratory fitness (b = 1.67 mL/kg/min; d = 0.40), systolic blood pressure (b = −3.33 mmHg; d = 0.22), diastolic blood pressure (b = −4.28 mmHg; d = 0.37), and pulse wave velocity (b = −0.46 m/s; d = 0.33). Eight-month cardiometabolic outcomes followed similar trends, but had high rates of missing data (45−53%) due to COVID-19 restrictions. Collectively, findings demonstrated favorable outcomes for acceptability and feasibility, while also highlighting key areas for refinement in future research.
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Affiliation(s)
- Rodney P. Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA
| | | | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ 85004, USA
| | - Marc A. Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Steven P. Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA 92182, USA
| | - Glenn A. Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA
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Community-based, cluster-randomized pilot trial of a cardiovascular mHealth intervention: Rationale, design, and baseline findings of the FAITH! Trial. Am Heart J 2022; 247:1-14. [PMID: 35065922 PMCID: PMC9037298 DOI: 10.1016/j.ahj.2022.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Compared to whites, African-Americans have lower prevalence of ideal cardiovascular health (CVH) based on the American Heart Association Life's Simple 7 (LS7). These CVH inequities have worsened during the COVID-19 pandemic. Ideal LS7 health-promoting behaviors and biological risk factors (eg, diet, blood pressure) are associated with improved CVH outcomes. The FAITH! (Fostering African-American Improvement in Total Health) App, a community-informed, mobile health (mHealth) intervention, previously demonstrated significant improvements in LS7 components among African-Americans, suggesting that mHealth interventions may be effective in improving CVH. This paper presents the FAITH! Trial design, baseline findings, and pandemic-related lessons learned. METHODS Utilizing a community-based participatory research approach, this study assessed the feasibility/preliminary efficacy of a refined FAITH! App for promoting LS7 among African-Americans in faith communities using a cluster, randomized controlled trial. Participants received the FAITH! App (immediate intervention) or were assigned to a delayed intervention comparator group. Baseline data were collected via electronic surveys and health assessments. Primary outcomes are change in LS7 score from baseline to 6-months post-intervention and app engagement/usability. RESULTS Of 85 enrolled individuals, 76 completed baseline surveys/health assessments, for a participation rate of 89% (N = 34 randomized to the immediate intervention, N = 42 to delayed intervention). At baseline, participants were predominantly female (54/76, 71%), employed (56/76, 78%) and of high cardiometabolic risk (72/76, 95% with hypertension and/or overweight/obesity) with mean LS7 scores in the poor range (6.8, SD = 1.9). CONCLUSIONS The FAITH! Trial recruitment was feasible, and its results may inform the use of mHealth tools to increase ideal CVH among African-Americans.
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Wade J, Alexander R, Giscombé CW, Keegan D, Parker S, Jackson K, Gibbs J, McElroy A, Ferguson JV. Using Black Feminist Theory and Methods to Uncover Best Practices in Health Promotion Programming. QUALITATIVE HEALTH RESEARCH 2022; 32:581-594. [PMID: 34931558 PMCID: PMC8879412 DOI: 10.1177/10497323211061108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study was created to uncover the social determinants of Black American women's success in health promotion programs. We used the Superwoman Schema to understand the complexities of Black womanhood and uncover best practices in the promotion of their health. The sample consisted of women ages 18-25 who attend a large southern HBCU. We collected data using qualitative focus groups. Participants reported the greatest health-related concerns Black American women facing are mental health, obesity, and relationships with Black men. When it comes to health promotion programs, respondents reported a desire for classes that are fun, interactive, informative, educational, and include group interaction, accessible, and incentivize participation. Uncovering the social determinants of Black American women's health and program success is central in decreasing extant health disparities. Future health scholars are urged to incorporate Black feminist theory and methods into their work to create health promotion interventions tailored for Black women.
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Affiliation(s)
- Jeannette Wade
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Ramine Alexander
- Department of Food and Nutritional Sciences, North Carolina A&T State University, Greensboro, NC, USA
| | - Cheryl Woods Giscombé
- Division & Program Levine Family Distinguished Scholar in Quality of Life, Health Promotion, and Wellness, University of North Carolina, Chapel Hill, NC, USA
| | - Daniel Keegan
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Sharon Parker
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Katia Jackson
- Department of Psychology, North Carolina A&T State University, Greensboro, NC, USA
| | - Jasmine Gibbs
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Asha McElroy
- Department of Food and Nutritional Sciences, North Carolina A&T State University, Greensboro, NC, USA
| | - Ja Vae Ferguson
- Department of Food and Nutritional Sciences, North Carolina A&T State University, Greensboro, NC, USA
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Daubenmier J, Chao MT, Hartogensis W, Liu R, Moran PJ, Acree MC, Kristeller J, Epel ES, Hecht FM. Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention. Psychosom Med 2021; 83:503-514. [PMID: 33214537 DOI: 10.1097/psy.0000000000000859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE People of color and lower socioeconomic groups have higher obesity prevalence, lose less weight compared with Whites and higher socioeconomic groups, and are underrepresented in randomized controlled trials of mindfulness-based interventions. We examined whether mindfulness approaches reduce disparities in weight loss interventions. METHODS We analyzed data from a randomized controlled trial of 194 participants with obesity (41% participants of color, 36% without college degree) comparing a 5.5-month mindfulness-based weight loss intervention to an active-control with identical diet-exercise guidelines. We assessed attendance, 18-month attrition, and weight change at 6, 12, and 18 months by race/ethnicity and education level using linear mixed models, adjusting for baseline body mass index, age, and education or race/ethnicity, respectively. RESULTS Participants without versus with a college degree attended fewer sessions and had higher attrition across interventions. Participants of color attended fewer intervention sessions in the mindfulness compared with the control intervention. Overall, participants of color lost significantly less weight at 12 and 18 months compared with Whites. However, during the 6- to 18-month maintenance period, we found an interaction of intervention arm, race/ethnicity, and time (p = .035), indicating that participants of color compared with Whites regained more weight in the control (0.33 kg/mo; p = .005) but not mindfulness intervention (0.06 kg/mo; p = .62). Participants without a college degree had greater initial weight loss in the mindfulness compared to control intervention from 0 to 6 months (-0.46 kg/mo; p = .039). CONCLUSIONS Although disparities persist, mindfulness approaches may mitigate some racial/ethnic and socioeconomic differences in weight loss compared with conventional diet-exercise programs.Trial Registration: Clinicaltrials.gov registration: NCT00960414.
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Affiliation(s)
- Jennifer Daubenmier
- From the Institute of Holistic Health Studies (Daubenmier), San Francisco State University; Osher Center for Integrative Medicine (Chao, Hartogensis, Liu, Moran, Acree, Hecht), University of California, San Francisco, San Francisco, California; Department of Psychology (Kristeller), Indiana State University, Terre Haute, Indiana; and Department of Psychiatry (Epel), University of California, San Francisco, San Francisco, California
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Skarin F, Wästlund E, Gustafsson H. Maintaining or Losing Intervention-Induced Health-Related Behavior Change. A Mixed Methods Field Study. Front Psychol 2021; 12:688192. [PMID: 34220651 PMCID: PMC8253310 DOI: 10.3389/fpsyg.2021.688192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/26/2021] [Indexed: 01/03/2023] Open
Abstract
The aim of this mixed methods field study was to gain a better understanding of how psychological factors can contribute to success in intervention-induced behavior change over time. While it can be difficult to change behavior, the use of interventions means that most participants succeed in change during the intervention. However, it is rare for the immediate change to automatically transform into maintained behavior changes. Most research conducted on health-related behavior change interventions contains quantitative studies that investigate key intervention components on a group level. Hence, to bring more knowledge about maintained intervention-induced behavior change, there is need for a study approach that enhances the understanding of individual participants' experiences during and after the intervention. Therefore, the present study, which was conducted in Sweden, used a mixed methods design (triangulation) consisting of pre-, post-, and follow-up quantitative data (questionnaires and body measurements) and qualitative data (interviews), where the individuals' accounts are used to broaden the understanding of the intervention and the behavior change process. All study participants were enrolled in a volitional (fee-based and non-manipulated) intervention given by certified gyms. The quantitative data collection included 22 participants who completed questionnaires and body measurements before and after the intervention, plus 13 complete body measurements 6 months after the intervention. The qualitative data included pre-interviews with 12 participants and six follow-up-interviews. The questions in both questionnaires and interviews related to expectations, efficacy, motivation, goals, achievements, behavior change, and future. Overall, the results show that levels of expectations, efficacy, and motivation cannot be used in isolation to predict maintained intervention-induced behavior change. To successfully extend and maintain immediate change, it was crucial to experience goal achievement (but not BMI change). Furthermore, enabling talk was salient in the pre-interviews with participants reporting successful immediate (and maintained) change. By contrast, pre-interview disabling talk turned out to be evident in interviews, with participants not responding to follow-up. When the qualitative and quantitative results are summarized and integrated, it appears that subjective goal achievement, combined with enabling self-talk, were crucial factors in successful maintained behavior change.
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Affiliation(s)
- Frida Skarin
- Department of Social and Psychological Studies, Service Research Center (CTF), Karlstad University, Karlstad, Sweden
| | - Erik Wästlund
- Department of Social and Psychological Studies, Service Research Center (CTF), Karlstad University, Karlstad, Sweden
| | - Henrik Gustafsson
- Department of Educational Studies, Faculty of Arts and Social Sciences, Karlstad University, Karlstad, Sweden.,Department of Sport and Social Sciences, Norwegian School of Sport Sciences, Oslo, Norway
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Joseph RP, Ainsworth BE, Hollingshead K, Todd M, Keller C. Results of a Culturally Tailored Smartphone-Delivered Physical Activity Intervention Among Midlife African American Women: Feasibility Trial. JMIR Mhealth Uhealth 2021; 9:e27383. [PMID: 33885368 PMCID: PMC8103296 DOI: 10.2196/27383] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Regular aerobic physical activity (PA) is an important component of healthy aging. However, only 27%-40% of African American women achieve national PA guidelines. Available data also show a clear decline in PA as African American women transition from young adulthood (ie, 25-44 years) into midlife. This decline in PA during midlife coincides with an increased risk for African American women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary African American women during midlife. OBJECTIVE This study aims to examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among African American women aged 24-49 years, among a slightly older sample of midlife African American women aged 50-65 years. METHODS A single-arm pretest-posttest study design was implemented. In total, 20 insufficiently active African American (ie, ≤60 min per week of PA) women between the ages of 50-65 years participated in the 4-month feasibility trial. The Smart Walk intervention was delivered through the study Smart Walk smartphone app and text messages. Features available on the Smart Walk app include personal profile pages, multimedia PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and social cognitive theory mediators targeted by the intervention (ie, self-regulation, behavioral capability, outcome expectations, self-efficacy, and social support) were assessed at baseline and at 4 months. Feasibility and acceptability were assessed using a postintervention satisfaction survey that included multiple-choice and open-ended questions evaluating participant perceptions of the intervention and suggestions for intervention improvement. Wilcoxon signed-rank tests were used to examine pre- and postintervention changes in the PA and social cognitive theory variables. The effect size estimates were calculated using the Pearson r test statistic. RESULTS Participants increased moderate-to-vigorous PA (median 30 minutes per week increase; r=0.503; P=.002) and reported improvements in 2 theoretical mediators (self-regulation: r=0.397; P=.01; behavioral capability: r=0.440; P=.006). Nearly all participants (14/15, 93% completing the satisfaction survey) indicated that they would recommend the intervention to a friend. Participants' suggestions for improving the intervention included enhancing the intervention's provisions of social support for PA. CONCLUSIONS The results provide preliminary support for the feasibility of the smartphone-based approach to increase PA among midlife African American women. However, before larger-scale implementation among midlife African American women, enhancements to the social support components of the intervention are warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355.
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Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Barbara E Ainsworth
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
- Department of Kinesiology, Shanghai University of Sport, Shanghai Shi, China
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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20
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Hornbuckle LM. Running while Black: A distinctive safety concern and barrier to exercise in White neighborhoods. Prev Med Rep 2021; 22:101378. [PMID: 33996391 PMCID: PMC8105660 DOI: 10.1016/j.pmedr.2021.101378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/25/2021] [Accepted: 03/28/2021] [Indexed: 11/24/2022] Open
Abstract
While literature has shown that some Black Americans cite safety concerns as a barrier to outdoor activity in their neighborhoods for reasons related to violence, limitations in the built environment (e.g., lack of sidewalks), and even unleashed dogs, recent national events suggest that attention should also be directed toward the safety concerns of Black Americans living in neighborhoods that do not involve the commonly referenced issues above. In this timely commentary, the unique personal perspectives and internal dialogue of Black exercisers while navigating predominantly White neighborhoods, particularly those of higher socioeconomic status are discussed. This piece also includes discussion of how racial profiling incites hypervigilance and often fear in Black Americans attempting to exercise outdoors in White spaces. This is problematic, as it can discourage this incredibly positive health behavior that has been shown to mitigate obesity, cardiometabolic risk, and several other health disparities that continue to afflict Black communities. A collaborative effort inclusive of physical activity, public health/health disparity, and social science researchers is warranted to build a body of current scientific literature that elucidates and explores this particular safety concern in various Black outdoor enthusiasts.
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Affiliation(s)
- Lyndsey M Hornbuckle
- Department of Kinesiology, Recreation, & Sport Studies, University of Tennessee, Knoxville, 322 HPER Building, 1914 Andy Holt Avenue, Knoxville, TN 37996-2700, USA
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21
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Tamura K, Vijayakumar NP, Troendle JF, Curlin K, Neally SJ, Mitchell VM, Collins BS, Baumer Y, Gutierrez-Huerta CA, Islam R, Turner BS, Andrews MR, Ceasar JN, Claudel SE, Tippey KG, Giuliano S, McCoy R, Zahurak J, Lambert S, Moore PJ, Douglas-Brown M, Wallen GR, Dodge T, Powell-Wiley TM. Multilevel mobile health approach to improve cardiovascular health in resource-limited communities with Step It Up: a randomised controlled trial protocol targeting physical activity. BMJ Open 2020; 10:e040702. [PMID: 33371027 PMCID: PMC7754642 DOI: 10.1136/bmjopen-2020-040702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Although physical activity (PA) reduces cardiovascular disease (CVD) risk, physical inactivity remains a pressing public health concern, especially among African American (AA) women in the USA. PA interventions focused on AA women living in resource-limited communities with scarce PA infrastructure are needed. Mobile health (mHealth) technology can increase access to PA interventions. We describe the development of a clinical protocol for a multilevel, community-based, mHealth PA intervention for AA women. METHODS AND ANALYSIS An mHealth intervention targeting AA women living in resource-limited Washington, DC communities was developed based on the socioecological framework for PA. Over 6 months, we will use a Sequential Multi-Assignment, Randomized Trial approach to compare the effects on PA of location-based remote messaging (named 'tailored-to-place') to standard remote messaging in an mHealth intervention. Participants will be randomised to a remote messaging intervention for 3 months, at which point the intervention strategy will adapt based on individuals' PA levels. Those who do not meet the PA goal will be rerandomised to more intensive treatment. Participants will be followed for another 3 months to determine the contribution of each mHealth intervention to PA level. This protocol will use novel statistical approaches to account for the adaptive strategy. Finally, effects of PA changes on CVD risk biomarkers will be characterised. ETHICS AND DISSEMINATION This protocol has been developed in partnership with a Washington, DC-area community advisory board to ensure feasibility and acceptability to community members. The National Institutes of Health Intramural IRB approved this research and the National Heart, Lung, and Blood Institute provided funding. Once published, results of this work will be disseminated to community members through presentations at community advisory board meetings and our quarterly newsletter. TRIAL REGISTRATION NUMBER NCT03288207.
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Affiliation(s)
- Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nithya P Vijayakumar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James F Troendle
- Office of Biostatistics Research, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kaveri Curlin
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sam J Neally
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Valerie M Mitchell
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Billy S Collins
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cristhian A Gutierrez-Huerta
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rafique Islam
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Briana S Turner
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Marcus R Andrews
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joniqua N Ceasar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sophie E Claudel
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kathryn G Tippey
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Shayne Giuliano
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Regina McCoy
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Jessica Zahurak
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Sharon Lambert
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Philip J Moore
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | | | - Gwenyth R Wallen
- National Institutes of Health Clinical Center, Nursing Department, Bethesda, Maryland, USA
| | - Tonya Dodge
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
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Better Together? A Pilot Study of Romantic Partner Influence on Exercise Adherence and Cardiometabolic Risk in African-American Couples. J Racial Ethn Health Disparities 2020; 8:1492-1504. [PMID: 33175348 PMCID: PMC7657066 DOI: 10.1007/s40615-020-00912-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/10/2020] [Accepted: 10/27/2020] [Indexed: 11/13/2022]
Abstract
Background African-Americans (AAs) have higher rates of inactivity, obesity, and cardiometabolic risk compared to other races/ethnicities. Romantic partners can positively influence health habits, yet whether or not couples have to exercise together in order to adopt regular exercise remains unclear. This study examined whether exercising together influences exercise adherence and cardiometabolic risk in AA couples. Methods Nine AA romantic couples (age 62.8 ± 7.7 years; body mass index 31.0 ± 4.4 kg/m2; 6105 ± 1689 average steps/day) completed a 12-week walking (≥ 30 min, 3 days/week) plus resistance training (RT; 2 days/week) pilot intervention. Couples were randomized to either exercise together (ET) or separately (ES). Waist and hip circumferences, iDXA-measured body composition, blood pressure, and blood biomarkers (glucose, hemoglobin A1c (HbA1c), total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein, and fibrinogen) were assessed pre- and post-intervention. Independent-sample t tests and generalized linear mixed models, controlling for gender, were used to analyze data. Significance was accepted at P < 0.05. Results There were no significant group × time interactions for any outcome. However, ET trended toward more walking (86.5 ± 57.7 min/week) than ES (66.1 ± 31.7 min/week). There were also significant overall time effects for waist circumference (P < 0.001), body fat (P = 0.020), fat mass (P = 0.007), gynoid fat (P = 0.041), HbA1c (P = 0.020), and HDL (P = 0.047), where all variables decreased. Conclusions Trends showed exercising together may promote walking prescription adherence, although more research is needed in a larger sample. This intervention may also improve cardiometabolic risk factors in this population. These pilot data will inform the current investigators’ future exercise intervention research in AA adult dyads.
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Blackman Carr LT, Nezami BT, Leone LA. Perceived Benefits and Barriers in the Mediation of Exercise Differences in Older Black Women with and Without Obesity. J Racial Ethn Health Disparities 2020; 7:807-815. [PMID: 32533532 DOI: 10.1007/s40615-020-00788-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/19/2020] [Accepted: 05/29/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Weight control is an exercise benefit, important for older Black women, a group experiencing obesity disparities. We compared perceived exercise benefits and barriers between Black women with and without obesity and determined which mediated the weight group-exercise relationship. METHODS A survey (n = 234) was administered to determine attitudinal agreement between weight groups (obese or non-obese). Multiple mediation analysis was used to investigate if attitudes mediated the weight group-exercise relationship. RESULTS High agreement with all exercise benefits was observed between women with and without obesity. Compared with women without obesity, women with obesity were more likely to report the barriers of only exercising to lose weight (OR = 2.52, 95% CI 1.40-4.55), lack of will power (OR = 1.82, 95% CI 1.05-3.19), weight (OR = 3.04, 95% CI 1.34-6.83), and cost (OR = 2.14, 95% CI 1.02-4.47). Exercising to lose weight and lack of will power mediated the weight group-exercise relationship. CONCLUSIONS Women largely agreed on the exercise benefits. Lack of will power and engaging in exercise only for weight loss were barriers that were more common among older Black women with obesity. The barriers partially explained the lower exercise engagement in women with obesity. Future work may address these barriers to increase exercise in older Black women.
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Affiliation(s)
- Loneke T Blackman Carr
- Department of Nutritional Sciences, Unit 4017, University of Connecticut, 27 Manter Road, Storrs, CT, 06269-4017, USA.
| | - Brooke T Nezami
- Department of Nutrition, Suite 136, University of North Carolina at Chapel Hill, 1700 Martin Luther King, Jr. Blvd, Chapel Hill, NC, 27514, USA
| | - Lucia A Leone
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, 14214, USA
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Engaging a Community Advisory Board to Inform an Exercise Intervention in Older African-American Couples. J Prim Prev 2020; 41:261-278. [DOI: 10.1007/s10935-020-00589-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Blackman Carr LT, Samuel-Hodge CD, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Comparative effectiveness of a standard behavioral and physical activity enhanced behavioral weight loss intervention in Black women. Women Health 2019; 60:676-691. [PMID: 31814531 DOI: 10.1080/03630242.2019.1700585] [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: 10/25/2022]
Abstract
Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m2. Standard and enhanced groups' weight change (-2.83 kg and -2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.
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Affiliation(s)
- Loneke T Blackman Carr
- Department of Nutritional Sciences, University of Connecticut , Storrs, Connecticut, USA.,Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Carmen D Samuel-Hodge
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Dianne S Ward
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Kelly R Evenson
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University , Hamilton, Ontario, Canada
| | - Deborah F Tate
- Department of Health Behavior, Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
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Sillice MA, Jennings E, Uebelacker LA, Abrantes AM, Holland CC, O’Keeffe B, Bock BC. African American women's relationship with their mobile phone, and what they want in a mobile delivered physical activity intervention: guidance for intervention development. Mhealth 2019; 5:18. [PMID: 31380410 PMCID: PMC6624361 DOI: 10.21037/mhealth.2019.05.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 05/24/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Mobile phone text messaging is an emerging platform in physical activity (PA) interventions with African American (AA) women. Research on the relationship that AA women have with their mobile phone as well as their views about text messaging as a potentially viable platform to help them acquire and maintain regular PA is central in advancing this field of research. Both self-report measures and qualitative interviews may be helpful in this endeavor. METHODS In the current study, a sample of 42 generally physically inactive AA women (mean age =35, SD =10.25) completed the Mobile Phone Affinity Scale (MPAS), which consists of six subscales that represent both positive (Connectedness, Productivity, Empowerment) and negative (Continuous Use, Anxious Attachment, Addiction) cognitions and behaviors that are associated with mobile phone use patterns. A subgroup of twenty participants completed a semi-structured qualitative interview that explored their views of text messaging technology as a potential platform to help become and remain physically active. Quantitative analyses included frequency and analyses of variance (ANOVAs) and assessed mobile phone use patterns and demographic differences based on age, marital status and education on the MPAS. Qualitative content analysis was conducted on participants' verbatim responses. RESULTS Results indicated that participants overall endorsed the positive MPAS subscales at a higher frequency compared to the negative subscales. Demographic differences were noted only for age and marital status for some of the MPAS subscales. Younger participants reported higher mean scores for the MPAS subscales Connectedness (P=0.005), Empowerment/Safety (P=0.04), Continuous Use (P=0.04), and Addiction (P=0.004) in comparison to older participants. Significant results for marital status showed single participants were higher on the Connectedness (P=0.02) and Productivity (P=0.01) subscales compared to married participants. Qualitative data showed that 19 of the 20 participants (95%) viewed text messaging as an appealing platform to deliver daily motivational messages to increase PA engagement. Participants stated a text messaging PA intervention would be "convenient" and "motivating". However, most participants suggested that other mobile phone technology applications in addition to text messaging would facilitate self-monitoring PA behaviors (e.g., goal setting, activity tracking) in mobile phone delivered (mHealth) PA interventions targeting AA women. CONCLUSIONS The study findings provide guidance in the development of mHealth intervention approaches for PA promotion that are likely to appeal to AA women, increase engagement, and behavior change among this group.
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Affiliation(s)
- Marie A. Sillice
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Behavioral Medicine & Addiction Research, Butler Hospital, Providence, RI, USA
- Psychosocial Research Center, Butler Hospital, Providence, RI, USA
| | - Ernestine Jennings
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Lisa A. Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Psychosocial Research Center, Butler Hospital, Providence, RI, USA
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Behavioral Medicine & Addiction Research, Butler Hospital, Providence, RI, USA
| | - Curtis C. Holland
- Department of Sociology and Anthropology, Northeastern University, Boston, MA, USA
| | - Bailey O’Keeffe
- Psychosocial Research Center, Butler Hospital, Providence, RI, USA
| | - Beth C. Bock
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
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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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Abshire DA, Wilson DK, Sweeney AM, Pinto BM. Correlates of Moderate-to-Vigorous Physical Activity and Exercise Motivation in Underserved African American Men. Am J Mens Health 2019; 13:1557988319855155. [PMID: 31148501 PMCID: PMC6545657 DOI: 10.1177/1557988319855155] [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] [Indexed: 11/26/2022] Open
Abstract
Effective interventions are needed to increase physical activity (PA) in African American men, but little is known about correlates of PA and exercise motivation in this population. Using an ecological approach that considers cognitive, social, and environmental factors, correlates of moderate-to-vigorous physical activity (MVPA) and exercise motivation in underserved African American men were examined. Greater exercise motivation, greater social support for exercise, and more favorable environmental perceptions were hypothesized to be associated with higher MVPA, and greater social support and environmental perceptions were hypothesized to be associated with higher exercise motivation. This secondary analysis used baseline data from the Positive Action for Today’s Health (PATH) trial. African American men (n = 166, aged 48 ± 15 years) completed surveys that assessed cognitive, social, and environmental factors theoretically relevant to MVPA. Accelerometers were used to obtain a 7-day estimate of MVPA. Hierarchical linear regression analyses showed that exercise motivation was positively associated with MVPA (B = 1.15, SE = .41, p = .006). Exercise attitudes (B = .16, SE = .07, p = .037), exercise self-concept (B = .28, SE = .06, p < .001), exercise support from friends (B = .12, SE = .06, p = .048), and places for walking and cycling (B = .13, SE = .06, p = .032) were positively associated with exercise motivation. Interventions that improve exercise motivation and associated variables may be warranted to increase MVPA in underserved African American men. ClinicalTrials.gov # NCT01025726
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Affiliation(s)
| | - Dawn K Wilson
- 2 Department of Psychology, University of South Carolina, College of Arts and Sciences, Columbia, SC, USA
| | - Allison M Sweeney
- 2 Department of Psychology, University of South Carolina, College of Arts and Sciences, Columbia, SC, USA
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A Systematic Review of Electronic and Mobile Health (e- and mHealth) Physical Activity Interventions for African American and Hispanic Women. J Phys Act Health 2019; 16:230-239. [PMID: 30782040 DOI: 10.1123/jpah.2018-0103] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The purpose of this systematic review was to evaluate the existing scientific literature on e- and mHealth interventions promoting physical activity (PA) among African American (AA) and Hispanic women. METHODS Using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, 5 electronic databases and gray literature sources were searched in August 2017. Inclusion criteria are published in English language peer-reviewed journals between 2000 and 2017, use of an e- or mHealth delivery strategy to promote PA, primary focus on AA or Hispanic women, and reported PA outcome data. RESULTS Ten articles met inclusion criteria for review, 6 studies focused on AA women and 4 studies on Hispanic women. The majority (n = 8) were pilot studies; only 2 studies were full-scale randomized controlled trials and both focused on Hispanic women. Six studies (60%) used websites as the primary method of intervention delivery, 3 studies (30%) used text messaging, and 1 study (10%) used the social networking website Facebook. In total, 70% of the studies (n = 7) reported significant within- or between-group differences for at least 1 PA outcome. CONCLUSIONS Findings provide preliminary support for e- and mHealth PA interventions among AA and Hispanic women. However, future large-scale, rigorously designed, randomized controlled trials are needed to further explore their effectiveness among AA and Hispanic women.
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Joseph RP, Ainsworth BE, Vega-López S, Adams MA, Hollingshead K, Hooker SP, Todd M, Gaesser GA, Keller C. Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women. Contemp Clin Trials 2019; 77:46-60. [PMID: 30576840 PMCID: PMC6344046 DOI: 10.1016/j.cct.2018.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/07/2018] [Accepted: 12/16/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women. OBJECTIVE To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women. DESIGN AND METHODS Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors. SUMMARY Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.
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Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| | - Barbara E Ainsworth
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Sonia Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Marc A Adams
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| | - Glenn A Gaesser
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
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Cardiovascular Health Disparities in Underserved Populations. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Stillman CM, Donahue PT, Williams MF, Callas M, Lwanga C, Brown C, Wollam ME, Jedrziewski MK, Kang C, Erickson KI. Weight-Loss Outcomes from a Pilot Study of African Dance in Older African Americans. Obesity (Silver Spring) 2018; 26:1893-1897. [PMID: 30358132 PMCID: PMC6249065 DOI: 10.1002/oby.22331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Obesity is a risk factor for both cognitive and physical impairment in late adulthood. Though the rates of obesity are high in many groups, older African Americans are disproportionately affected. A randomized pilot intervention of African Dance was conducted with 28 African American older adults with obesity (mean age = 68.4 ± 5.1 years; mean BMI = 33.4 ± 6.2). The goal of the study was to evaluate the physiological outcomes of a culturally sensitive exercise intervention and specifically changes in weight. METHODS Participants were randomly assigned to an African Dance (experimental) or Culture Education (control) group. They attended their assigned class for 1 hour per session, 3 days per week, for 6 months. RESULTS There was a significant group × time interaction on weight (P = 0.005) such that the African Dance group lost weight (mean = 4.0 ± 6.0 lb) while the Culture Education group gained weight (mean = 2.6 ± 3.9 lb). CONCLUSIONS These results suggest that a culturally sensitive form of physical activity, African Dance, may be effective for promoting weight loss in a population at increased risk for obesity and cognitive decline.
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Affiliation(s)
- Chelsea M. Stillman
- Department of Psychiatry, University of Pittsburgh
- Corresponding author , Address: 4805 Sennott Square, 210 S Bouquet Street, Pittsburgh, PA 15260
| | | | | | | | | | | | | | | | - Chaeryon Kang
- Department of Biostatistics, University of Pittsburgh
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Exercise in African American and White Colorectal Cancer Survivors: A Mixed Methods Approach. REHABILITATION ONCOLOGY 2018; 36:188-197. [PMID: 30467528 DOI: 10.1097/01.reo.0000000000000125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background African-American (AA) colorectal cancer (CRC) survivors tend to be more obese and less physically active compared to white survivors. Purpose/Objective To test the feasibility of an aerobic exercise program as well as explore perceptions about supervised exercise among AA CRC survivors. Methods A prospective supervised exercise intervention performed on a cycle ergometer 2 days/week for 12 weeks. Peak (VO2peak) and sub-maximal exercise (6MWT) along with questionnaires (SF-36, Memorial Sloan Kettering Cancer Center Bowel Function Instrument (BFI), Functional Assessment of Cancer Therapy Scale-Colorectal (FACT-C) and Fatigue (FACIT-F), Brief Symptom Inventory (BSI). A second group of survivors participated in an interview evaluating perceptions regarding exercise. Design Prospective case series and qualitative interview. Setting Research university and academic medical center. Patients African American and white colorectal cancer survivors. Results Quantitative: A total of 237 letters were mailed to CRC survivors (112 white, 126 AAs). From the letters, 25 white and 15 AAs expressed interest; only five white (4.5%) and four AAs (3.2%) enrolled. Two AAs and five white survivors (7/9) finished the program. There was an improvement in peak exercise (p=0.011) and quality of life (QoL) (SF-36 total, p=0.035) post-training. Qualitative: 30 CRC survivors (12 AA and 18 white) participated in qualitative interviews and selected co-morbidity, motivation and location as primary barriers to exercise. Limitations Small sample size. Conclusions Recruiting CRC survivors (regardless of race) into an exercise program is challenging, however, there are exercise and QoL benefits associated with participation. Barriers to exercise are similar between AA and white CRC survivors.
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Pekmezi D, Ainsworth C, Desmond R, Pisu M, Williams V, Wang K, Holly T, Meneses K, Marcus B, Demark-Wahnefried W. Physical Activity Maintenance Following Home-Based, Individually Tailored Print Interventions for African American Women. Health Promot Pract 2018; 21:268-276. [PMID: 30203677 PMCID: PMC8258802 DOI: 10.1177/1524839918798819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
African American women report low participation in physical activity and are disproportionately burdened by related conditions (obesity, breast, and colon cancer). Physical activity interventions have shown promising results among African American women, but most studies in this area have focused on short-term increases. More enduring changes in health behavior will be needed to eliminate existing health disparities. Thus, the current study examined 12-month physical activity and psychosocial outcomes from a pilot randomized controlled trial (N = 84) of a Home-based Individually tailored Physical activity Print (HIPP) intervention for African American women in the Deep South. Retention was 77.4% at 12 months. HIPP participants increased self-reported moderate-to-vigorous physical activity from 35.1 minutes/week (standard deviation [SD] = 47.8) at baseline to 124 minutes/week (SD = 95.5) at 12 months, compared with the wellness contact control participants who reported increases from 48.2 minutes/week (SD = 51.3) to 102.5 minutes/week (SD = 94.5) over 12 months (between-group p > .05). Results indicate that modest improvements in moderate-to-vigorous physical activity and related psychosocial variables occurred during the active intervention phase (months 0-6) and were sustained during the tapered maintenance period (months 6-12). Low-cost, high-reach, home-based strategies have great potential for supporting sustained participation in physical activity and achieving long-term health benefits among African American women in the Deep South.
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Affiliation(s)
- Dori Pekmezi
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cole Ainsworth
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Renee Desmond
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maria Pisu
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Kaiying Wang
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Taylor Holly
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Meneses
- University of Alabama at Birmingham, Birmingham, AL, USA
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Bevel M, Babatunde OA, Heiney SP, Brandt HM, Wirth MD, Hurley TG, Khan S, Johnson H, Wineglass CM, Warren TY, Murphy EA, Sercy E, Thomas AS, Hébert JR, Adams SA. Sistas Inspiring Sistas Through Activity and Support (SISTAS): Study Design and Demographics of Participants. Ethn Dis 2018; 28:75-84. [PMID: 29725191 DOI: 10.18865/ed.28.2.75] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction Recruiting racial, ethnic, and other underserved minorities into conventional clinic-based and other trials is known to be challenging. The Sistas Inspiring Sistas Through Activity and Support (SISTAS) Program was a one-year randomized controlled trial (RCT) to promote physical activity and healthy eating among AA women in SC to reduce inflammatory biomarkers, which are linked to increased breast cancer (BrCa) risk and mortality. This study describes the development, recruitment, and implementation of the SISTAS clinical trial and provides baseline characteristics of the study participants. Methods SISTAS was developed using community-based participatory research (CBPR) approaches. At baseline, study participants completed assessments and underwent clinical measurements and blood draws to measure C-reactive protein (CRP) and interleukin-6 (IL-6). Participants randomized to the intervention received 12 weekly classes followed by nine monthly booster sessions. Post-intervention measurements were assessed at 12-week and 12-month follow-ups. Results We recruited a total of 337 women who tended to: be middle-aged (mean age 48.2 years); have some college education; be employed full-time; have Medicare as their primary insurance; be non-smokers; and perceive their personal health as good. On average, the women were pre-hypertensive at baseline (mean systolic blood pressure = 133.9 mm Hg; mean diastolic blood pressure = 84.0 mm Hg) and morbidly obese (mean BMI >40.0 kg/m2); the mean fat mass and fat-free mass among participants were 106.4 lb and 121.0 lb, respectively. Conclusion The SISTAS RCT addresses some of the gaps in the literature with respect to CBPR interventions targeting AA women, such as implementing diet and physical activity in CBPR-based studies to decrease BrCa risk.
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Affiliation(s)
- Malcolm Bevel
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Oluwole A Babatunde
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Sue P Heiney
- College of Nursing, University of South Carolina
| | - Heather M Brandt
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina
| | - Michael D Wirth
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina
| | - Thomas G Hurley
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Samira Khan
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Hiluv Johnson
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Cassandra M Wineglass
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Tatiana Y Warren
- Community Works, Bon Secours Baltimore Health Systems; Baltimore, Maryland
| | - E Angela Murphy
- Department of Pathology, Microbiology, and Immunology, School of Medicine, University of South Carolina
| | - Erica Sercy
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Amanda S Thomas
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - James R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina
| | - Swann Arp Adams
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina.,College of Nursing, University of South Carolina
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Griffith DM, Bergner EM, Cornish EK, McQueen CM. Physical Activity Interventions With African American or Latino Men: A Systematic Review. Am J Mens Health 2018; 12:1102-1117. [PMID: 29557237 PMCID: PMC6131438 DOI: 10.1177/1557988318763647] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Relatively little is known about what helps increase physical activity in African
American men, and even less is known about promoting physical activity among Latino men.
This systematic review aimed to address the key questions: (a) what is the state of the
evidence on health-related behavior change interventions targeting physical activity among
African American or Latino men? and (b) What factors facilitate physical activity for
these men? For this review, nine electronic databases were searched to identify
peer-reviewed articles published between 2011–2017 that reported interventions to promote
physical activity among African American or Latino men. Following PRISMA guidelines, nine
articles representing seven studies that met our criteria were identified: six published
studies that provided data for African American men, and one published study provided data
for Latino men. Consistent with previous reviews, more research is needed to better
understand how gender can be incorporated in physical activity interventions for African
American and Latino men. Future interventions should explore how being an adult male and a
man of color shapes motivations, attitudes, and preferences to be physically active.
Studies should consider how race and ethnicity intersect with notions of masculinity,
manhood and Machismo to enhance the effectiveness of physical activity interventions for
these populations. Despite the health benefits of physical activity, rates of these
behaviors remain low among African American and Latino men. It is essential to determine
how best to increase the motivation and salience for these men to overcome the obesogenic
environments and contexts in which they often live.
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Affiliation(s)
- Derek M Griffith
- 1 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA.,2 Center for Medicine, Health & Society, Vanderbilt University, Nashville, TN, USA
| | - Erin M Bergner
- 1 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Emily K Cornish
- 1 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Chelsea M McQueen
- 1 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
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Brown CW, Alexander DS, Cummins K, Price AA, Anderson-Booker M. STEPS to a Healthier Heart: Improving Coronary Heart Disease (CHD) Knowledge Among African American Women. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2017.1414640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Whitt-Glover MC, Goldmon MV, Gizlice Z, Sillice M, Hornbuckle L, Heil DP. Increasing Physical Activity in Black Women: Results from a Randomized Trial Conducted in Faith-Based Settings. Ethn Dis 2017; 27:411-420. [PMID: 29225442 PMCID: PMC5720951 DOI: 10.18865/ed.27.4.411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-integrated (FI) and a secular (SEC) intervention for increasing physical activity with a self-guided (SG) control group among African American women. Design/Setting/Participants L.A.D.I.E.S. was a cluster randomized, controlled trial. Churches (n=31) were randomized and women within each church (n=12 - 15) received the same intervention. Interventions FI and SEC participants received 24 group-based sessions, delivered over 10 months. SG participants received printed materials to review independently for 10 months. Participants were followed for 12-months post-intervention to assess long-term intervention impact. Main Outcome Measures Data on participant characteristics, physical activity, and intervention-related constructs were collected at baseline, 10 months, and 22 months. Results Intervention session attendance was greater for FI compared with SEC participants (15.7 + 5.7 vs 12.4 + 7.3 sessions, respectively, P<.01). After 10 months, FI and SEC participants significantly increased daily walking (+1,451 and +1,107 steps/day, respectively) compared with SG participants (-128 steps/day). Increases were maintained after 22 months in the FI group compared with the SG group (+1092 vs. +336 daily steps, P<.01). Between-group changes in accelerometer-assessed physical activity were not statistically significant at any time point. Conclusions The FI intervention is a feasible strategy for short- and long-term increases in physical activity among African American women. Additional dissemination and evaluation of the strategy could be useful for reducing chronic disease in this high-risk population.
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Affiliation(s)
| | | | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marie Sillice
- The Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island
| | | | - Daniel P. Heil
- Exercise Physiology, Montana State University, Bozeman, Montana
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Cothran FA, Paun O, Barnes LL, Epps F, Schoeny M, Farran CJ. Comparing the Effect of a Moderate Physical Activity Intervention on the Mental Health Outcomes of African American and Caucasian Dementia Family Caregivers: A Secondary Data Analysis. Issues Ment Health Nurs 2017; 38:996-1004. [PMID: 28956706 DOI: 10.1080/01612840.2017.1364807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Increased attention to the effects of the stressful demands of caregiving on the mental health of dementia caregivers has resulted in the development of numerous interventions. The current study is a secondary analysis of a randomized controlled trial that tested a 12-month moderate physical activity intervention with dementia caregivers. Our secondary data analysis examined racial differences in caregiver mental health outcomes including subjective burden, depressive symptoms, and positive affect, as well as differences in physical activity. A total of 211 community-dwelling dementia family caregivers were randomly assigned to a 12-month Enhanced Physical Activity (treatment) Intervention (EPAI) or a Caregiver Skill Building (control) Intervention (CSBI). Of these, 34 African American and 80 Caucasian caregivers completed the study. At baseline, race was associated with subjective burden and positive affect, but not with depressive symptoms. Post intervention (12 months), there were no racial differences in subjective burden or depressive symptoms. However, race was significantly associated with decreased positive affect (p = 0.003) and decreased total minutes of physical activity (p = 0.012). Findings suggest that the mental health needs of African American caregivers warrant additional exploration, where physical activity may be of benefit. These findings provide a cultural perspective to consider during intervention development for future nurse-driven research.
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Affiliation(s)
- Fawn A Cothran
- a Rush University College of Nursing , Adult Health and Gerontological Nursing , 600 S. Paulina St, Rm 1080, Chicago , Illinois , USA
| | - Olimpia Paun
- b Rush University College of Nursing , 600 S. Paulina St., Chicago , Illinois , USA
| | - Lisa L Barnes
- c Rush Alzheimer's Disease Center , Chicago , Illinois , USA
| | - Fayron Epps
- d Georgia State University , Byrdine F Lewis School of Nursing and Health Professions , Atlanta , Georgia , USA
| | - Michael Schoeny
- e Rush University, College of Nursing , Chicago , Illinois , USA
| | - Carol J Farran
- e Rush University, College of Nursing , Chicago , Illinois , USA
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Greaney ML, Askew S, Wallington SF, Foley PB, Quintiliani LM, Bennett GG. The effect of a weight gain prevention intervention on moderate-vigorous physical activity among black women: the Shape Program. Int J Behav Nutr Phys Act 2017; 14:139. [PMID: 29037247 PMCID: PMC5644166 DOI: 10.1186/s12966-017-0596-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/09/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Rates of physical inactivity are high among Black women living in the United States with overweight or obesity, especially those living in the rural South. This study was conducted to determine if an efficacious weight gain prevention intervention increased moderate-vigorous physical activity (MVPA). METHODS The Shape Program, a weight gain prevention intervention implemented in community health centers in rural North Carolina, was designed for socioeconomically disadvantaged Black women with overweight or obesity. MVPA was measured using accelerometers, and summarized into 1- and 10-min bouts. We employed analyses of covariance (ANCOVA) to assess the relationship between changes in MVPA over 12 months, calculated as a change score, and intervention assignment (intervention versus usual care). RESULTS Participants completing both baseline and 12-month accelerometer assessments (n = 121) had a mean age of 36.1 (SD = 5.43) years and a mean body mass index of 30.24 kg/m2 (SD = 2.60). At baseline, 38% met the physical activity recommendation (150 min of MVPA/week) when assessed using 10-min bouts, and 76% met the recommendation when assessed using 1-min bouts. There were no significant differences in change in MVPA participation among participants randomized to the intervention from baseline to 12-months using 1-min bouts (adjusted intervention mean [95% CI]: 20.50 [-109.09 to 150.10] vs. adjusted usual care mean [95% CI]: -80.04 [-209.21 to 49.13], P = .29), or 10-min bouts (adjusted intervention mean [95% CI]: 7.39 [-83.57 to 98.35] vs. adjusted usual care mean [95% CI]: -17.26 [-107.93 to 73.40], P = .70). CONCLUSIONS Although prior research determined that the Shape intervention promoted weight gain prevention, MVPA did not increase significantly among intervention participants from baseline to 12 months. The classification of bouts had a marked effect on the prevalence estimates of those meeting physical activity recommendations. More research is needed to understand how to promote increased MVPA in weight gain prevention interventions. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov database (No. NCT00938535. Retrospectively Registered 7/10/2009).
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Affiliation(s)
- Mary L Greaney
- Department of Kinesiology and Health Studies, 25 West Independence Way, University of Rhode Island, Kingston, RI, 02881, USA.
| | - Sandy Askew
- Duke Global Digital Health Science Center, Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
| | - Sherrie F Wallington
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C., 20007, USA
| | - Perry B Foley
- Duke Global Digital Health Science Center, Duke Global Health Institute, Duke University, Durham, NC, 27710, USA
| | - Lisa M Quintiliani
- Section of General Internal Medicine, Department of Medicine, Boston University, Boston, MA, 02118, USA
| | - Gary G Bennett
- Duke Global Digital Health Science Center, Duke Global Health Institute, Duke University, Durham, NC, 27710, USA.,Department of Psychology and Neuroscience, Duke University, Durham, NC, 27708, USA
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Cultural Factors relevant to Korean Americans in Health Research: A Systematic Review. J Community Health 2017; 43:421-432. [PMID: 28905156 DOI: 10.1007/s10900-017-0418-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To eliminate health disparities in the United States, identifying cultural contexts salient to the target populations in an intervention study is critical; however, little research has been conducted on the identification of cultural contexts among Korean Americans who have significant risk factors for chronic diseases. This systematic review identifies critical cultural contexts central to the literature discussed in health research on Korean Americans. We examined 14 research reports of 801 potentially eligible articles published between 2000 and 2016 and analyzed their contribution to cultural contexts among Korean Americans based on the PEN-3 model. This review highlights how cultural contexts impact health and health behaviors of Korean Americans, and may contribute to health disparities in the United States. The key cultural contexts highlighted in this review include social support/social network, family, gender role expectations, and a holistic view of health and illness. These cultural contexts should be incorporated in designing culturally relevant, effective, and sustainable health interventions for Korean Americans, which will contribute to eliminating health disparities for this ethnic group who experience great obstacles to healthcare access and healthy behaviors.
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Joseph RP, Ainsworth BE, Mathis L, Hooker SP, Keller C. Utility of Social Cognitive Theory in Intervention Design for Promoting Physical Activity among African-American Women: A Qualitative Study. Am J Health Behav 2017; 41:518-533. [PMID: 28760174 DOI: 10.5993/ajhb.41.5.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We examined the cultural relevance of Social Cognitive Theory (SCT) in the design of a physical activity intervention for African-American women. METHODS A qualitative study design was used. Twenty-five African-American women (Mean age = 38.5 years, Mean BMI = 39.4 kg·m2) were enrolled in a series of focus groups (N = 9) to elucidate how 5 SCT constructs (ie, Behavioral Capability, Outcome Expectations, Self-efficacy, Self-regulation, Social Support) can be culturally tailored in the design of a physical activity program for African-American women. RESULTS For the construct of Behavioral Capability, participants were generally unaware of the amount, intensity, and types of physical activity needed for health benefits. Outcome Expectations associated with physical activity included increased energy, improved health, weight loss, and positive role modeling behaviors. Constructs of Self-efficacy and Self-regulation were elicited through the women perceiving themselves as a primary barrier to physical activity. Participants endorsed the need of a strong social support component and identified a variety of acceptable sources to include in a physical activity program (ie, family, friends, other program participants). CONCLUSIONS Findings explicate the utility of SCT as a behavioral change theoretical basis for tailoring physical activity programs to African-American women.
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Affiliation(s)
- Rodney P. Joseph
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ;,
| | - Barbara E. Ainsworth
- Exercise Science and Health Promotion Program, School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, Phoenix, AZ
| | - LaTanya Mathis
- Community member of the metropolitan Phoenix area, Phoenix, AZ
| | - Steven P. Hooker
- Exercise Science and Health Promotion Program, School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Colleen Keller
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
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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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Chao YY, Musanti R, Zha P, Katigbak C. The Feasibility of an Exergaming Program in Underserved Older African Americans. West J Nurs Res 2017; 40:815-833. [PMID: 28322649 DOI: 10.1177/0193945916687529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study tested the feasibility and efficacy of an exergaming program in underserved older African American communities. The study is a single-group with pre- and posttest design. Twelve female participants ( M age = 64.17 ± 6.74 years) completed an exergaming program once or twice a week for 24 sessions over 14 weeks. Community health workers implemented the program through coaching and supporting mechanisms to motivate participants to exercise. A mixed-methods analysis was used to assess the intervention. After the program, participants showed significant improvements in lower body flexibility ( p = .012), and physical health-related quality of life ( p = .005). Four themes were identified related to the self-reported benefits of the exergaming program: (a) improving health, (b) feeling enjoyment, (c) getting connected, and (d) knowing you. The exergaming program provides an easy-to-implement and potentially effective intervention that can be used in community-directed centers to improve health and well-being in the underserved population.
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Affiliation(s)
- Ying-Yu Chao
- 1 Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Rita Musanti
- 1 Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Peijia Zha
- 1 Rutgers, The State University of New Jersey, Newark, NJ, USA
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Bland V, Sharma M. Physical activity interventions in African American women: A systematic review. Health Promot Perspect 2017; 7:52-59. [PMID: 28326284 PMCID: PMC5350550 DOI: 10.15171/hpp.2017.11] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 10/31/2016] [Indexed: 11/09/2022] Open
Abstract
Background: African American women are at high risk of acquiring chronic diseases due to sedentary lifestyles. This objective of this article was to perform a narrative systematic review of physical activity interventions among African American women published between 2009 and 2015. Methods: A review of literature in following databases: Academic Search Premier, CINAHL (Cumulative Index to Nursing & Allied Health), ERIC (Education Resources Information Center), MEDLINE, PsychInfo, and SPORTDiscus was performed to locate interventions promoting physical activity among African American women. Results: The search yielded 13 interventions. All the studies were conducted within the United States. It was found that walking coupled with healthy food choices were salient strategies in the interventions. Studies using social support along with healthy diet were found to be more efficacious in fostering physical activity among African American women. Conclusion: Walking, social support and a healthy diet were found to be significant strategies promoting physical activity in African American women. Physical activity for African American women must build on the constructs of healthier food choices and social support.
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Affiliation(s)
- Vanessa Bland
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
| | - Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA
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Mouton CP, Hayden M, Southerland JH. Cardiovascular Health Disparities in Underserved Populations. Prim Care 2017; 44:e37-e71. [DOI: 10.1016/j.pop.2016.09.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Cornish EK, McKissic SA, Dean DAL, Griffith DM. Lessons Learned About Motivation From a Pilot Physical Activity Intervention for African American Men. Health Promot Pract 2017; 18:102-109. [PMID: 26637233 PMCID: PMC4893343 DOI: 10.1177/1524839915614800] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
African American men are less likely than White men to meet physical activity recommendations, and few physical activity interventions have focused on the unique needs of African American men. Because health is not more important to men than fulfilling the role of a provider or other socially important roles, one of the biggest challenges in creating interventions for African American men is helping them identify reasons that they should prioritize both health and life goals. In a recent pilot physical activity intervention for 30- to 70-year-old African American men, we used self-determination theory and motivational interviewing principles to create worksheets that helped men identify their core values and life goals and asked them to describe how their values and goals were related to health and physical activity. We used basic statistics and thematic analysis to identify and examine key sources of motivation for men to be healthier and more physically active. We found that being healthy, a good Christian, a good spouse/partner, disciplined, and successful were among men's most important life goals. This article highlights a strategy for identifying key sources of motivation in African American men's lives and key themes that can be used in to enhance future interventions.
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Affiliation(s)
| | | | - Donnatesa A L Dean
- 2 Brown School of Social Work, Washington University in St. Louis, MO, USA
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Thomas S, Yingling L, Adu-Brimpong J, Mitchell V, Ayers CR, Wallen GR, Peters-Lawrence M, Brooks AT, Sampson DM, Wiley KL, Saygbe J, Henry J, Johnson A, Graham A, Graham L, Powell-Wiley TM. Mobile Health Technology Can Objectively Capture Physical Activity (PA) Targets Among African-American Women Within Resource-Limited Communities-the Washington, D.C. Cardiovascular Health and Needs Assessment. J Racial Ethn Health Disparities 2016; 4:10.1007/s40615-016-0290-4. [PMID: 27913983 PMCID: PMC5457361 DOI: 10.1007/s40615-016-0290-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/09/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Little is understood about using mobile health (mHealth) technology to improve cardiovascular (CV) health among African-American women in resource-limited communities. METHODS We conducted the Washington, D.C. CV Health and Needs Assessment in predominantly African-American churches in city wards 5, 7, and 8 with the lowest socioeconomic status based on community-based participatory research (CBPR) principles. The assessment measured CV health factors: body mass index (BMI), fasting blood glucose and cholesterol, blood pressure, fruit/vegetable (F/V) intake, physical activity (PA), and smoking. Participants were trained to use a PA monitoring wristband to measure 30 days of PA, wirelessly upload the PA data to hubs at the participating churches, and access their data from a church/home computer. CV health factors were compared across weight classes. RESULTS Among females (N = 78; 99 % African-American; mean age = 59 years), 90 % had a BMI categorized as overweight/obese. Across weight classes, PA decreased and self-reported sedentary time (ST) increased (p ≤ 0.05). Diastolic blood pressure and glucose increased across weight classes (p ≤ 0.05); however, cholesterol, glucose, and BP were near intermediate CV health goals. CONCLUSIONS Decreased PA and increased ST are potential community intervention targets for overweight and obese African-American women in resource-limited Washington D.C. areas. mHealth technology can assist in adapting CBPR intervention resources to improve PA for African-American women in resource-limited communities.
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Affiliation(s)
- S Thomas
- Office of Intramural Training and Education, National Institutes of Health, Bethesda, MD, 20892, USA
| | - L Yingling
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Room 5-3340, Bethesda, MD, 20892, USA
| | - J Adu-Brimpong
- Office of Intramural Training and Education, National Institutes of Health, Bethesda, MD, 20892, USA
| | - V Mitchell
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Room 5-3340, Bethesda, MD, 20892, USA
| | - C R Ayers
- Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - G R Wallen
- Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M Peters-Lawrence
- Division of Intramural Research - Hematology Branch, National Heart Lung and Blood Institute, NIH, Bethesda, MD, 20892, USA
| | - A T Brooks
- Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - D M Sampson
- Office of Behavioral and Social Sciences Research, Office of the Director, National Institutes of Health, Bethesda, MD, 20892, USA
| | - K L Wiley
- Division of Genomic Medicine, National Human Genome Research Institute, Bethesda, MD, 20892, USA
| | - J Saygbe
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Room 5-3340, Bethesda, MD, 20892, USA
| | - J Henry
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, MD, 21201, USA
| | - A Johnson
- Department of Nutritional Sciences, Howard University, Washington, DC, 20059, USA
| | - A Graham
- Department of Nutritional Sciences, Howard University, Washington, DC, 20059, USA
| | - L Graham
- Department of Nutritional Sciences, Howard University, Washington, DC, 20059, USA
| | - T M Powell-Wiley
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Room 5-3340, Bethesda, MD, 20892, USA.
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