Correlates of Self-Efficacy for Physical Activity in African American Women

Moderate physical activity and healthy eating habits among older African American women with diabetes and hypertension: a qualitative study of barriers and facilitators

OBJECTIVE

African American women have a high prevalence of atherosclerotic risk factors. Many of these atherosclerotic risk factors can be modified through increased physical activity and a healthy diet.

DESIGN

We conducted a phenomenological qualitative study on perceptions of physical activity and healthy eating among 26 African American women, 55 years and older. Interviews were conducted and coded for emerging themes on barriers and facilitators of physical activity and dietary behaviors.

RESULTS

Perceived barriers were pain and motivation to be active, limited definition of physical activity, time, preparation, cost of healthy meals, and daily decisions on food choice and preference. Facilitators were a routine of regular physical activity, awareness of healthy food choices, and influence of family.

CONCLUSIONS

Overall, participants had a general perception about the importance of physical activity and healthy eating; however, their motivation to engage in these behaviors depends on their definition, personal motivation, and food preference.

Enhanced Curriculum Intervention Did Not Result in Increased Postnatal Physical Activity in Rural, Southern, Primarily African American Women

Purpose:

To test the impact of an enhanced home visiting curriculum on postnatal physical activity in rural, southern, primarily African American mothers.

Design:

Randomized controlled trial.

Setting:

Three rural counties in Mississippi.

Participants:

Between September 2013 and May 2016, 54 postpartum women randomized to standard home visiting curriculum (n = 30 control) or lifestyle enhanced home visiting curriculum (n = 24 experimental) were followed for 12 months.

Intervention:

The experimental arm of the intervention built upon the Parents as Teachers curriculum (control arm) by adding culturally tailored, maternal weight management and early childhood obesity prevention components.

Measures:

Physical activity behavior and related psychosocial constructs including attitudes, expectations, self-efficacy, social support, and barriers.

Analysis:

Generalized linear mixed models were applied to test for treatment and time effects on physical activity and related psychosocial constructs.

Results:

Postnatal retention rates were 83% and 88% for control and experimental arms, respectively. Mean weekly minutes of moderate-to-vigorous physical activity were 28 and 50 minutes at postnatal months 1 and 12 in the control arm and 40 minutes for both time points in the experimental arm. Although a significant time effect was found, pairwise comparisons failed to reach statistical significance.

Conclusion:

The enhanced treatment was not effective at increasing postnatal physical activity nor improving related psychosocial construct measures in this cohort of rural, southern women.

Study design and protocol for moving forward: a weight loss intervention trial for African-American breast cancer survivors

BACKGROUND

Breast cancer survival rates are significantly lower among African-American women compared to white women. In addition, African-American women with breast cancer are more likely than white women to die from co-morbid conditions. Obesity is common among African-American women, and it contributes to breast cancer progression and the development and exacerbation of many weight-related conditions. Intervening upon obesity may decrease breast cancer and all-cause mortality among African-American breast cancer survivors.

METHODS/DESIGN

Moving Forward is a weight loss intervention being evaluated in a randomized trial with a projected sample of 240 African American breast cancer survivors. Outcomes include body mass index, body composition, waist:hip ratio, and behavioral, psychosocial and physiological measures. Survivors are randomized to either a 6-month guided weight loss intervention that involves twice weekly classes and text messaging or a self-guided weight loss intervention based on the same materials offered in the guided program. The guided intervention is being conducted in partnership with the Chicago Park District at park facilities in predominantly African-American neighborhoods in Chicago. Recruitment strategies include direct contact to women identified in hospital cancer registries, as well as community-based efforts. Data collection occurs at baseline, post-intervention (6 months) and at a 12-month follow-up.

DISCUSSION

This study evaluates a community-based, guided lifestyle intervention designed to improve the health of African-American breast cancer survivors. Few studies have addressed behavioral interventions in this high-risk population. If successful, the intervention may help reduce the risk for breast cancer recurrence, secondary cancers, and co-morbid conditions, as well as improve quality of life.

TRIAL REGISTRATION

U.S. Clinicaltrials.gov number: NCT02482506, April 2015.

Obesity in urban women: associations with sleep and sleepiness, fatigue and activity

BACKGROUND

African-American women (AAW) have the highest prevalence of obesity and therefore are at greater risk for obesity-related symptoms and diseases. Obese individuals frequently report poorer sleep quality, more daytime sleepiness, more severe fatigue, and higher physical inactivity than normal weight individuals. The relationships among these variables have not been well-characterized in obese, urban-dwelling, AAW.

METHODS

This descriptive, correlational study examined the relationships among sleep quality, daytime sleepiness, fatigue, level of physical activity, and body mass index (BMI) in AAW living in an urban setting. A convenience sample of 69 young adult women with a BMI of greater than 30 kg/m(2) completed measures of sleep quality, sleepiness, fatigue severity, sense of community, and physical activity. Further analysis was done to determine if any of the study variables predicted level of physical activity.

FINDINGS

There was a strong and significant correlation between BMI and overall fatigue severity and a significant, negative correlation between BMI and physical activity performance. BMI was significantly correlated with sleep latency but not global sleep quality. There were significant relationships between fatigue severity and poorer global sleep quality and daytime sleepiness. Multiple regression analysis showed BMI and age accounted for a significant amount of the variance in physical activity.

CONCLUSIONS

Higher BMI was associated with significant fatigue. Fatigue severity was associated with poorer global sleep quality, daytime sleepiness, and a sense of community. Higher BMI may be a barrier to having an active lifestyle.

Relationships Between Body Areas Satisfaction, Exercise, and Mood in Obese African American Women

Despite a rate of morbid obesity that is 2.5 times that of European American women, African American women have higher body areas satisfaction than any other ethnicities. Previous research suggested differences in African American women’s attitudes toward body image may contribute to a lack of motivation to engage in weight management behaviors, such as physical activity. In addition, factors such as self-efficacy, self-regulation, and mood have been shown to affect healthy behavior participation but have not been studied among obese African American women. This study investigated if changes from baseline to posttreatment in self-efficacy and self-regulation for exercise and mood mediatedthe association between changes in body areas satisfaction and physical activity. The study used archival data consisting of 109 obese African American women who participated in a 6-month weight management intervention. The relationship between changes in body areas satisfaction and physical activity was mediated by changes in self-regulation for exercise and mood but not by change in self-efficacy for exercise. These findings may help in devising treatments targeted at this population. Implications are discussed.

Is Attitude a Key Factor to Consider When Designing Physical Activity Interventions for Black Adolescent Girls

Chronic diseases continue to be disproportionately higher in Black women in comparison with other ethnic groups, with physical inactivity being linked to the growing incidences of many of these diseases. The review of the literature indicates that attitude which is shaped by beliefs, self-efficacy, and cultural factors is a key variable in promoting physical activity (PA) in Black adolescent girls. Specific aims of this review were to identify PA interventions designed specifically for adolescent girls, with an emphasis on Black adolescent girls, and to identify what factor promotes PA in this group. The long-term goal is to use the information from this review to design effective PA programs aimed at Black adolescent girls. Physical activity and fitness were improved in four of the interventions in this review that focused on enhanced self-efficacy, goal setting, social support, and measures aimed at changing attitudes. Overall, this review shows that more effective interventions targeting Black adolescent girls are needed that consider the cultural factors (beliefs, self-efficacy, and family dynamics) that shape one’s attitude toward being physically active.

Effects of current physical activity on affective response to exercise: physical and social-cognitive mechanisms

Affective responses during exercise are often important determinants of exercise initiation and maintenance. Current physical activity may be one individual difference that is associated with the degree to which individuals have positive (or negative) affective experiences during exercise. The objective of this study was to explore physical and cognitive explanations of the relationship between current activity status (more versus less active) and affective response during a 30-minute bout of moderate-intensity exercise. Participants reported their current level of physical activity, exercise self-efficacy and affect during a 30-minute bout of moderate-intensity exercise. More active individuals experienced higher levels of positive affect and tranquillity and lower levels of negative affect and fatigue during exercise. Multivariate models for each affective state indicated separate processes through which physical activity may be associated with changes in affect during exercise. These models indicate that affect experienced during physical activity is related to the current activity level and these relationships can be partially explained by the physical and cognitive factors explored in this study. Recommendations for future research to elucidate whether positive affective response to physical activity improves as a function of becoming more active over time are discussed.

Using the health belief model to develop culturally appropriate weight-management materials for African-American women

African-American women have the highest prevalence of adult obesity in the United States. They are less likely to participate in weight-loss programs and tend to have a low success rate when they do so. The goal of this project was to explore the use of the Health Belief Model in developing culturally appropriate weight-management programs for African-American women. Seven focus groups were conducted with 50 African-American women. The Health Belief Model was used as the study's theoretical framework. Participants made a clear delineation between the terms healthy weight, overweight, and obese. Sexy, flirtatious words, such as thick, stacked, and curvy were often used to describe their extra weight. Participants accurately described the health risks of obesity. Most believed that culture and genetics made them more susceptible to obesity. The perceived benefits of losing weight included reduced risk for health problems, improved physical appearance, and living life to the fullest. Perceived barriers included a lack of motivation, reliable dieting information, and social support. Motivators to lose weight included being diagnosed with a health problem, physical appearance, and saving money on clothes. Self-efficacy was primarily affected by a frustrated history of dieting. The data themes suggest areas that should be addressed when developing culturally appropriate weight-loss messages, programs, and materials for African-American women.

Physical activity-related experiences, counseling expectations, personal responsibility, and altruism among urban African American women with type 2 diabetes

PURPOSE

The purpose of this study was to explore physical activity-related experiences, perceptions, and counseling expectations among urban, underactive, African American women with type 2 diabetes.

METHODS

Participants were recruited via flyers and endocrinologist referral. A professional, African American female moderator led 2 focus groups among 11 participants. Focus groups were conducted in a video- and audio-equipped focus group room in the evening hours. Using a content-based, stepped analytic approach, 2 raters independently analyzed data and collaborated to compare results and finalize themes.

RESULTS

Competing priorities and lack of motivation were perceived as significant barriers to physical activity. Physical activity-related counseling expectations (ie, physician encouragement) and experiences (physician advising) were inconsistent. Participants expressed a high degree of physical activity-related health responsibility. Altruistic intentions were high relative to helping others incorporate healthful lifestyle changes.

CONCLUSIONS

When counseling women about physical activity, diabetes educators should acknowledge and provide support and resources to help women incorporate more physical activity into their regular routines and enhance motivation for physical activity. Educators should also couple physical activity-related advice with encouragement and support. Because of high levels of altruism, educators should consider implementing group- and/or peer-based physical activity interventions in this patient group.

Sense of security among people aged 65 and 75: external and inner sources of security

AIM

This paper is a report of a study exploring possible external and inner sources of the sense of security felt by older people aged 65 and 75. Background.  The concept of 'security' has been parsimoniously defined and explored, especially as pertains to older people, and previous research has primarily focused on risks in relation to individuals' declining health and functional ability.

METHODS

In 2005, population-based cross-sectional surveys were carried out in 15 municipalities in Västerbotten, Sweden and 18 municipalities in Ostrobothnia, Finland. A 15-page questionnaire (84 questions) was distributed, with the final total response rate reaching 68· % (n = 3370): 1825 Swedish-speaking Swedes, 926 Swedish-speaking Finns and 621 Finnish-speaking Finns. The statistical analysis was three-stage, including nominal stepwise regressions.

RESULTS

Older people who indicate that they are 'very secure' are more likely to consider life meaningful and are able to master various life crises. Moreover, they possess confidence in economic institutions and are more likely to feel economically secure. Weak trust in family and friends or neighbours and decreased functional ability seem to indicate a subjective feeling of 'insecurity'.

CONCLUSION

Caregivers in health care should focus more on supporting older persons' meaningfulness in life and how their feelings of security can be strengthened by trusting relationships and activities. In nursing, there should be more focus on developing knowledge of inner health resources, including positive life orientation and meaningfulness in life.

Effects of the Youth Fit for Life Protocol on Physiological, Psychological, and Behavioral Factors at YMCA Calgary After-School Care Sites

Youth inactivity and inappropriately high weight is a problem in the United States, Canada, and much of the industrialized world. Physiological and behavioral changes associated with the Youth Fit For Life protocol, a physical activity and nutrition education treatment based on self-efficacy theory, were assessed in 7- to 12-yr.-olds ( N = 43) from Calgary, Alberta, Canada. Body Mass Index, strength, and cardiorespiratory endurance significantly improved over a 12-wk. period when contrasted with changes based on normative data. Significant within-group improvements in measures of self-efficacy, vegetable intake, and voluntary moderate-to-vigorous physical activity were also found over 12 wk. Multiple regression analysis indicated that score changes in measures of self-regulatory and task self-efficacy, and general self, accounted for changes in voluntary physical activity. Implications for use of behaviorally based methods for large-scale obesity prevention treatments in preadolescents were discussed.

Do the determinants of physical activity change by physical activity level?

AIM

The paper reports on a study to describe the determinants of physical activity according to physical activity level among rural women in Korea.

BACKGROUND

The benefits of physical activity for promoting health and preventing illness are well known, and gender and regional disparities in physical activity have been reported. Although the number of women who perform physical activity has increased, many still do not meet the recommended levels to gain health benefits.

METHOD

A cross-sectional descriptive study was conducted using a structured questionnaire. A convenience sample of 245 women living in a rural area of Korea was recruited during 2004. Self-efficacy, benefits, barriers and sociodemographics were examined in relation to three levels of physical activity: inactive, insufficiently active and active. Descriptive statistics and multinomial logistic regression were used for data analysis.

RESULT

Perceived self-efficacy, benefits and barriers were statistically significant determinants only when the insufficiently active group was compared with the inactive group. Sociodemographic factors related to work and family roles statistically significantly explained the physical activity levels of rural women.

CONCLUSION

Nursing interventions to increase self-efficacy and benefits, or decrease perceived barriers could be effective for initiating physical activity for inactive women, whereas the same may not apply for insufficiently active women. Insufficiently active women may have false confidence that their physical activity will help them gain health benefits. Reducing the burdens of work and family roles of rural women might improve their physical activity levels.

An Overview and Proposed Framework of Social-Environmental Influences on the Physical-Activity Behavior of Women

Objective.

The primary purposes of this review were to identify key social-environmental influences on the physical-activity behavior of women and to propose an organizing framework of these influences in the social environment.

Data Sources.

Computerized searches of MEDLINE, Science Direct, and CINAHL were conducted to identify relevant research.

Study Inclusion and Exclusion Criteria.

Studies were included if they used a sample of adult women or included gender-specific analysis, identified or measured some aspect of the social environment in relation to physical activity, and were published in English within the last two decades.

Data Extraction.

Characteristics of study design, sample population, and identified social-environmental variables were extracted.

Data Synthesis.

Through an iterative review of the data by several researchers, common influences and themes were identified and organized into a social environment framework, which included the following components: social support/social networks, life transitions/multiple roles, and cultural standards/gender role expectations.

Results.

Women are exposed to societal messages that indicate physical activity is not a priority and may be inappropriate; they may also lack the social support necessary to adopt and maintain physical activity.

Conclusions.

This review reveals the complex range of factors in the social environment that influence women, and it provides support for the importance of the social environment on physical-activity behavior in women. A social-environmental framework related to Bronfenbrenner's social ecological model is proposed along with recommended strategies to apply in interventions targeting women.

Contextualizing the effects of yoga therapy on diabetes management: a review of the social determinants of physical activity

This article provides a review of literature both to identify the effects of yoga-based therapy on the management of type 2 diabetes mellitus and to examine the social context of physical activity. Findings from the review indicate that yoga has a positive short-term effect on multiple diabetes-related outcomes; however, long-term effects of yoga therapy on diabetes management remain unclear. The context of the social environment, including interpersonal relationships, community characteristics, and discrimination, influences the adoption and maintenance of health behaviors such as physical activity, including yoga practice. Further research is necessary to determine the extent of this influence.

Relationship of health behavior theories with self-efficacy among insufficiently active hypertensive African-American women

OBJECTIVE

While self-efficacy plays an important role in physical activity, relatively little research has examined this construct in minorities. This study identified theoretical correlates associated with self-efficacy among insufficiently active, hypertensive Black women.

METHODS

Correlates of self-efficacy to: (1) overcoming barriers to physical activity; (2) making time for activity; and (3) "sticking with" physical activity were studied.

RESULTS

Sixty-one women (M=50.48+/-4.2 years) participated. We accounted for 32% of the variance in confidence in overcoming barriers. Women confident in overcoming barriers reported less worry about physical activity. The TTM processes of change were also in the model: consciousness raising, environmental reevaluation, counter conditioning, and self-liberation. We accounted for 16% of the variance in "making time" self-efficacy. An aversiveness barrier (e.g., physical activity is boring, physical activity is hard work) was the dominant variable in the model. Confidence to 'stick with' physical activity was associated with self-reevaluation (i.e., reflection on how personal values correspond to behavior). Social support and competing demands were not associated with self-efficacy.

CONCLUSIONS

Consistent with Social Cognitive Theory, results suggest that self-efficacy is behavior specific and each measure likely provides unique information.

PRACTICE IMPLICATIONS

Interventions should be tailored to address specific self-efficacy types.

Relationship between health-related fitness and educational and income levels in Spanish women

OBJECTIVES

The aim of this study was to determine whether a relationship exists between health-related fitness, taken as an indicator of regular physical activity, and educational and income levels in adult Spanish women.

STUDY DESIGN

Descriptive, correlation, cross-sectional study.

METHODS

A stepwise stratification procedure according to population size, age and level of physical activity according to a previous epidemiological survey was used for sampling. Two thousand and thirty-eight women gave their written consent to participate (62.8% of those invited). The final sample consisted of 1709 healthy women (aged 18-88 years). Subjects were categorized into high, medium and low level groups for education and income. All participants were assessed for morphological and physical health-related fitness. Three-way MANCOVA (age as covariate) and Bonferroni's post hoc test were used to determine the differences between groups.

RESULTS

No significant relationships were found between age-adjusted educational and income levels. The lowest values for health-related fitness were found in the lowest educational and income groups (P<0.001). The higher the level of education and income, the better the values for all fitness variables (P<0.001), except anterior trunk flexibility.

CONCLUSIONS

A positive relationship was found between health-related fitness and educational and income levels, which appeared to be most evident in the lowest educational and income groups. This implies that health-related promotion policies in Spain should stress the importance of regular physical activity in social classes with low levels of education and income.

Racial disparities in sense of community and health status: implications in community-based participatory interventions targeting chronic disease in African Americans

This study examined the relation between sense of community (SOC), sociodemographic characteristics, and health status to inform community-based interventions designed to prevent and reduce chronic disease in African Americans. A telephone survey was conducted with 1463 randomly selected residents in Nashville, Tenn. Respondents were majority female (69%), African American (59%), and single (59%), with a mean age of 55 (+/-17.61 years). African Americans have lower overall SOC scores, or lower scores on the domains related to perceived influence over community and sharing of common community values compared to Whites. High rates of chronic disease and low SES, combined with a low SOC, can hinder efforts to reduce and eliminate disparities. The goal of community-based participatory initiatives is to create programs that are sustainable by the target community after the funding is gone. Thus, to maximize the success, uptake, and sustainability of disease-specific interventions, it is imperative to incorporate assessment of SOC, identify factors that depress SOC, and engage in community collaboration to develop a plan to improve SOC.