Retention of African American Women in a Lifestyle Physical Activity Program

Buchholz, Susan Weber; Wilbur, JoEllen; Schoeny, Michael; Fogg, Louis; Ingram, Diana; Miller, Arlene Michaels; Braun, Lynne T.

doi:10.1177/0193945915609902

Cited by 18 publications

(13 citation statements)

References 30 publications

(61 reference statements)

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“…Several researchers have published on reasons and motivators of adults to continue in exercise trials. For example, Buchholz and colleagues found that women with more hardships and perceived poor health took more reminder phone calls to encourage their continued participation [33]. In a study of motivators to join and stay with an exercise trial, Viljoen and Christie found that participant motivators changed over time.…”

Section: Discussionmentioning

confidence: 99%

Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Tomioka

Braun

et al. 2019

Journal of Aging Research

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Introduction. Enhance®Fitness is a low-cost group exercise program designed specifically for older adults (60+ years) to improve physical performance. The Hawai‘i Healthy Aging Partnership, a statewide health promotion initiative, has continuously offered Enhance®Fitness to Hawai‘i’s multicultural population since 2007. This study examined 12-month participation in and impact of Enhance®Fitness on physical performance among older adults in Hawai‘i. Method. Linear mixed-effects models were applied to analyze the physical performance measures (chair-stands, arm curls, and the up-and-go test) collected at baseline (month 0) and at 4, 8, and 12 months. We also compared the characteristics of participants who participated in the program for 12 months with those who dropped out in order to gain insights on participant retention. Results. Of 1,202 older adults with baseline data, 427 (35.5%) were continuously enrolled in Enhance®Fitness for 12 months and participated in follow-up data collection. On average, participants attended 63.7% of thrice-weekly classes each month. Participants’ physical performance measures improved after 4 months, continued to improve until 8 months, and were maintained thereafter. Besides continuous attendance, performance-measure improvements were associated with younger age, male gender, living with others (vs. alone), and fewer chronic conditions. Compared to those who completed 12 months of the program, the 775 who left the program over the course of the year were more likely to be younger, to be Caucasian (vs. Asian or Pacific Islander), to self-report depression as a chronic condition, and to have lower levels of fitness at baseline. Common reasons for dropping out were illness, relocation, time conflicts, lost interest, and transportation issues. Conclusions. Long-term participants in Enhance®Fitness initially improved and then maintained physical performance. Future research is needed to identify strategies to maintain enrollment of older adults in the exercise programs over time.

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Section: Discussionmentioning

confidence: 99%

Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Tomioka

Braun

et al. 2019

Journal of Aging Research

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“…25 Among retention strategies described earlier was $40 for completing each study assessment (baseline, 24 weeks, and 48 weeks) and a pedometer given to participants at study completion. 26 All participants provided informed written consent. A total of 288 women were screened eligible for the study and are included in these analyses.…”

Section: Setting and Samplementioning

confidence: 99%

Randomized Controlled Trial of Lifestyle Walking for African American Women: Blood Pressure Outcomes

Wilbur

Braun

Buchholz

et al. 2018

American Journal of Lifestyle Medicine

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The aim of this study was to test the effects of a lifestyle physical activity intervention (group meetings alone vs supplemented by personal or automated calls) on changes in systolic/diastolic blood pressures from baseline to 24 and 48 weeks among African American women. This was a randomized controlled trial with intervention conditions randomly assigned across 6 community health care sites. Participants were 288 sedentary African American women without major signs/symptoms of cardiovascular disease. Each intervention had 6 group meetings over 48 weeks, with 1 of 3 options between meetings: (1) no calls, (2) personal motivational calls, or (3) automated motivational calls. Blood pressures were taken at baseline, 24 weeks, and 48 weeks. Separate analyses were conducted using blood pressure classifications from the 2003 and 2017 high blood pressure guidelines. Average blood pressures decreased approximately 3 mm Hg for systolic and 2 mm Hg for diastolic from baseline to 48 weeks, with no differences between conditions. For both 2003 and 2017 blood pressure classifications, the risk ratio (odds of moving to a lower classification) was 1.44 for each assessment (P < .001). This lifestyle walking intervention appears beneficial in lowering blood pressure across blood pressure classifications in midlife African American women.

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“…18-20 Several PA interventions have relied upon popular theories to promote PA among African American women. 21-25 Each study acknowledged the benefits of utilizing a theoretical framework to drive the development and deployment of their intervention to promote and increase PA. However, there is further need to ameliorate theoretical approaches.…”

Section: Introductionmentioning

confidence: 99%

The evaluation of a fourth-generation multi-theory model (MTM) based intervention to initiate and sustain physical activity

Hayes

Sharma

Shahbazi

et al. 2019

Health Promot Perspect

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Background: The United States Department of Health and Human Services (USDHHS)recommends that adults achieve 150 minutes per week of moderate-intensity aerobic activity.Most African American women do not meet these guidelines. The purpose of this study was to determine the efficacy of an intervention based on the fourth generation, multi-theory model (MTM) of health behavior change for initiating and sustaining physical activity among African American women when compared to a first generation, knowledge-based intervention. Methods: The randomized controlled trial (RCT) utilized a pre-test, post-test and 6-week followup evaluation with an experimental (n=25) group and a comparison group (n=23). Process evaluation for satisfaction and program fidelity was conducted along with impact evaluation for changes in MTM constructs, intent to initiate and sustain physical activity, minutes of physical activity, body mass index (BMI), waist circumference and blood pressure in hypertensives. Results:The MTM-based intervention proved significantly efficacious in increasing the minutes of physical activity from pre-test mean of 37 minutes to 172 minutes at follow-up (mean difference135.08 minutes, 95% CI: 106.04 to 164.13, P<0.0001), reducing waist circumference from pretest mean of 39 inches to 38 inches at follow-up (mean difference -1.12 inches, 95% CI: -1.70 to-0.545, P<0.001) and modifying the MTM construct of changes in physical environment from a mean of 7 units at pre-test to 9 units at follow-up (mean difference 2.08 units, 95% CI: 0.73 to 3.43, P<0.004) when compared to the knowledge-based intervention over time. Conclusion: There were directional improvements in the mean scores for most of the study variables over time for the MTM intervention group and statistically significant improvement in minutes of physical activity and waist circumference.

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Retention of African American Women in a Lifestyle Physical Activity Program

Cited by 18 publications

References 30 publications

Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Randomized Controlled Trial of Lifestyle Walking for African American Women: Blood Pressure Outcomes

The evaluation of a fourth-generation multi-theory model (MTM) based intervention to initiate and sustain physical activity

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