"Physical activity as a luxury": African American women's attitudes toward physical activity

Engagement in physical activity among African American women caregivers: a cross-sectional study

Family caregivers and African Americans often do not achieve the recommended 150 minutes of moderate-intensity aerobic activity per week. Factors associated with engaging in physical activity among African American caregivers have not been systematically examined. This cross-sectional study examined how contextual factors were associated with meeting the recommended amount of physical activity among African American women caregivers. We used a population-based sample of 1,478 African American women caregivers in the U.S. from the 2015, 2017, and 2019 Behavioral Risk Factor Surveillance System. We used survey-weighted multivariate regression analyses to examine associations between condition-specific factors, physical and social environment, and individual and family factors and meeting the national aerobic physical activity guideline (i.e., participating in 150 minutes (or vigorous equivalent minutes) of physical activity per week). Over half (53.9%) of African American women caregivers in the U.S. did not meet the guideline. Being age 65 years or older was associated with decreased odds of meeting the guideline compared to being between the ages of 25-44 years (OR = 0.50, 95% CI[0.26-0.99]). Compared to college graduates, women with partial college education had higher odds of meeting the guideline (OR = 2.08, 95%CI[1.24-3.51]). Having health insurance was associated with increased odds of meeting the guideline (OR = 2.28, 95%CI[1.12-4.63]). Our findings suggest several contextual factors are independently associated with meeting the national guideline. Understanding the relationships between contextual factors and engaging in physical activity among African American women caregivers can inform interventions aimed at protecting and promoting the health of these women.

Cardiorespiratory fitness and physical activity in the lens of social justice - Reporting on the disparities that exist

Cardiorespiratory fitness (CRF), heavily influenced by physical activity (PA), represents a strong and independent risk factor for a wide range of health conditions, most notably, cardiovascular disease. Substantial disparities in CRF have been identified between white and non-white populations. These disparities may partly account for group differences in susceptibility to poor health outcomes, including non-communicable disease. Race and ethnic differences in CRF may partly be explained by social injustices rooted in persistent structural and systemic racism. These forces contribute to environments that are unsupportive for opportunities to achieve optimal CRF levels. This review aims to examine, through the lens of social justice, the inequities in key social ecological factors, including socioeconomic status, the built environment, and structural racism, that underly the systemic differences in CRF and PA in vulnerable communities. Further, this review highlights current public health initiatives, as well as opportunities in future research, to address inequities and enhance CRF through the promotion of regular PA.

Factors Associated with Prevention of Metabolic Syndrome Among Middle-Aged Postmenopausal Korean Women: A Study Based on the Information, Motivation, Behavioral Skills (IMB) Model

Purpose

Metabolic syndrome (MetS) is a significant risk factor for cardiovascular disease. Middle-aged women, in particular, have been reported to have significantly increased cardiovascular disease rates after menopause; however, their adherence to health behaviors is lower than that of other populations. This study examined the factors associated with health behaviors for MetS prevention based on the Information-Motivation-Behavior skills model and described the relationships between the components of the model in middle-aged women.

Patients and Methods

This investigative study used an online self-report questionnaire survey that included 241 middle-aged postmenopausal women aged 45-64 years. The collected data were analyzed using descriptive statistics with SPSS 28.0, independent t-tests, one-way ANOVA, and Pearson's correlation coefficient. Multiple regression analysis was used to examine the relationships among the variables.

Results

After controlling for age, time since menopause, and comorbidities, knowledge of MetS, social support, self-efficacy, and attitudes explained 42% of the variance in health behaviors for MetS prevention (F=18.38, p<0.001). Among these variables, self-efficacy (β=0.33, p<0.001), attitudes toward health behaviors (β=0.26, p<0.001), and knowledge of MetS (β=0.13, p=0.005) had a significant impact on health behaviors for MetS prevention.

Conclusion

Significant associations were found between knowledge, self-efficacy, and attitudes toward health behaviors for MetS prevention among middle-aged women. The results of this study suggest that it is essential for healthcare provider to consider the components of the Information-Motivation-Behavior skills model when developing interventions aimed at improving health behaviors for MetS prevention among middle-aged postmenopausal women.

"I feel terrible and need to exercise to find any sort of joy": What COVID stay-at-home orders tell us about exercise as vitality politics and entertainment in the United States

During COVID-19 stay-at-home orders (SaHOs), people faced drastic shifts in their work and home lives. These shifts, in combination with the temporary closure of gyms and fitness centers, led to exercise-routine disruption. We conducted a survey to assess how people were affected by SaHOs in terms of exercise-routine change, feelings about exercise, perceived physical and mental health, as well as exercise-routine plans once SaHOs were lifted. In this article, we examine why affluent white American women exercised before and during COVID-19 SaHOs. The article focuses on the role of pleasure and entertainment as key components of exercise practices for these women. We found that changes in motivation reveal that exercise regimens are part of contemporary vitality politics, or current cultural and subjective desires and abilities to manipulate and optimize biological human processes, that include both health and entertainment. Therefore, we argue that exercise is a meaningful cultural, entertainment, and biopolitical activity.

Exploring the social-ecological factors related to physical activity participation among Black, Asian and minority ethnic immigrants

Purpose

Despite the health benefits of physical activity (PA), participation rates Black, Asian and minority ethnic (BAME) adults in the United Kingdom (UK) are low in comparison to the general population. This study aimed to explore the social-ecological factors related to PA participation among BAME immigrants.

Design/methodology/approach

Semi-structured interviews were carried out with 12 purposively selected adults from the BAME populace residing in one postcode district of a city in southern England.

Findings

The three main themes that developed from this study demonstrated that the barriers to PA participation among BAME were perceived to exist at intrapersonal, and environmental (social and physical) levels.

Research limitations/implications

Understanding these unique social-ecological factors may assist in intervention development.

Originality/value

Prominent barriers included intrapersonal factors such as deportation fear and cultural beliefs; and environmental factors such as the cost of accessing PA facilities. Length of residency appeared to be related to increased PA.

"Mane"taining: How Black Adolescent Girls Maintain Their Cultural Hair Practices in Physical Education Class

BACKGROUND

Although hair has been found to be a barrier to physical activity (PA) among adult black women, the research exploring this phenomenon among black adolescent girls is deficient. This presents a concern because physical inactivity can lead to obesity and a host of comorbidities. This qualitative study explores hair experiences of black adolescent girls and how they maintain their cultural hair practices in hopes of promoting PA among this at-risk population.

METHODS

Focus groups were conducted for 37 black adolescent girls attending a public high school in Newark, New Jersey.

RESULTS

The participants reported increasing hair knowledge via social media, sociocultural influences of family and culture, and the driving force of their peer group, a concept identified in the focus groups as Hair IQ (intelligence quotient). Hair IQ helped the participants learn how to maintain their hair practices before and after PA. These factors combined to develop a framework described as the "Mane"taining model.

CONCLUSIONS

The findings suggest the "Mane"taining model may provide pathways for engaging in PA for this population and serve as an example for adult black women who face similar barriers to PA.

Hair Maintenance and Chemical Hair Product Usage as Barriers to Physical Activity in Childhood and Adulthood among African American Women

Qualitative studies have identified haircare practices as important culturally specific barriers to physical activity (PA) among Black/African American (AA) women, but quantitative investigations are lacking. Using the Study of Environment, Lifestyle and Fibroids data among 1558 Black/AA women, we investigated associations between hair product usage/hair maintenance behaviors and PA during childhood and adulthood. Participants reported childhood and current chemical relaxer and leave-in conditioner use. Self-reported PA included childhood recreational sports participation, leisure-time PA engagement during adulthood, and, at each life stage, minutes of and intensity of PA. Adjusting for socioeconomic and health characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each PA measure for more vs. less frequent hair product use/hair maintenance. Thirty-four percent reported ≥twice/year chemical relaxer use and 22% reported ≥once/week leave-in conditioner use at age 10 years, and neither were associated with PA at age 10 years. In adulthood, ≥twice/year chemical relaxer users (30%) were less likely (PR = 0.90 [95% CI: 0.79-1.02]) and ≥once/week leave-in conditioner users (24%) were more likely (PR = 1.09 [95% CI: 0.99-1.20]) to report intense PA compared to counterparts reporting rarely/never use. Hair product use/maintenance may influence PA among Black/AA women and impact cardiometabolic health disparities.

Perceived Benefits and Barriers in the Mediation of Exercise Differences in Older Black Women with and Without Obesity

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.

Racial/Ethnic Variations in Clustered Risk Behaviors in the U.S

INTRODUCTION

Alcohol misuse, cigarette smoking, poor diet, and physical inactivity, known as the "big four" contributors to chronic conditions and mortality, typically co-occur or cluster together, with their synergistic effect more detrimental to health than their cumulative individual effects. Little research has been reported on race/ethnicity-specific analyses of the clustering of these behaviors in the U.S. This study identified clustered risk behaviors among whites, blacks, and Hispanics and examined whether unhealthy clusters were associated with lower SES (assessed by education level and family income) and poor health status.

METHODS

A nationally representative sample of U.S. adults aged 30-69 years (n=9,761) from the 2010 and 2015 National Alcohol Surveys was used to perform latent class analysis and multinomial and logistic regression modeling in 2018-2019. Obesity was used as a proxy for unhealthy diet.

RESULTS

Three lifestyle classes were identified in each group. The relatively healthy lifestyle class was identified among whites and Hispanics. The nonsmoking and low risky drinking class among blacks, though showing a healthier lifestyle than the other 2 classes, still had relatively high prevalence of inactivity and obesity. The inactive and obese class was found in all 3 groups. Also identified were the smoking and risky drinking class among whites; the smoking and inactive class among blacks; and the smoking, inactive, and risky drinking class among Hispanics. For all 3 groups, unhealthy lifestyle classes mostly were associated with lower SES. Unhealthy lifestyle classes were also associated with poorer health status.

CONCLUSIONS

Multi-behavior interventions are warranted to address inactivity and obesity in all 3 groups and unhealthy clusters involving smoking in each group.

Chemical/straightening and other hair product usage during childhood, adolescence, and adulthood among African-American women: potential implications for health

Few studies have characterized life course hair product usage beyond ever/never. We investigated hair product use from childhood to adulthood, usage patterns in adulthood, and socioeconomic status (SES) correlates among African-American (AA) women. Using self-reported data from 1555 AA women enrolled in the Study of Environment, Lifestyle, and Fibroids (2010-2018), we estimated the usage frequency of chemical relaxer/straightener (≥twice/year, once/year, and rarely/never) and leave-in/leave-on conditioner (≥once/week, 1-3 times/month, and rarely/never) during childhood, adolescence, and adulthood. Latent class analysis was used to identify patterns of adulthood usage of multiple hair products. SES was compared across latent classes. With a mean age of 33 ± 3.4 years, most women reported ever using chemical relaxers/straighteners (89%), and use ≥twice/year increased from childhood (9%) to adolescence (73%) but decreased in adulthood (29%). Leave-in/leave-on conditioner use followed the same pattern. Each of three identified latent classes reported frequent styling product use and infrequent relaxer/straightener use. Class One was unlikely to use any other products, Class Two moderately used shampoo and conditioner, and Class Three frequently used multiple product types (e.g., moisturizers and conditioners). Participants in the latter two classes reported higher SES. Ever/never characterization may miss important and distinctive patterns of hair product use, which may vary by SES.

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

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.

University⁻Community Partnerships Using a Participatory Action Research Model to Evaluate the Impact of Dance for Health

Little is known about fostering sustainable, collaborative community-academic partnerships that effectively improve physical activity and health in residents of under resourced communities using Participatory Action Research (PAR) driven models. The purpose of this PAR study was to evaluate the impact of an urban, intergenerational, and physical activity dance program by identifying community preferred measurable outcomes that promote program participation and sustainability. A descriptive, qualitative design was employed using semi-structured interview guides to facilitate discussions for two adult focus groups and one youth focus group. Exactly 19 community-residing adults and six youth who lived in urban neighborhoods in West Philadelphia participated in the discussions. The audiotapes were transcribed and analyzed using directed content analysis. Five outcome themes emerged and included: (1). Enhancing the psychological and emotional well-being of the individual, (2). Enhancement of social well-being and management of interpersonal relationships and responsibilities (3). Enhancing and promoting physiologic well-being (4). Changes in health promoting behaviors and skill acquisition, and (5). Concerns about accessibility of dance for health and other physical activity programs in the community. Focused attention to measuring community preferred outcomes can promote sustainability of Dance for Health and possibly other urban-based physical activity dance programs.

Promoting Team-Based Exercise Among African American Breast Cancer Survivors

Physical activity benefits the health and well-being of breast cancer survivors (BCS). Yet, many African American survivors do not routinely exercise and have increased risk of poor outcomes. The purpose of this mixed-method study was to identify motivational factors compelling African American BCS to participate in a 14-week team walking program and to intend to continue exercise after the intervention concluded. Focus groups were held with participants ( n = 12) before and after training. Content analysis discovered themes before the intervention: Not wanting to go at it alone, exercise not a life or treatment priority, cancer treatment affected activity, advocates to exercise, and can exercise really help? Four themes postintervention themes included: In the same boat, changed mind-set, improved weight and activity, and overcoming barriers. Physical data verified improvements. Results suggest that a team-based exercise training program may assist in overcoming a sedentary behavior tendency and subsequently improve health among survivors.

Estimating physical activity trends among blacks in the United States through examination of four national surveys

Physical activity is essential for overall good health and aids in the prevention and reduction of many diseases. In 2008, the U.S. Department of Health and Human Services (DHHS) issued the Physical Activity Guidelines for Americans to foster appropriate levels of physical activity at various ages of development. Despite these guidelines and the known benefit to being physically active; physical activity levels are significantly lower in Blacks, contributing to higher prevalence of poor health outcomes. Therefore, the purpose of this paper was to look at four national datasets [Youth Risk Behavior Survey (YRBS), Behavioral Risk Factor Surveillance System (BRFSS), The National Health and Nutrition Examination Survey (NHANES), and National Health Interview Survey (NHIS)] to identify any patterns and trends that could be used to improve physical activity behavior within this population. These national datasets were used to estimate the proportion of Black adults and youth meeting national physical activity recommendations overall-stratified by age, gender and other demographic characteristics, to help identify patterns. The proportion of Black youth reporting regular physical activity ranged from 33% to 52%; and of Black adults, 27% to 52%. Physical activity was highest among men, younger age groups, highest education and income groups, and those who were employed or married. Trends were consistent across surveys. Among Black youth, physical activity decline with increasing grade level, and improvements over the past 10 years have been minimal. The percentage of Black adults achieving physical activity guidelines has improved slightly over the last ten years, but physical activity participation is still low and continues to decline with age. Trends identified from examining these national datasets can be used to inform development of physical activity interventions aimed at promoting and maintaining regular physical activity behavior among high risk subgroups across the life span.

Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration

Background

African American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention.

Methods

A qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m²). Content analysis was used to analyze these focus group data.

Results

Three key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman’s hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants.

Conclusion

Findings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.

Utility of Social Cognitive Theory in Intervention Design for Promoting Physical Activity among African-American Women: A Qualitative Study

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.

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development

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.

Behavior-Specific Influences for Physical Activity Among African American Women

The purpose of this study was to describe physical activity (PA) behaviors and physical functioning of prehypertensive and Stage I hypertensive African American Women (AAW) and to examine the relationships between PA behavior, physical functioning, personal factors, and behavior-specific influences. Pender's Health Promotion Model was the conceptual framework for the study. A cross-sectional design and convenience sample were used. The PA domain where the greatest amount of time was spent was in work-related activity, followed by household, leisure time, and transportation activity. Personal factors most strongly correlated to lower PA were greater body mass index and waist circumference. AAW perceived moderate barriers to PA and minimal family and friend social support for PA. Future interventions need to focus on removing barriers to and improving social support for PA among AAW.

"My hair or my health:" Overcoming barriers to physical activity in African American women with a focus on hairstyle-related factors

Physical activity disparities among African American (AA) women may be related to sociocultural barriers, including difficulties with restyling hair after exercise. We sought to identify physical activity barriers and facilitators in AA women with a focus on sociocultural factors related to hairstyle maintenance. Participants (n = 51) were AA women aged 19-73 years who completed valid surveys and participated in structured focus groups, stratified by age and physical activity levels, from November 2012 to February 2013. The Constant Comparison method was used to develop qualitative themes for barriers and facilitators. The most frequently reported general physical activity barrier among exercisers was "lack of money" (27%) and among non-exercisers was "lack of self-discipline" (57%). A hairstyle-related barrier of "sweating out my hairstyle" was reported by 7% of exercisers and 29% of non-exercisers. This hairstyle-related barrier included the need for extra time and money to restyle hair due to perspiration. Hairstyle-related facilitators included: prioritizing health over hairstyle and high self-efficacy to restyle hair after perspiration. Participants were interested in resources to simplify hairstyle maintenance. AA women whose hairstyle is affected by perspiration may avoid physical activity due to time and financial burdens. Increasing self-efficacy to restyle hair after perspiration may help to overcome this barrier.

The need to modify physical activity messages to better speak to older African American women: a pilot study

BACKGROUND

Combating the physical inactivity crisis and improving health and quality of life is a challenge and a public health priority, especially in underserved populations. A key role of public health consists of informing, educating, and empowering individuals and communities about health issues. Researchers have found that mass communication messages often have limited effectiveness in reaching and impacting the health of underserved populations. The present pilot study was designed to explore perceptions of older African American women (AAW) in response to widely disseminated public information pertaining to physical activity (PA) and aging.

METHODS

A total of 10 older AAW aged 60 years and over participated in this study. Participants were evenly assigned in one of the 2 focus groups (i.e. active, n = 5; and inactive, n = 5) based on their PA level. The focus group approach was employed to gather information about widely available public information materials related to PA that target the adult and older adult population. The three guides used were: (1) Exercise and Physical Activity: Your Everyday Guide; (2) The Physical Activity Guidelines for Older Adults; and (3) Be Active Your Way: A Guide for Adults. NVIVO 10 software was used to help in the qualitative data analysis. Descriptive thematic analysis was employed in identifying, analyzing and reporting patterns/themes within the data.

RESULTS

Older AAW in the present study identified some shortcomings in current public health materials. Participants from both focus groups raised concerns regarding language and the types of activities used as examples in the materials. After analysis, two themes emerged: "We may have trouble in reading it" and "It does not reflect us". Participants' evaluation was found to be similar between the active and inactive focus groups.

CONCLUSIONS

Older AAW's perceptions of the materials suggest that materials intended to educate and motivate the general public towards PA need to be modified to better speak to older African American women, especially to those who are sedentary and have difficulty in building PA into their daily lives.

Feasibility, acceptability, and characteristics associated with adherence and completion of a culturally relevant internet-enhanced physical activity pilot intervention for overweight and obese young adult African American women enrolled in college

Background

African American women are one of the least active demographic groups in the US, with only 36% meeting the national physical activity recommendations in comparison to 46% of White women. Physical activity begins to decline in African American women in adolescence and continues to decline into young adulthood. Yet, few interventions have been developed to promote physical activity in African American women during this critical period of life. The purpose of this article was to evaluate the acceptability and feasibility of a culturally-relevant Internet-enhanced physical activity pilot intervention for overweight/obese African American college females and to examine psychosocial and behavioral characteristics associated with intervention adherence and completion.

Methods

A 6-month single group pre-posttest design was used. Participants (n = 27) accessed a culturally-relevant Social Cognitive Theory-based physical activity promotion website while engaging in a minimum of four moderate-intensity physical activity sessions each week. Acceptability and feasibility of the intervention was assessed by participant retention and a consumer satisfaction survey completed by participants.

Results

Fifty-six percent of participants (n = 15) completed the intervention. Study completers were more physically active at baseline (P = 0.05) and had greater social support for exercise from family members (P = 0.04). Sixty percent of study completers (n = 9) reported the website as “enjoyable” or “very enjoyable” to use and 60% (n = 9) reported increased motivation from participation in the physical activity program. Moreover, 87% (n = 13) reported they would recommend the website to a friend.

Conclusions

Results provide some preliminary support for the acceptability and feasibility of an Internet-enhanced physical activity program for overweight/obese African American women, while highlighting important limitations of the approach. Successful promotion of physical activity in college aged African American women as they emerge into adulthood may result in the development of life-long healthy physical activity patterns which may ultimately reduce physical activity-related health disparities in this high risk underserved population. Future studies with larger samples are needed to further explore the use of Internet-based programs to promote physical activity in this population.

Barriers to Physical Activity Among African American Women: An Integrative Review of the Literature

A key aspect for researchers to consider when developing culturally appropriate physical activity (PA) interventions for African American (AA) women are the specific barriers AA women face that limit their participation in PA. Identification and critical examination of these barriers is the first step in developing comprehensive culturally relevant approaches to promote PA and help resolve PA-related health disparities in this underserved population. We conducted a systematic integrative literature review to identify barriers to PA among AA women. Five electronic databases were searched, and forty-two studies (twenty-seven qualitative, fourteen quantitative, one mixed method) published since 1990 (range 1998-2013) in English language journals met inclusion criteria for review. Barriers were classified as intrapersonal, interpersonal, or environment/community according to their respective level of influence within our social ecological framework. Intrapersonal barriers included lack of time, knowledge, and motivation; physical appearance concerns; health concerns; monetary cost of exercise facilities; and tiredness/fatigue. Interpersonal barriers included family/caregiving responsibilities; lack of social support; and lack of a PA partner. Environmental barriers included safety concerns; lack of facilities; weather concerns; lack of sidewalks; and lack of physically active AA role models. Results provide key leverage points for researchers to consider when developing culturally relevant PA interventions for AA women.

Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial

Background

African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women.

Methods

Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction.

Results

All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = −74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = −34 minutes/week) in comparison to PI participants (all P’s < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend.

Conclusions

A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women.

Trial Registration

ClinicalTrials.gov NCT02372565. Registered 25 February 2015.

Physical activity differences between children from migrant and native origin

BACKGROUND

Children from migrant origin are at higher risk for overweight and obesity. As limited physical activity is a key factor in this overweight and obesity risk, in general, the aim of this study is to assess to what degree children from migrant and native Dutch origin differ with regard to levels of physical activity and to determine which home environment aspects contribute to these differences.

METHODS

A cross-sectional survey among primary caregivers of primary school children at the age of 8-9 years old (n = 1943) from 101 primary schools in two urban areas in The Netherlands. We used bivariate correlation and multivariate regression techniques to examine the relationship between physical and social environment aspects and the child's level of physical activity. All outcomes were reported by primary caregivers. Outcome measure was the physical activity level of the child. Main independent variables were migrant background, based on country of birth of the parents, and variables in the physical and social home environment which may enhance or restrict physical activity: the availability and the accessibility of toys and equipment, as well as sport club membership (physical environment), and both parental role modeling, and supportive parental policies (social environment). We controlled for age and sex of the child, and for socio-economic status, as indicated by educational level of the parents.

RESULTS

In this sample, physical activity levels were significantly lower in migrant children, as compared to children in the native population. Less physical activity was most often seen in Turkish, Moroccan, and other non-western children (p < .05).

CONCLUSIONS

Although traditional home characteristics in both the physical, and the social environment are often associated with child's physical activity, these characteristics provided only modest explanation of the differences in physical activity between migrant and non-migrant children in this study. The question arises whether interventions aimed at overweight and obesity should have to focus on home environmental characteristics with regard to physical activity.

Centering perspectives on Black women, hair politics, and physical activity

As researchers categorize issues facing Black women's health, obesity and physical exercise continue to be significant topics of debate. General interventions targeted toward Black women to address obesity and increase physical exercise have been largely ineffective. In this article, I situate the current public health discourse on obesity and related interventions within a sociocultural context of body appearance, with a specific focus on hair. Why do some African American women feel such strong ties to their hair that they will avoid exercise? What can be done to understand this phenomenon and address alternatives that may make both hair maintenance and regular exercise feasible? I map a theoretical argument for why hair matters for some women, and discuss how physical activity intervention strategies might be improved by considering such complexities.

Menopausal symptoms and physical activity in multiethnic groups of midlife women: a secondary analysis

AIMS

To explore the effect of diverse types of women's physical activity on menopausal symptoms among multiethnic groups of midlife women in the USA.

BACKGROUND

Although physical activity is one of the most widely used non-pharmacological methods for managing menopausal symptoms, there is a paucity of clinical guidelines for women and healthcare providers because the relationship between physical activity and menopausal symptoms has been found inconsistent in previous studies.

DESIGN

A secondary analysis of the data from a lager Internet survey study conducted in 2008-2010.

METHODS

A total of 481 midlife women among four ethnic groups were selected from the original study. The data were collected using the Kaiser Physical Activity Survey and the Midlife Women's Symptom Index. Bivariate correlation analyses and hierarchical multiple regression analyses were used to analyse the data.

RESULTS/FINDINGS

The household/caregiving activity index was positively associated with the prevalence scores of the psychological symptoms in both non-Hispanic Asians and non-Hispanic African Americans. The increased sports/exercise activity index was negatively associated with the severity scores of the physical symptoms in both Hispanics and non-Hispanic Whites. The occupational activity index and the active living activity index significantly predicted the severity scores of the psychosomatic symptoms in Hispanics and non-Hispanic African Americans, respectively.

CONCLUSION

Nurses who take care of multiethnic groups of midlife women who experience menopausal symptoms should be aware of diverse types of women's physical activities within the cultural context.

Racial/ethnic differences in midlife women's attitudes toward physical activity

INTRODUCTION

Women's racial/ethnic-specific attitudes toward physical activity have been pointed out as a plausible reason for their low participation rates in physical activity. However, very little is actually known about racial/ethnic commonalities and differences in midlife women's attitudes toward physical activity. The purpose of this study was to explore commonalities and differences in midlife women's attitudes toward physical activity among 4 major racial/ethnic groups in the United States (whites, Hispanics, African Americans, and Asians).

METHODS

This was a secondary analysis of the qualitative data from a larger study that explored midlife women's attitudes toward physical activity. Qualitative data from 4 racial/ethnic-specific online forums among 90 midlife women were used for this study. The data were analyzed using thematic analysis, and themes reflecting commonalties and differences in the women's attitudes toward physical activity across the racial/ethnic groups were extracted.

RESULTS

The themes reflecting the commonalities were: 1) physical activity is good for health, 2) not as active as I could be, 3) physical activity was not encouraged, 4) inherited diseases motivated participation in physical activity, and 5) lack of accessibility to physical activity. The themes reflecting the differences were: 1) physical activity as necessity or luxury, 2) organized versus natural physical activity, 3) individual versus family-oriented physical activity, and 4) beauty ideal or culturally accepted physical appearance.

DISCUSSION

Developing an intervention that could change the social influences and environmental factors and address the women's racial/ethnic-specific attitudes would be a priority in increasing physical activity of racial/ethnic minority midlife women.

Postpartum Weight Self-Management: A Concept Analysis

Aim: The aim of this concept analysis is to create a clear definition and framework to guide weight self-management research and promotion of healthy weight self-management during the postpartum period. Background: A woman’s ability to manage her weight through the postpartum transition has lifelong implications for her weight status. Methods: This concept analysis was guided by Walker and Avant (2005). A broad search of sources was performed, yielding 56 articles in which postpartum weight self-management was the main focus. Results: From consideration of the attributes of postpartum weight self-management, a descriptive, situation-specific theory emerged: Postpartum weight self-management is a process by which the transition to motherhood is viewed by the woman as an opportunity to intentionally engage in healthy weight self-management behaviors by minimizing the salient inhibitors and maximizing the salient facilitators to action. Conclusion: This analysis provides a clarification of the process concept of postpartum weight self-management and its consequences, giving direction for measurement, clinical application, and further research. Future nursing interventions and research should be aimed at helping women to view the postpartum period as a normative transition in which they have the opportunity to take charge of their own health and the health of their family.

Asian American midlife women's attitudes toward physical activity

OBJECTIVES

To explore Asian American midlife women's attitudes toward physical activity using a feminist perspective.

DESIGN

A qualitative online forum study.

SETTINGS

Internet communities/groups for midlife women and ethnic minorities.

PARTICIPANTS

A total of 17 Asian American women recruited through the Internet using a convenience sampling method.

METHODS

A 6-month qualitative online forum was conducted using 17 online forum topics. The data were analyzed using thematic analysis.

RESULTS

Three major themes related to Asian American midlife women's attitudes toward physical activity were extracted from the data: keeping traditions, not a priority, and not for Asian girls. Because Asian American midlife women were busy in keeping their cultural traditions, they rarely found time for physical activity. The women gave the highest priority to their children, and physical activity was the lowest priority in their busy lives. Also, the women were rarely encouraged to participate in physical activity during their childhoods, and they perceived that their weak and small bodies were not appropriate for physical activity.

CONCLUSIONS

Several implications for future development of physical activity promotion programs for this specific population have been suggested based on the findings.