A Faith-Based and Cultural Approach to Promoting Self-Efficacy and Regular Exercise in Older African American Women

Abstract

The health benefits of regular exercise are well documented, yet there has been limited success in the promotion of regular exercise in older African American women. Based on theoretical and evidence-based findings, the authors recommend a behavioral self-efficacy approach to guide exercise interventions in this high-risk population. Interventions should be developed that are age appropriate, group delivered in the community, focused on a single behavior, and only include general health education as a secondary purpose. Suggested cultural tailoring of exercise interventions includes addressing beliefs about exercise, focusing on the "possible self," promoting participants as "cultural consultants," and spiritual and religious strategies.

Effectiveness of Interventions to Increase Physical Activity Among Minority Populations: An Umbrella Review

“…20 Three reviews targeted studies with African-American men and women, 5,27,29 and three targeted studies involving AfricanAmerican women. 11,18,21 Seven reviews focused on studies that included exclusively Latino subjects. Four of these reviews targeted studies with both men and women, 14,16,24,25 and three focused on studies of Latino women.…”

“…An integrative review approach was used in 11 studies. [11][12][13][14][15][16][17][18][19][20][21] In these reviews, p values from primary studies were evaluated to determine the proportion of studies reporting statistically significant findings. A narrative approach was used in the remaining 10 reviews.…”

“…Use text messaging as a method of delivering PA promotion messages 15 Choose PA activities that are appealing and fun, and design interventions that enhance self-management skills 14 Select intervention components that are sustainable in the long-term and that do not place unrealistic demands on the participants 15,19,21,27 Provide participant-specific information about the benefits of PA on health and give participants an opportunity to rehearse the prescribed PA activity in the presence of project staff before having them engage in the activity on their own* 21,27 Provide continued support for PA after the conclusion of the study 14 Examine the potentially different outcomes of targeting PA alone versus targeting PA and diet 11,22,27 Use churches, hospitals, or other community centers familiar to subject population as delivery settings* 11,17 Select delivery sites that are on bus routes 16 Use researchers, facilitators, exercise leaders, or community health workers who are members of the target minority group* 4,11,14,15,[18][19][20] Promote participant involvement in interactive, unstructured group interventions* 11,14,18 Address the cultural relevance of interventions* 14,25,28 Address spiritual and religious beliefs about exercise 18 Take into account ethnic variations, acculturation, and generational status 25 Incorporate established community rituals and practices into interventions* 14,25,28 Assess the needs, preferences, and unique barriers of the population 26 Incorporate feedback from the community on what types of interventions may work best for that particular community …”

“…12,[14][15][16]18,20 Five of these reviews included primary studies of both men and women. Two reviews focused on African Americans, two on Latinos, one on Native Americans, and one on American Indian/ Alaska Native, aboriginal, Native Hawaiian, and/or native U.S. Samoans.…”

People reducing risk and improving strength through exercise, diet, and drug adherence (PRAISEDD): a case report on long-term single site adoption

“…For example, AA are reported to prefer group exercises compared with exercising alone at home [8], and there is rising support for the effectiveness of faith-based group exercise programs in this population [2,[9][10][11]. Also, within a particular housing facility, individuals may be influenced by extensive friendships and social networks.…”