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

Abstract

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 PA 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.

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

“…Historically, AA women have been viewed as the primary caretakers of their familial units (ie, family and other kinship-type relationships). 17 This caretaking role is something many AA women take great pride in, and as a result, can limit their available time to engage in PA. 17,24 Previous research indeed shows that some AA women view PA as a self-indulgent or self-serving behavior that takes valuable time away from their family and caretaking responsibilities. 43,44 Together, these phenomena have been termed collectively as an AA woman’s “ethic of care” (referring to the self-sacrificing behaviors of AA women to ensure the needs of their familial and community units are met before their own needs).…”

“…Potential strategies to leverage these findings in the design of culturally relevant PA program for AA women include incorporating success stories or testimonials from other AA women to instill a sense of self-worth and self-entitlement for PA (ie, aligning with the emotional arousal and verbal persuasion concepts of Self-Efficacy) and emphasizing how PA is relevant to the various caretaking and community roles of AA women (ie, illustrate the importance of PA as a role modeling behavior to others and highlight how being active on a regular basis can result in increased energy that can help women perform their caretaking tasks and their ability to engage with their children,). 17,49 …”

“…Focus group guides were derived from our previous PA promotion work with AA women 17,24–28 and a critical review of the extant literature. In particular, the guides were designed to: (1) examine specific SCT constructs (Table 1) underpinning a PA program previously developed by the research team; and (2) elucidate how these constructs can be optimized in the design of a culturally relevant PA program for AA women.…”

“…14–16 These constructs can be culturally tailored to address deeply-rooted aspects of AA culture (ie, of collectivism/ethic of care, experiential knowledge, and kinship) for the promotion of PA among AA women. 17 However, few researchers have explicated the utility of the SCT in the design of culturally relevant PA programs for AA women. A 2014 review of PA interventions for AAs 18 revealed that 7 of 16 studies used SCT as a theoretical basis for activities.…”

Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life: A Church-Based Physical Activity Intervention - Baseline Participant Characteristics

“…6,7 Faith-based interventions have been successful in reducing weight, improving dietary practices, and increasing physical activity among African American women. 8,9 Previous studies have identified positive linkages between cultural adaptation, spirituality/ religion and social support, and promotion of health-related behaviors among African American women, [10][11][12][13][14][15][16] perhaps through their impact on self-efficacy, selfconfidence, and "normalizing" behaviors through role modeling and accountability partners. Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.)…”