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Tidwell Torres M, Bailey A, Riscia PM, Kang AW. A Systematic Narrative Review of Recent Obesity Interventions with Black Women in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02026-9. [PMID: 38771451 DOI: 10.1007/s40615-024-02026-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/06/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVES This study is to comprehensively review recent obesity interventions for Black women in the United States. METHODS We searched PubMed and EBSCOhost for articles published between 2013 and 2022 using a comprehensive search strategy. Two reviewers screened titles, abstracts, and full texts. Data from the included articles were extracted. Qualitative themes related to the intervention designs were identified across studies. RESULTS Fifty-two studies were included in the review. Interventions typically aimed to reduce weight by targeting diet and/or physical activity. Intervention activities were delivered virtually and in-person via several formats including didactic content and interactive sessions. Outcomes were assessed through a variety of research designs. Across papers, we identified six key themes of intervention design: integration of technology, centering community and culture, personalization of content, use of social support, skill-building through intervention activities, and addressing comorbid health conditions. CONCLUSIONS To address the obesity epidemic, future research can build upon key lessons learned from recent interventions tailored to Black women.
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Affiliation(s)
- Melina Tidwell Torres
- Department of Behavioral and Social Science, Brown School of Public Health, Providence, RI, USA
| | - Amelia Bailey
- Department of Behavioral and Social Science, Brown School of Public Health, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA
| | - Patricia Markham Riscia
- Department of Behavioral and Social Science, Brown School of Public Health, Providence, RI, USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Providence, RI, USA
- Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
| | - Augustine W Kang
- Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA.
- Stanford University School of Medicine, Stanford, CA, USA.
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Arevalo WM, Caicedo BI, Urizar GG, Schroeder J. Active Moms: a feasibility study of a community-based and home-based physical activity intervention for low-income, ethnic-minority mothers. Pilot Feasibility Stud 2023; 9:187. [PMID: 37978576 PMCID: PMC10655306 DOI: 10.1186/s40814-023-01378-z] [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: 09/26/2022] [Accepted: 07/18/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Despite the health benefits of physical activity, increasing regular physical activity levels among low-income, ethnic-minority mothers has remained a significant challenge. Yet, few studies have examined the feasibility of implementing interventions to address physical activity barriers often experienced by this population. METHODS The current mixed-methods pilot study assessed the feasibility, impact, and acceptability of a 3-month community-based (CBI) and a home-based intervention (HBI) designed to improve physical activity and fitness levels, as well as psychosocial outcomes (self-efficacy and social support), among low-income, ethnic minority mothers. Mothers were randomized to either a 3-month CBI or HBI and completed pre- and post-intervention assessments of physical activity, fitness, self-efficacy, and social support. Intervention feasibility was assessed by tracking recruitment, retention, and adverse event rates, whereas intervention acceptability was assessed through post-intervention focus groups. RESULTS Although participant recruitment was lower than expected (30 vs. target of 52 mothers), retention and adverse event feasibility goals were met (> 60% retention rate, 0% adverse events). Mothers in both groups (CBI and HBI) showed significant improvements in their physical activity and fitness levels and short-term improvements in receiving social support for physical activity. However, only mothers in the CBI group showed improvements in their self-efficacy for physical activity. Mothers also reported both types of interventions (CBI and HBI) to be acceptable with minor modifications highlighted, including the potential for graduates of these programs to serve as group facilitators. CONCLUSIONS Overall, the study protocol was feasible, impactful, and acceptable to low-income, ethnic minority mothers with modifications required before large-scale evaluation. (TRN: NCT05540509; 9/12/22; retrospectively registered; ClinicalTrials.org).
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Affiliation(s)
- Wendy Miranda Arevalo
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Urban Planning, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Brianna Isabel Caicedo
- Department of Psychology, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA
| | - Guido G Urizar
- Department of Psychology, California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA, 90840-0901, USA.
| | - Jan Schroeder
- Department of Kinesiology, California State University, Long Beach, Long Beach, CA, USA
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Golsteijn RHJ, Bolman C, Peels DA, Volders E, de Vries H, Lechner L. Long-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: A randomized controlled trial. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:690-704. [PMID: 37591482 PMCID: PMC10658345 DOI: 10.1016/j.jshs.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/18/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Physical activity (PA) can improve the physical and psychological health of prostate and colorectal cancer survivors, but PA behavior change maintenance is necessary for long-term health benefits. OncoActive is a print- and web-based intervention in which prostate and colorectal cancer patients and survivors receive automatically generated, personalized feedback aimed at integrating PA into daily life to increase and maintain PA. We evaluated the long-term outcomes of OncoActive by examining the 12-month follow-up differences between OncoActive and a control group, and we explored whether PA was maintained during a 6-month non-intervention follow-up period. METHODS Prostate or colorectal cancer patients were randomly assigned to an OncoActive (n = 249) or a usual care waitlist control group (n = 229). OncoActive participants received PA advice and a pedometer. PA outcomes (i.e., ActiGraph and self-report moderate-to-vigorous intensity PA (MVPA) min/week and days with ≥30 min PA) and health-related outcomes (i.e., fatigue, depression, physical functioning) were assessed at baseline, 6 months, and 12 months. Differences between groups and changes over time were assessed with multilevel linear regressions for the primary outcome (ActiGraph MVPA min/week) and all additional outcomes. RESULTS At 12 months, OncoActive participants did not perform better than control group participants at ActiGraph MVPA min/week, self-report MVPA min/week, or ActiGraph days with PA. Only self-report days with PA were significantly higher in OncoActive compared to the control group. For health-related outcomes only long-term fatigue was significantly lower in OncoActive. When exploratively examining PA within OncoActive, the previously found PA effects at the end of the intervention (6 months follow-up) were maintained at 12 months. Furthermore, all PA outcomes improved significantly from baseline to 12 months. The control group showed small but non-significant improvements from 6 months to 12 months (and from baseline to 12 months), resulting in a decline of differences between groups. CONCLUSION The majority of previously reported significant between-group differences at 6 months follow-up were no longer present at long-term follow-up, possibly because of natural improvement in the control group. At long-term follow-up, fatigue was significantly lower in OncoActive compared to control group participants. Computer-tailored PA advice may give participants an early start toward recovery and potentially contributes to improving long-term health.
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Affiliation(s)
| | - Catherine Bolman
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Denise Astrid Peels
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Esmee Volders
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, 6200 MD, the Netherlands
| | - Lilian Lechner
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
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Kim Y, Lee H, Chung ML. Living labs for a mobile app-based health program: effectiveness of a 24-week walking intervention for cardiovascular disease risk reduction among female Korean-Chinese migrant workers: a randomized controlled trial. Arch Public Health 2022; 80:181. [PMID: 35927769 PMCID: PMC9351079 DOI: 10.1186/s13690-022-00941-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background The risk of Cardiovascular disease (CVDs) among adult populations is influenced by environmental factors, and immigrant populations tend to be more vulnerable. This study examined the effectiveness of a 24-week walking program based on social-cognitive determinants through mobile app for CVD risk reduction among female Korean-Chinese middle-aged workers. Methods This study used a parallel randomized controlled trial. Participants were recruited by distributing posters and flyers and randomly assigned to either the standard treatment (ST, n = 22) or enhanced treatment group (ET, n = 28). Participants were provided with a mobile app linked to Fitbit Alta for 24 weeks and instructed to walk at least 30 minutes five times a week and moderate-intensity physical activity. The ET group had additional interventions that enhanced social-cognitive determinants such as self-efficacy, social support. All participants were guided to voluntary physical activity during the 12-week maintenance period. Data were analyzed by the Mann Whitney U-test and a generalized estimating equation. Results There were significant between-group differences regarding the number of steps (B = 1.295, P < .001) and moderate physical activity time (OR = 6.396, P = .030) at week 12. ET group had significant changes in high-density lipoprotein cholesterol (B = 10.522, P = .007), low-density lipoprotein cholesterol (B = -16.178, P = .024), total cholesterol (B = -20.325, P = .039), fasting blood sugar (B = − 8.138, P = -.046). In addition, there was a significant reduction of 10-year CVD risk for the ET group over 12 weeks compared to the ST group (B = -0.521, P<. 001). Conclusions Long-term studies are needed to reduce the risk of cardiovascular disease in large-scale migrant workers and to confirm the direct and insdirect effects of social-cognitive determinants on health outcomes. Trial registration The trial was retrospectively registered in WHO ICTRP (KCT0006467) August 19th, 2021. (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0006467,
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Carroll JE, Bower JE, Ganz PA. Cancer-related accelerated ageing and biobehavioural modifiers: a framework for research and clinical care. Nat Rev Clin Oncol 2022; 19:173-187. [PMID: 34873313 PMCID: PMC9974153 DOI: 10.1038/s41571-021-00580-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
A growing body of evidence indicates that patients with cancer who receive cytotoxic treatments (such as chemotherapy or radiotherapy) have an increased risk of accelerated physical and cognitive ageing. Furthermore, accelerated biological ageing is a suspected driving force behind many of these observed effects. In this Review, we describe the mechanisms of biological ageing and how they apply to patients with cancer. We highlight the important role of specific behavioural factors, namely stress, sleep and lifestyle-related factors such as physical activity, weight management, diet and substance use, in the accelerated ageing of patients with cancer and cancer survivors. We also present a framework of how modifiable behaviours could operate to either increase the risk of accelerated ageing, provide protection, or promote resilience at both the biological level and in terms of patient-reported outcomes.
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Affiliation(s)
- Judith E Carroll
- Norman Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behaviour, University of California, Los Angeles, CA, USA.
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.
| | - Julienne E Bower
- Norman Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behaviour, University of California, Los Angeles, CA, USA
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
- Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Kariuki JK, Gibbs BB, Erickson KI, Kriska A, Sereika S, Ogutu D, Milton H, Wagner L, Rao N, Peralta R, Bobb J, Bermudez A, Hirshfield S, Goetze T, Burke LE. The feasibility and acceptability of a web-based physical activity for the heart (PATH) intervention designed to reduce the risk of heart disease among inactive African Americans: Protocol for a pilot randomized controlled trial. Contemp Clin Trials 2021; 104:106380. [PMID: 33798731 PMCID: PMC8180502 DOI: 10.1016/j.cct.2021.106380] [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: 12/24/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Many studies have used the internet to promote physical activity (PA) in several settings, including the home environment, but few have been tailored for African Americans (AAs). To address this research gap, we conducted focus groups with AAs to inform the development of a web-based intervention, Physical Activity for The Heart (PATH), that leverages openly accessible platforms, such as YouTube, to promote PA in any setting. PURPOSE To describe the rationale and design of a pilot randomized clinical trial (RCT), that examines the feasibility and acceptability of the PATH intervention among 30 AA adults aged 40--70 years without history of cardiovascular disease. METHODS A 12-week, single-site, wait-listed RCT with subjects randomized 1:1 to either: 1) treatment group - participants receive the PATH intervention, including the online portal and twice a month phone calls from a PA coach, or 2) attention control group - participants receive a self-help PA handout and twice a month general health newsletter. All participants self-monitor step count using actigraphy. The primary outcomes of this 12-week, pilot RCT are recruitment, retention, and adherence to self-monitoring (Actigraph wear time) and the intervention protocol (PATH utilization). The secondary outcomes include changes in PA (step count, moderate-to-vigorous PA, exercise self-efficacy), and cardiometabolic risk (HbA1C, HDL, LDL, total cholesterol, type 2 diabetes risk score, percent body fat, weight, and waist circumference) from baseline to 12 weeks. CONCLUSIONS This study will provide PATH intervention feasibility and acceptability data among inactive AA adults and will inform a future, full-scale RCT testing efficacy.
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Affiliation(s)
| | | | | | | | | | - David Ogutu
- Ritiko Cloud-based Home-care Software, MA, USA
| | | | | | - Neel Rao
- University of Pittsburgh, PA, USA
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Sheppard VB, Dash C, Nomura S, Sutton AL, Franco RL, Lucas A, Ross M, Adams-Campbell L. Physical activity, health-related quality of life, and adjuvant endocrine therapy-related symptoms in women with hormone receptor-positive breast cancer. Cancer 2020; 126:4059-4066. [PMID: 32614992 PMCID: PMC8018708 DOI: 10.1002/cncr.33054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Physical activity (PA) is recommended for women with breast cancer (BC); however, data are sparse on the association of PA with quality of life (QOL) and patient-reported symptoms for women on adjuvant endocrine therapy (AET). METHODS Women with hormone receptor-positive BC who were taking AET completed standardized surveys about their health-related QOL, AET-related symptoms, and levels of PA using validated measures. A Wald chi-square test and an analysis of variance were used to assess associations with PA and independent variables. Generalized linear regression analyses assessed associations between PA, QOL, and AET-related symptoms. RESULTS The analytic cohort included 485 Black and White women. Black race, a high body mass index (BMI), and being on aromatase inhibitors (vs tamoxifen) were associated with lower PA in a bivariate analysis. In a multivariate analysis, lower self-reported PA was associated with a high BMI (P = .02) and chemotherapy uptake (P = .006). Better health-related QOL (P = .01), less severe overall AET-related symptoms (P = .02), and less severe gynecological symptoms (P = .03) were associated with increasing levels of moderate PA. CONCLUSIONS Among women taking AET, moderate levels of PA may be associated with fewer medication-related symptoms and overall better ratings of health-related QOL. Because of the low levels of PA observed in the sample overall and particularly for Black women, identifying successful strategies to promote PA are needed.
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Affiliation(s)
- Vanessa B. Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA
- Massey Cancer Center Office of Health Equity and Disparities Research Virginia Commonwealth University, Richmond, VA
| | - Chiranjeev Dash
- Department of Oncology, Georgetown University, Washington, DC
| | - Sarah Nomura
- Department of Oncology, Georgetown University, Washington, DC
| | - Arnethea L. Sutton
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Robert Lee Franco
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University College of Humanities and Sciences, Richmond, VA
| | - Alexander Lucas
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Masey Ross
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA
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Pierre A, Williams TH. African American Patients With Multiple Myeloma: Optimizing Care to Decrease Racial Disparities. Clin J Oncol Nurs 2020; 24:439-443. [PMID: 32678364 DOI: 10.1188/20.cjon.439-443] [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: 11/17/2022]
Abstract
The incidence of multiple myeloma in African Americans is two to three times higher than in other ethnicities and is the leading hematologic malignancy in African Americans. Despite the high incidence of multiple myeloma in African American individuals, a vast majority experience delays in diagnosis and reduced usage of effective therapies, including stem cell transplantation, as well as low participation in clinical trials. Racial disparities, social and financial health disparities, and barriers to earlier access to care can lead to poorer patient outcomes. There are also unique characteristics in the disease manifestation in African Americans with multiple myeloma that are imperative for oncology nurses to understand and recognize to provide optimal care.
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