The Results of the “Positive Action for Today’s Health” (PATH) Trial for Increasing Walking and Physical Activity in Underserved African-American Communities

Abstract

Background The “Positive Action for Today’s Health” (PATH) trial tested an environmental intervention to increase walking in underserved communities. Methods Three matched communities were randomized to a police-patrolled walking plus social marketing, a police-patrolled walking-only, or a no-walking intervention. The 24-month intervention addressed safety and access for physical activity (PA) and utilized social marketing to enhance environmental supports for PA. African-Americans (N=434; 62 % females; aged 51±16 years) provided accelerometry and psychosocial measures at baseline and 12, 18, and 24 months. Walking attendance and trail use were obtained over 24 months. Results There were no significant differences across communities over 24 months for moderate-to-vigorous PA. Walking attendance in the social marketing community showed an increase from 40 to 400 walkers per month at 9 months and sustained ~200 walkers per month through 24 months. No change in attendance was observed in the walking-only community. Conclusions Findings support integrating social marketing strategies to increase walking in underserved African-Americans (ClinicalTrials.gov #NCT01025726).

Physical activity: a synopsis and comment on “community-wide interventions for increasing physical activity”

“…Null results were found in both dichotomously and continuously measured PA and included, but were not limited to no increases in leisure time physical activity, no differential increase in physical activity between experimental and control communities, no changes in the proportion of a population achieving 30 min of MVPA 5 days per week, and no difference between communities in average daily minutes of MVPA as measured by both accelerometry and 4-month recall [1]. Positive changes most likely to be observed included increased use of trails and pathways [6,9], attendance at walking programs [6], supervised leisure time activity in school-aged adolescents [10] and daily walking [11]. The four high quality studies showed no overall effect of community-PA interventions, although one [6] did observe increased walking.…”

“…Positive changes most likely to be observed included increased use of trails and pathways [6,9], attendance at walking programs [6], supervised leisure time activity in school-aged adolescents [10] and daily walking [11]. The four high quality studies showed no overall effect of community-PA interventions, although one [6] did observe increased walking.…”

“…An encouraging trend noted by the reviewers is that many of the more recent studies [6,[12][13][14] were of higher quality, involved less bias, increased use of randomization and some use of wearable accelerometers to measure PA more objectively and accurately (as compared to self-report) [6]. However, even these high quality studies did not show that intervention increased PA within their community samples.…”

Neighborhood Social Predictors of Weight-related Measures in Underserved African-Americans in the PATH Trial

“…16,17 Data for our study were assessed at baseline and included height, weight, blood pressure and physical activity. Additionally, psychosocial and demographic data (age, sex, education status, annual income, occupational status, and marital status) were obtained by trained research staff.…”

“…16,17 Specifically, our study expands on past literature by evaluating the associations of neighborhood factors (places to walk and bike, neighborhood satisfaction, perception of safety, and neighborhood social interaction) and peer support on body mass index (BMI) in African American adults. Based on previous research, it was hypothesized that neighborhood social and environmental factors would be significantly predictive of BMI in our study.…”