Objective This study reports the results of the “Active by Choice Today” (ACT) trial for increasing moderate-to-vigorous physical activity (MVPA) in low-income and minority adolescents. Design The ACT program was a randomized controlled school-based trial testing the efficacy of a motivational plus behavioral skills intervention on increasing MVPA in underserved adolescents. Twenty-four middle schools were matched on school size, percentage minorities, percentage free or reduce lunch, and urban or rural setting before randomization. A total of 1,563 6th grade students (mean age, 11.3 years, 73% African American, 71% free or reduced lunch, 55% female) participated in either a 17-week (over one academic year) intervention or comparison after-school program. Main Outcome Measure The primary outcome measure was MVPA based on 7-day accelerometry estimates at 2-weeks postintervention and an intermediate outcome was MVPA at midintervention. Results At midintervention students in the intervention condition engaged in 4.87 greater minutes of MVPA per day (95% CI: 1.18 to 8.57) than control students. Students in intervention schools engaged in 9.11 min (95% CI: 5.73 to 12.48) more of MVPA per day than those in control schools during the program time periods; indicating a 27 min per week increase in MVPA. No significant effect of the ACT intervention was found outside of school times or for MVPA at 2-weeks postintervention. Conclusions Motivational and behavioral skills programs are effective at increasing MVPA in low-income and minority adolescents during program hours, but further research is needed to address home barriers to youth MVPA.

The current study tested coping efforts as moderators of the effects of minority status stress on general levels of perceived stress and academic performance for African American students at a predominantly White college and university (PWCU) and a historically Black college and university (HBCU). Multivariate analyses revealed that African American students at the PWCU experienced significantly higher levels of minority status stress than their counterparts at the HBCU. Students did not differ in overall levels of perceived stress and in most coping efforts assessed. HBCU students reported higher mean use of problemoriented strategies and spiritual efforts than students at the PWCU. Moderated regression analyses revealed an increase in the effects of minority status stress on perceived stress at high levels of problem-oriented efforts. The effects of minority status stress on perceived stress decreased at higher levels of disengagement. In predicting academic performance, type of institution was the strongest predictor. Implications of the findings are discussed.

BackgroundThis study describes the development of a social marketing campaign for increasing walking in a low income, high crime community as part of the Positive Action for Today’s Health (PATH) trial.MethodsFocus groups were conducted with 52 African American adults (ages 18 to 65 yrs), from two underserved communities to develop themes for a social marketing campaign to promote walking. Participants responded to questions concerning social marketing principles related to product, price, place, promotion, and positioning for increasing neighbourhood walking.ResultsFocus group data informed the development of the campaign objectives that were derived from the “5 Ps” to promote physical and mental health, social connectedness, safety, and confidence in walking regularly. Focus group themes indicated that physical and mental health benefits of walking were important motivators. Walking for social reasons was also important for overcoming barriers to walking. Police support from trusted officers while walking was also essential to promoting safety for walking. Print materials were developed by the steering committee, with a 12-month calendar and door hangers delivered to residents’ homes to invite them to walk. Pride Stride walks empowered community walkers to serve as peer leaders for special walking events to engage new walkers.ConclusionsEssential elements for developing culturally tailored social marketing interventions for promoting walking in underserved communities are outlined for future researchers.

The overall findings suggest that patients who perceive themselves as infrequently exposed to systemic racism possess the greatest risk for nonadherence to hypertension treatment in relation to increased perceptions of provider racial biases. Implications of the findings are discussed.

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