Publications by authors named "Rodney P Joseph"

31 Publications

Physical Activity Patterns and Neighborhood Characteristics of First-Generation Latina Immigrants Living in Arizona: Cross-sectional Study.

JMIR Form Res 2021 May 17;5(5):e25663. Epub 2021 May 17.

Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.

Background: Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants.

Objective: The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns.

Methods: Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines).

Results: Preliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes.

Conclusions: Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.
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http://dx.doi.org/10.2196/25663DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167607PMC
May 2021

Physical Activity Among Predominantly White Middle-Aged and Older US Adults During the SARS-CoV-2 Pandemic: Results From a National Longitudinal Survey.

Front Public Health 2021 13;9:652197. Epub 2021 Apr 13.

Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.

The first COVID-19 case in the US was diagnosed late January 2020. In the subsequent months, cases grew exponentially. By March 2020, SARS-CoV-2 (the novel coronavirus that causes COVID-19) was a global pandemic and the US declared a national emergency. To mitigate transmission, federal guidelines were established for social and physical distancing. These events disrupted daily routines of individuals around the world, including Americans. The impact of the pandemic on PA patterns of Americans is largely unknown, especially among those at greater risk for severe COVID-19 outcomes. The aim of this study was to assess levels of PA over time during the pandemic among US adults aged >50 years. Data were collected as part of a web-based, longitudinal, 3-wave study examining health and well-being among adults aged > 50. PA data were collected at Waves 2 and 3 using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). At Wave 2 (conducted mid-May to early June, 2020), participants completed the IPAQ-SF twice, once in reference to a typical 7-day period before the pandemic, and again in reference to the past 7 days. At Wave 3 (conducted mid-June to early July 2020), participants completed the IPAQ-SF once, with reference to the past 7 days. Potential predictors of PA change were collected using items from previously established surveys and included demographic characteristics, pre-pandemic PA levels, perceived COVID-19 threat, self-rated general health, and number of chronic disease conditions. Respondents ( = 589) had a mean age of 63 ± 7.39 years and were mostly female (88%) and non-Hispanic White (96%). Mean MET-min/week across the three time-referents were 2,904 (pre-pandemic), 1,682 (Wave 2 past 7-days), and 2,001 (Wave 3 past 7-days), with PA declining between the first and second time referents ( = -0.45, < 0.001) and remaining below pre-pandemic levels at the third ( = -0.34, < 0.001). Changes over time were predicted by pre-pandemic PA and self-rated general health ( < .05). Effective strategies are needed to promote safe and socially-distanced PA among adults aged >50 years until the risk of contracting COVID-19 subsides. In the post-pandemic era, PA programming will be imperative to address pandemic-associated declines in PA.
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http://dx.doi.org/10.3389/fpubh.2021.652197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076643PMC
May 2021

Results of a Culturally Tailored Smartphone-Delivered Physical Activity Intervention Among Midlife African American Women: Feasibility Trial.

JMIR Mhealth Uhealth 2021 04 22;9(4):e27383. Epub 2021 Apr 22.

Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.

Background: Regular aerobic physical activity (PA) is an important component of healthy aging. However, only 27%-40% of African American women achieve national PA guidelines. Available data also show a clear decline in PA as African American women transition from young adulthood (ie, 25-44 years) into midlife. This decline in PA during midlife coincides with an increased risk for African American women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary African American women during midlife.

Objective: This study aims to examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among African American women aged 24-49 years, among a slightly older sample of midlife African American women aged 50-65 years.

Methods: A single-arm pretest-posttest study design was implemented. In total, 20 insufficiently active African American (ie, ≤60 min per week of PA) women between the ages of 50-65 years participated in the 4-month feasibility trial. The Smart Walk intervention was delivered through the study Smart Walk smartphone app and text messages. Features available on the Smart Walk app include personal profile pages, multimedia PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and social cognitive theory mediators targeted by the intervention (ie, self-regulation, behavioral capability, outcome expectations, self-efficacy, and social support) were assessed at baseline and at 4 months. Feasibility and acceptability were assessed using a postintervention satisfaction survey that included multiple-choice and open-ended questions evaluating participant perceptions of the intervention and suggestions for intervention improvement. Wilcoxon signed-rank tests were used to examine pre- and postintervention changes in the PA and social cognitive theory variables. The effect size estimates were calculated using the Pearson r test statistic.

Results: Participants increased moderate-to-vigorous PA (median 30 minutes per week increase; r=0.503; P=.002) and reported improvements in 2 theoretical mediators (self-regulation: r=0.397; P=.01; behavioral capability: r=0.440; P=.006). Nearly all participants (14/15, 93% completing the satisfaction survey) indicated that they would recommend the intervention to a friend. Participants' suggestions for improving the intervention included enhancing the intervention's provisions of social support for PA.

Conclusions: The results provide preliminary support for the feasibility of the smartphone-based approach to increase PA among midlife African American women. However, before larger-scale implementation among midlife African American women, enhancements to the social support components of the intervention are warranted.

Trial Registration: ClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355.
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http://dx.doi.org/10.2196/27383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103296PMC
April 2021

Still striding toward social justice? Redirecting physical activity research in a post-COVID-19 world.

Transl Behav Med 2021 06;11(6):1205-1215

The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion and Prevention Research, Michael & Susan Dell Center for Healthy Living, Houston, TX, USA.

The COVID-19 crisis and parallel Black Lives Matter movement have amplified longstanding systemic injustices among people of color (POC). POC have been differentially affected by COVID-19, reflecting the disproportionate burden of ongoing chronic health challenges associated with socioeconomic inequalities and unhealthy behaviors, including a lack of physical activity. Clear and well-established benefits link daily physical activity to health and well-being-physical, mental, and existential. Despite these benefits, POC face additional barriers to participation. Thus, increasing physical activity among POC requires additional considerations so that POC can receive the same opportunities to safely participate in physical activity as Americans who are White. Framed within the Ecologic Model of Physical Activity, this commentary briefly describes health disparities in COVID-19, physical activity, and chronic disease experienced by POC; outlines underlying putative mechanisms that connect these disparities; and offers potential solutions to reduce these disparities. As behavioral medicine leaders, we advocate that solutions must redirect the focus of behavioral research toward community-informed and systems solutions.
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http://dx.doi.org/10.1093/tbm/ibab026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083595PMC
June 2021

Associations of perceived neighborhood environment and physical activity with metabolic syndrome among Mexican-Americans adults: a cross sectional examination.

BMC Res Notes 2020 Jun 26;13(1):306. Epub 2020 Jun 26.

College of Health Solutions and Southwest Interdisciplinary Research Center, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA.

Objective: This secondary data analysis examined associations among perceived neighborhood environmental factors, physical activity (PA), and the presence of metabolic syndrome (MS) in Mexican-American (MA) adults. Seventy-five MA adults (mean age of 37.9 ± 9.3 years) provided anthropometric, biomarker, and survey data. The Neighborhood Scales Questionnaire evaluated six perceived neighborhood factors: walking environment, aesthetic quality, safety, violence, social cohesion, and activities with neighbors. The Rapid Assessment of PA questionnaire assessed PA. MS was determined according to ATP III criteria.

Results: PA was significantly associated with MS (OR = .338, CI .204-.738). Neighborhood factors of safety (B = .255, p = .024), walking environment (B = .384, p = .001), and social cohesion (B = .230, p = .043) were positively associated with PA. No other neighborhood factors were significantly related to PA. Analyses examining whether neighborhood factors moderated the relationship between PA and MS were not significant.
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http://dx.doi.org/10.1186/s13104-020-05143-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320589PMC
June 2020

A Culturally Relevant Smartphone-Delivered Physical Activity Intervention for African American Women: Development and Initial Usability Tests of Smart Walk.

JMIR Mhealth Uhealth 2020 03 2;8(3):e15346. Epub 2020 Mar 2.

College of Health Solutions, Arizona State University, Phoenix, AZ, United States.

Background: Smart Walk is a culturally relevant, social cognitive theory-based, smartphone-delivered intervention designed to increase physical activity (PA) and reduce cardiometabolic disease risk among African American (AA) women.

Objective: This study aimed to describe the development and initial usability testing results of Smart Walk.

Methods: Smart Walk was developed in 5 phases. Phases 1 to 3 focused on initial intervention development, phase 4 involved usability testing, and phase 5 included intervention refinement based on usability testing results. In phase 1, a series of 9 focus groups with 25 AA women (mean age 38.5 years, SD 7.8; mean BMI 39.4 kg/m2, SD 7.3) was used to identify cultural factors associated with PA and ascertain how constructs of social cognitive theory can be leveraged in the design of a PA intervention. Phase 2 included the analysis of phase 1 qualitative data and development of the structured PA intervention. Phase 3 focused on the technical development of the smartphone app used to deliver the intervention. Phase 4 consisted of a 1-month usability trial of Smart Walk (n=12 women; mean age 35.0 years, SD 8.5; mean BMI 40 kg/m2, SD 5.0). Phase 5 included refinement of the intervention based on the usability trial results.

Results: The 5-phase process resulted in the development of the Smart Walk smartphone-delivered PA intervention. This PA intervention was designed to target social cognitive theory constructs of behavioral capability, outcome expectations, social support, self-efficacy, and self-regulation and address deep structure sociocultural characteristics of collectivism, racial pride, and body appearance preferences of AA women. Key features of the smartphone app included (1) personal profile pages, (2) multimedia PA promotion modules (ie, electronic text and videos), (3) discussion boards, and (4) a PA self-monitoring tool. Participants also received 3 PA promotion text messages each week.

Conclusions: The development process of Smart Walk was designed to maximize the usability, cultural relevance, and impact of the smartphone-delivered PA intervention.
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http://dx.doi.org/10.2196/15346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076402PMC
March 2020

A Systematic Review of Electronic and Mobile Health (e- and mHealth) Physical Activity Interventions for African American and Hispanic Women.

J Phys Act Health 2019 03 19;16(3):230-239. Epub 2019 Feb 19.

Background: The purpose of this systematic review was to evaluate the existing scientific literature on e- and mHealth interventions promoting physical activity (PA) among African American (AA) and Hispanic women.

Methods: Using Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, 5 electronic databases and gray literature sources were searched in August 2017. Inclusion criteria are published in English language peer-reviewed journals between 2000 and 2017, use of an e- or mHealth delivery strategy to promote PA, primary focus on AA or Hispanic women, and reported PA outcome data.

Results: Ten articles met inclusion criteria for review, 6 studies focused on AA women and 4 studies on Hispanic women. The majority (n = 8) were pilot studies; only 2 studies were full-scale randomized controlled trials and both focused on Hispanic women. Six studies (60%) used websites as the primary method of intervention delivery, 3 studies (30%) used text messaging, and 1 study (10%) used the social networking website Facebook. In total, 70% of the studies (n = 7) reported significant within- or between-group differences for at least 1 PA outcome.

Conclusions: Findings provide preliminary support for e- and mHealth PA interventions among AA and Hispanic women. However, future large-scale, rigorously designed, randomized controlled trials are needed to further explore their effectiveness among AA and Hispanic women.
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http://dx.doi.org/10.1123/jpah.2018-0103DOI Listing
March 2019

Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women.

Contemp Clin Trials 2019 02 18;77:46-60. Epub 2018 Dec 18.

Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA. Electronic address:

Background: African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women.

Objective: To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women.

Design And Methods: Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors.

Summary: Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.
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http://dx.doi.org/10.1016/j.cct.2018.12.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344046PMC
February 2019

Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration.

Front Public Health 2017 17;5:367. Epub 2018 Jan 17.

Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.

Background: African American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention.

Methods: A qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m). Content analysis was used to analyze these focus group data.

Results: Three key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman's hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants.

Conclusion: Findings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.
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http://dx.doi.org/10.3389/fpubh.2017.00367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777534PMC
January 2018

Incorporating religion and spirituality into the design of community-based physical activity programs for African American women: a qualitative inquiry.

BMC Res Notes 2017 Oct 23;10(1):506. Epub 2017 Oct 23.

Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street, Phoenix, AZ, 85004, USA.

Objective: Limited research has examined how aspects of religion and spirituality can be incorporated into community-based physical activity programs delivered outside of religious institutions. The purpose of this study was to qualitatively explore how spirituality and religion can be leveraged in the design of community-based physical activity programs for African American women delivered outside of faith-based or faith-placed settings.

Results: Three focus groups were conducted were conducted with 23 African American women (M age = 37.8 years, M BMI = 39.6 kg m). Results showed that incorporating aspects of spirituality (i.e., words encouraging connectedness to a higher power, meditation, mind-body activities) into a physical activity program was universally accepted among participants, regardless of religious affiliation. In contrast, including concepts of religion (i.e., bible verses and/or quotes from religious leaders) was controversial and not recommended among women who did not identify with a religious faith. Findings indicate that when developing community-based physical activity interventions that will not be delivered through faith-based or faith-placed settings, researchers should avoid references to specific religious beliefs. Instead, interventions should focus on spirituality and emphasize the mind-body relationship between physical activity and an African American women's inner-being and her connectedness with a higher power. Trial Registration ClinicalTrials.gov NCT02823379. Registered July 1, 2016.
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http://dx.doi.org/10.1186/s13104-017-2830-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651617PMC
October 2017

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

Am J Health Behav 2017 Sep;41(5):518-533

College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ.

Objective: We examined the cultural relevance of Social Cognitive Theory (SCT) in the design of a physical activity intervention for African-American women.

Methods: A qualitative study design was used. Twenty-five African-American women (Mean age = 38.5 years, Mean BMI = 39.4 kg·m2) were enrolled in a series of focus groups (N = 9) to elucidate how 5 SCT constructs (ie, Behavioral Capability, Outcome Expectations, Self-efficacy, Self-regulation, Social Support) can be culturally tailored in the design of a physical activity program for African-American women.

Results: For the construct of Behavioral Capability, participants were generally unaware of the amount, intensity, and types of physical activity needed for health benefits. Outcome Expectations associated with physical activity included increased energy, improved health, weight loss, and positive role modeling behaviors. Constructs of Self-efficacy and Self-regulation were elicited through the women perceiving themselves as a primary barrier to physical activity. Participants endorsed the need of a strong social support component and identified a variety of acceptable sources to include in a physical activity program (ie, family, friends, other program participants).

Conclusions: Findings explicate the utility of SCT as a behavioral change theoretical basis for tailoring physical activity programs to African-American women.
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http://dx.doi.org/10.5993/AJHB.41.5.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5553562PMC
September 2017

Pilot Trial of a Home-based Physical Activity Program for African American Women.

Med Sci Sports Exerc 2017 Dec;49(12):2528-2536

1School of Public Health, University of Alabama at Birmingham, Birmingham, AL; 2College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ; 3Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL; 4School of Nursing, University of Alabama at Birmingham, Birmingham, AL; 5School of Public Health, Brown University, Providence, RI; and 6Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.

Purpose: This study aimed to assess the feasibility of a Home-based, Individually-tailored Physical activity Print (HIPP) intervention for African American women in the Deep South.

Methods: A pilot randomized trial of the HIPP intervention (N = 43) versus wellness contact control (N = 41) was conducted. Recruitment, retention, and adherence were examined, along with physical activity (7-d physical activity recalls, accelerometers) and related psychosocial variables at baseline and 6 months.

Results: The sample included 84 overweight/obese African American women 50-69 yr old in Birmingham, AL. Retention was high at 6 months (90%). Most participants reported being satisfied with the HIPP program and finding it helpful (91.67%). There were no significant between-group differences in physical activity (P = 0.22); however, HIPP participants reported larger increases (mean of +73.9 min·wk (SD 90.9)) in moderate-intensity or greater physical activity from baseline to 6 months compared with the control group (+41.5 min·wk (64.4)). The HIPP group also reported significantly greater improvements in physical activity goal setting (P = 0.02) and enjoyment (P = 0.04) from baseline to 6 months compared with the control group. There were no other significant between-group differences (6-min walk test, weight, physical activity planning, behavioral processes, stage of change); however, trends in the data for cognitive processes, self-efficacy, outcome expectations, and family support for physical activity indicated small improvements for HIPP participants (P > 0.05) and declines for control participants. Significant decreases in decisional balance (P = 0.01) and friend support (P = 0.03) from baseline to 6 months were observed in the control arm and not the intervention arm.

Conclusions: The HIPP intervention has great potential as a low-cost, high-reach method for reducing physical activity-related health disparities. The lack of improvement in some domains may indicate that additional resources are needed to help this target population reach national guidelines.
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http://dx.doi.org/10.1249/MSS.0000000000001370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688013PMC
December 2017

Acculturation and Physical Activity Among Latinas Enrolled in a 12-Month Walking Intervention.

West J Nurs Res 2018 07 20;40(7):942-960. Epub 2017 Feb 20.

1 Arizona State University, Phoenix, AZ, USA.

This report evaluates the relationship between acculturation and assimilation with the physical activity (PA) outcomes of a 12-month walking intervention for postpartum Latinas ( n = 81, M age = 29.2 years, M BMI [body mass index] = 30.0). PA was measured by ActiGraph GT1M accelerometers. Acculturation and assimilation were measured by the Hazuda Acculturation and Assimilation Scales. Data were collected at baseline, 6 months, and 12 months. Results showed a trend for participants classified in the least acculturated groups to engage in more moderate-to-vigorous PA than participants classified in the higher acculturated/assimilated groups for two dimensions of acculturation (Adult Proficiency in English Versus Spanish, p = .002; Adult Pattern of English Versus Spanish Language Usage, p = .001) and two dimensions of assimilation (Childhood Interaction With Members of Mainstream Society, p = .028; Adult Functional Integration With Mainstream Society, p ≤ .001). No other significant effects were observed. Findings highlight the continued need to understand the context in which acculturation and assimilation influence PA.
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http://dx.doi.org/10.1177/0193945917692305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538931PMC
July 2018

Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors.

Am J Lifestyle Med 2016 Nov 27;10(6):356-368. Epub 2014 Oct 27.

Department of Health Behavior, University of Alabama at Birmingham, 1665 Ryals Public Health Building, Birmingham, AL 35294-0022, 205-975-8061 (phone).

Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed.
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http://dx.doi.org/10.1177/1559827614554594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313056PMC
November 2016

Recruiting Participants into Pilot Trials: Techniques for Researchers with Shoestring Budgets.

Calif J Health Promot 2016 ;14(2):81-89

School of Nutrition and Health Promotion, College of Health Solutions Arizona State University.

Limited research has focused on recruitment strategies for health promotion researchers conducting small-scale pilot studies. Such research is important because small studies often have limited funding streams and personnel resources. Accordingly, many techniques implemented by large-scale studies are of limited use to smaller research projects. This article provides an overview effective participant recruitment techniques for pilot studies with limited funds and personnel resources. Recruitment techniques were derived from the first author's experience in recruiting participants during his doctoral and postdoctoral studies, the over 25 years of research experience of each of the co-authors, and an extensive review of the literature. Five key recruitment techniques are discussed: 1) leverage existing social networks and personal contacts, 2) identify and foster collaborations with community gatekeepers, 3) develop a comprehensive list of potential recruitment platforms and venues, 4) create recruitment materials that succinctly describe the purpose of the study, and 5) build respectful and trusting relationships with potential participants. Implementation of the proposed techniques can lead to enhanced recruitment, as well as retention among study participants.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5231400PMC
January 2016

Comparative Analysis of Five Observational Audit Tools to Assess the Physical Environment of Parks for Physical Activity, 2016.

Prev Chronic Dis 2016 12 15;13:E166. Epub 2016 Dec 15.

Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, College Station, Texas.

We reviewed prominent audit tools used to assess the physical environment of parks and their potential to promote physical activity. To accomplish this, we manually searched the Active Living Research website (http://www.activelivingresearch.com) for published observational audit tools that evaluate the physical environment of parks, and we reviewed park audit tools used in studies included in a systematic review of observational park-based physical activity studies. We identified 5 observational audit tools for review: Bedimo-Rung Assessment Tool-Direct Observation (BRAT-DO), Community Park Audit Tool (CPAT), Environmental Assessment of Public Recreation Spaces (EAPRS) tool, Physical Activity Resource Assessment (PARA), and Quality of Public Open Space Tool (POST). All 5 tools have established inter-rater reliability estimates ranging from moderate to good. However, BRAT-DO is the only tool with published validity. We found substantial heterogeneity among the 5 in length, format, intended users, and specific items assessed. Researchers, practitioners, or community coalition members should review the goal of their specific project and match their goal with the most appropriate tool and the people who will be using it.
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http://dx.doi.org/10.5888/pcd13.160176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201154PMC
December 2016

Observational Park-based physical activity studies: A systematic review of the literature.

Prev Med 2016 08 14;89:257-277. Epub 2016 Jun 14.

Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, 282 SPH Administration Building, College Station, TX 77843-1266, USA. Electronic address:

This article reports the outcomes of a systematic review of observational park-based physical activity (PA) studies. Five electronic databases and the Active Living Research website were searched in July 2015 to identify relevant articles. Studies were included if they: a) reported observational data collected at outdoor park-based settings during free living conditions, b) reported results of a park audit, c) included PA as an outcome measure of the park audit, and d) were published after 1990 in English-language peer-review journals. Thirty-two articles, reporting outcomes of 26 unique studies, met inclusion criteria for review. Most studies (n=20, 87%) had cross-sectional or non-interventional study designs, while 6 (23%) employed quasi-experimental designs. Studies were predominately conducted in the U.S. (n=19, 76%). The median number of park users across studies was 4558 (Range=815 to 76,632). Approximately half (51%) of all park users were female. Eighty-one percent of studies (n=21) reported PA outcomes for individuals of all ages, while 4 studies (15%) reported PA outcomes for children only and 1 study (4%) for adults only. Moderate-to-vigorous physical activity (MVPA) of park users ranged from 31% to 85% (Median=55.0%). Studies conducted in the U.S. reported a slightly higher median number of park-users engaging in MVPA than those outside the U.S. (60.5% vs. 52.8%). Fifteen studies examined gender differences in MVPA. Among these, 12 (87%) reported more males engaging in MVPA than females. Results of this review highlight the need for innovative strategies to promote MVPA among park users and to increase park use among children.
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http://dx.doi.org/10.1016/j.ypmed.2016.06.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973509PMC
August 2016

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

J Racial Ethn Health Disparities 2017 06 13;4(3):397-409. Epub 2016 May 13.

School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, 550 N. 3rd Street, Phoenix, AZ, 85004, USA.

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 physical activity 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.
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http://dx.doi.org/10.1007/s40615-016-0240-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107357PMC
June 2017

Development of Participant-Informed Text Messages to Promote Physical Activity Among African American Women Attending College: A Qualitative Mixed-Methods Inquiry.

J Transcult Nurs 2017 05 19;28(3):236-242. Epub 2016 Apr 19.

3 University of Alabama at Birmingham, AL, USA.

The purpose of this study was to develop a participant-informed technology-based physical activity (PA) promotion tool for young overweight and obese African American (AA) women. A mixed-method 3-phase study protocol design was used to develop text messages to promote PA in AA women attending the University of Alabama at Birmingham during the Spring of 2013. Nominal focus groups and a 2-week pilot were used to generate and test participant-developed messages. Participants ( n = 14) had a mean age of 19.79 years ( SD = 1.4) and mean body mass index of 35.9 ( SD = 5.926). Focus group data identified key themes associated with the use of text messages to promote PA including message frequency, length, tone, and time of day. Participants preferred text messages that were brief, specific, and time sensitive. Results showed that text messaging was a feasible and acceptable strategy to promote PA in overweight and obese AA women in a university setting.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071114PMC
http://dx.doi.org/10.1177/1043659616644959DOI Listing
May 2017

Validity of two brief physical activity questionnaires with accelerometers among African-American women.

Prim Health Care Res Dev 2016 May 16;17(3):265-76. Epub 2015 Jul 16.

4Professor,School of Nutrition and Health Promotion,Arizona State University,Phoenix,Arizona,USA.

Aim: To evaluate the validity of the Stanford Brief Activity Survey (SBAS) and Exercise Vital Sign (EVS) questionnaire against accelerometer-determined time in moderate-to-vigorous physical activity (MVPA) among African-American (AA) women.

Background: Limited research has evaluated the validity of brief physical activity (PA) questionnaires among AA women. Since the validity of PA questionnaires may differ among members of varying racial/ethnic groups, research is needed to explore the validity of self-report PA measures among AA women.

Methods: A total of 30 AA women [M age = 35.5 ± 5.3; M body mass index (BMI) = 31.1 ± 7.8] wore ActiGraph GT3X+ accelerometers (ActiGraph, LLC, Pensacola FL, USA) for seven days and completed both the SBAS and EVS at two different assessment periods (T1 and T2). Criterion validity was calculated using Spearman's rank order correlations between each questionnaire score and accelerometer-measured MVPA. Sensitivity, specificity, and positive and negative predictive values were calculated using accelerometer-measured MVPA as the criterion to determine the ability of each questionnaire to predict whether or not a participant was meeting the 2008 US PA Guidelines.

Findings: Spearman correlation coefficients between questionnaire scores and minutes of accelerometer-measured MVPA were low (EVS, r = 0.27 at T1 and r = 0.26 at T2; SBAS, r = 0.10 at T1 and r = 0.28 at T2) and not statistically significant (P's > 0.05). The EVS had sensitivity, specificity, and negative and positive predictive values of 27, 89, 59, and 68% at T1 and 33, 74, 38, and 70% at T2, respectively. The SBAS had sensitivity, specificity, and negative and positive predictive values were 18, 79, 33, and 62% at T1 and 67, 58, 43, and 79% at T2. While both questionnaires may be useful in identifying AA women who do not meet the 2008 PA Guidelines, using the questionnaires to identify AA women meeting the PA Guidelines should be done with caution.
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http://dx.doi.org/10.1017/S1463423615000390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715783PMC
May 2016

Using Web-Based Technology to Promote Physical Activity in Latinas: Results of the Muévete Alabama Pilot Study.

Comput Inform Nurs 2015 Jul;33(7):315-24

Author Affiliations: College of Nursing and Health Innovation, Arizona State University, Phoenix (Drs Benitez, Joseph, and Keller); Division of Preventive Medicine, University of Alabama at Birmingham (Dr Cherrington); Department of Family Medicine & Public Health, University of California, San Diego (Drs Marcus and Marquez); and Office of Research Scholarship (Dr Meneses), and Department of Health Behavior (Dr Pekmezi), University of Alabama at Birmingham.

Latinas in the US report high levels of physical inactivity and are disproportionally burdened by related health conditions (eg, type 2 diabetes, obesity), highlighting the need for innovative strategies to reduce these disparities. A 1-month single-arm pretest-posttest design was utilized to assess the feasibility and acceptability of a culturally and linguistically adapted Internet-based physical activity intervention for Spanish-speaking Latinas. The intervention was based on the Social Cognitive Theory and the Transtheoretical Model. Changes in physical activity and related psychosocial variables were measured at baseline and the end of the 1-month intervention. The sample included 24 Latina adults (mean age, 35.17±11.22 years). Most (83.3%) were born outside the continental US. Intent-to-treat analyses showed a significant increase (P=.001) in self-reported moderate- to vigorous-intensity physical activity from a median of 12.5 min/wk at baseline to 67.5 min/wk at the 1-month assessment. Participants reported significant increases in self-efficacy as well as cognitive and behavioral processes of change. Nearly half of the participants (45.8%) reported advancing at least one stage of change during the course of the 1-month intervention. Findings support the feasibility and acceptability of using interactive Internet-based technology to promote physical activity among Latinas in Alabama.
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http://dx.doi.org/10.1097/CIN.0000000000000162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4506230PMC
July 2015

Feasibility, acceptability, and characteristics associated with adherence and completion of a culturally relevant internet-enhanced physical activity pilot intervention for overweight and obese young adult African American women enrolled in college.

BMC Res Notes 2015 Jun 2;8:209. Epub 2015 Jun 2.

Department of Pediatrics, University of Alabama at Birmingham, CPPI, Suite 410, 1600 7th Avenue South, Birmingham, AL, 35233, USA.

Background: African American women are one of the least active demographic groups in the US, with only 36% meeting the national physical activity recommendations in comparison to 46% of White women. Physical activity begins to decline in African American women in adolescence and continues to decline into young adulthood. Yet, few interventions have been developed to promote physical activity in African American women during this critical period of life. The purpose of this article was to evaluate the acceptability and feasibility of a culturally-relevant Internet-enhanced physical activity pilot intervention for overweight/obese African American college females and to examine psychosocial and behavioral characteristics associated with intervention adherence and completion.

Methods: A 6-month single group pre-posttest design was used. Participants (n = 27) accessed a culturally-relevant Social Cognitive Theory-based physical activity promotion website while engaging in a minimum of four moderate-intensity physical activity sessions each week. Acceptability and feasibility of the intervention was assessed by participant retention and a consumer satisfaction survey completed by participants.

Results: Fifty-six percent of participants (n = 15) completed the intervention. Study completers were more physically active at baseline (P = 0.05) and had greater social support for exercise from family members (P = 0.04). Sixty percent of study completers (n = 9) reported the website as "enjoyable" or "very enjoyable" to use and 60% (n = 9) reported increased motivation from participation in the physical activity program. Moreover, 87% (n = 13) reported they would recommend the website to a friend.

Conclusions: Results provide some preliminary support for the acceptability and feasibility of an Internet-enhanced physical activity program for overweight/obese African American women, while highlighting important limitations of the approach. Successful promotion of physical activity in college aged African American women as they emerge into adulthood may result in the development of life-long healthy physical activity patterns which may ultimately reduce physical activity-related health disparities in this high risk underserved population. Future studies with larger samples are needed to further explore the use of Internet-based programs to promote physical activity in this population.
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http://dx.doi.org/10.1186/s13104-015-1159-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702398PMC
June 2015

Barriers to Physical Activity Among African American Women: An Integrative Review of the Literature.

Women Health 2015 24;55(6):679-99. Epub 2015 Apr 24.

a College of Nursing and Health Innovation , Arizona State University , Phoenix , Arizona , USA.

A key aspect for researchers to consider when developing culturally appropriate physical activity (PA) interventions for African American (AA) women are the specific barriers AA women face that limit their participation in PA. Identification and critical examination of these barriers is the first step in developing comprehensive culturally relevant approaches to promote PA and help resolve PA-related health disparities in this underserved population. We conducted a systematic integrative literature review to identify barriers to PA among AA women. Five electronic databases were searched, and forty-two studies (twenty-seven qualitative, fourteen quantitative, one mixed method) published since 1990 (range 1998-2013) in English language journals met inclusion criteria for review. Barriers were classified as intrapersonal, interpersonal, or environment/community according to their respective level of influence within our social ecological framework. Intrapersonal barriers included lack of time, knowledge, and motivation; physical appearance concerns; health concerns; monetary cost of exercise facilities; and tiredness/fatigue. Interpersonal barriers included family/caregiving responsibilities; lack of social support; and lack of a PA partner. Environmental barriers included safety concerns; lack of facilities; weather concerns; lack of sidewalks; and lack of physically active AA role models. Results provide key leverage points for researchers to consider when developing culturally relevant PA interventions for AA women.
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http://dx.doi.org/10.1080/03630242.2015.1039184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516615PMC
January 2016

Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial.

BMC Womens Health 2015 Mar 27;15:30. Epub 2015 Mar 27.

Arizona State University, College of Nursing and Health Innovation, 500 N. 3rd Street, Phoenix, AZ, 85004, USA.

Background: African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women.

Methods: Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction.

Results: All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = -74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = -34 minutes/week) in comparison to PI participants (all P's < .05). No between group differences for accelerometer measured moderate-to-vigorous intensity physical activity were observed (P > .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P < .001) and social support from family for physical activity (P = .044). Satisfaction with the FI was also high: 100% reported physical activity-related knowledge gains and 100% would recommend the program to a friend.

Conclusions: A culturally-relevant Facebook and text message delivered physical activity program was associated with several positive outcomes, including decreased sedentary behavior, increased light- and moderate-lifestyle intensity physical activity, enhanced psychosocial outcomes, and high participant satisfaction. Future studies with larger samples are warranted to further explore the efficacy of technology-based approaches to promote physical activity among African American women.

Trial Registration: ClinicalTrials.gov NCT02372565 . Registered 25 February 2015.
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http://dx.doi.org/10.1186/s12905-015-0186-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4407714PMC
March 2015

Lessons Learned from the Development and Implementation of Two Internet-enhanced Culturally Relevant Physical Activity Interventions for Young Overweight African-American Women.

J Natl Black Nurses Assoc 2014 Jul;25(1):42-47

Associate Professor, Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.

This research team has designed and implemented 2 culturally relevant, Internet-enhanced physical activity (PA) interventions for overweight/obese African-American female college students. Presumably, these are the only prospectively designed, culturally relevant interventions using the Internet to promote PA among African-American women. Due to the limited research on this topic, the experiences associated the design and implementation of these studies were syntesized and 5 key lessons learned from this research were formulated. Findings provide insight for researchers to consider when developing Internet-based PA promotion interventions for African-American women. Lessons learned included: 1) Elicit and incorporate feedback from the target population throughout development of an Internet-based PA promotion tool; 2) Incorporate new and emerging technologies into Internet-enhanced PA programs; 3) Maintain frequent participant contact and provide frequent incentives to promote participant engagement; 4) Supplement Internet-based efforts with face-to-face interactions; 5) Include diverse images of African-American women and culturally relevant PA-related information in Internet-based PA promotion materials.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314098PMC
July 2014

Use of the Stanford Brief Activity Survey for physical activity assessment in postpartum Latinas: a validation study of a linguistically translated Spanish version.

Hisp Health Care Int 2014 ;12(3):146-54

Arizona State University, Phoenix, USA.

This study assessed the concurrent validity of the English and a linguistic Spanish translation of the Stanford Brief Activity Survey (SBAS) with pedometer-measured physical activity (PA) among postpartum Latinas. Latinas (n 97) completed the SBAS in either English (n 47) or Spanish (n 50) and wore pedometers 7 days at three different assessment periods. The English version demonstrated significant trends (p .01) for differentiating aerobic walking steps (AWS) and aerobic walking time (AWT) across SBAS intensity categories at two of the three assessment periods. The Spanish version showed marginally significant trends for differentiating AWS (p .048) and AWT (p .052) across SBAS intensity categories at only one assessment period. The English version of the SBAS is effective in assessing PA status among Latinas; however, the Spanish version indicates a need for research to further explore cultural and linguistic adaptations of the SBAS.
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http://dx.doi.org/10.1891/1540-4153.12.3.146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176775PMC
November 2015

Internet-Based Physical Activity Interventions.

Am J Lifestyle Med 2014 Jan;8(1):42-68

School of Public Health (RPJ, TJB, DWP) and the Division of General Pediatrics and Adolescent Medicine (NHD), University of Alabama at Birmingham, Alabama.

This article provides a comprehensive review of Internet- and Website-based physical activity interventions targeting adult populations. Search procedures identified 72 unique Internet-based physical activity interventions published in peer-reviewed journals. Participants of the studies were predominately White, middle-aged (mean age = 43.3 years), and female (65.9%). Intervention durations ranged from 2 weeks to 13 months (median = 12 weeks). Forty-six of the studies were randomized controlled trials, 21 were randomized trials without a control condition, 2 were non-randomized controlled trials, and 3 used a single-group design. The majority of studies (n = 68) assessed outcomes immediately following the end of the intervention period, and 16 studies provided delayed postintervention assessments. Forty-four of the 72 studies (61.1%) reported significant increases in physical activity. Future directions for Internet-based physical activity interventions include increasing representation of minority and male populations in Internet-based efforts, conducting delayed postintervention follow-up assessments, and incorporating emerging technologies (ie, cellular and Smartphones) into Internet-based physical activity efforts.
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http://dx.doi.org/10.1177/1559827613498059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103664PMC
January 2014

Results of a Culturally Adapted Internet-Enhanced Physical Activity Pilot Intervention for Overweight and Obese Young Adult African American Women.

J Transcult Nurs 2016 Mar 16;27(2):136-46. Epub 2014 Jun 16.

University of Alabama at Birmingham, Birmingham, AL, USA.

Purpose: This study evaluated a culturally relevant, social cognitive theory-based, Internet-enhanced physical activity (PA) pilot intervention developed for overweight/obese African American (AA) female college students.

Design: Using a 3-month, single group, pretest-posttest design, participants accessed a culturally relevant PA promotion website and engaged in four moderate-intensity PA sessions each week.

Results: Study completers (n = 25, mean age = 21.9 years) reported a decrease in sedentary screen time (p < .0001); however, no changes in moderate-to-vigorous PA were reported (p = .150). A significant increase in self-regulation for PA (p < .0001) and marginally significant increases in social support (p = .052) and outcome expectations (p = .057) for PA were observed. No changes in body mass index (p = .162), PA enjoyment (p = .151), or exercise self-efficacy (p = .086) were reported.

Conclusions: Findings of this exploratory study show some preliminary support for Internet-enhanced approaches to promote PA among overweight/obese AA women.

Implications For Practice: Future studies with larger samples are needed to further explore culturally relevant Internet-enhanced PA programs in this underserved population.
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http://dx.doi.org/10.1177/1043659614539176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723286PMC
March 2016

Recommendations for a culturally relevant Internet-based tool to promote physical activity among overweight young African American women, Alabama, 2010-2011.

Prev Chronic Dis 2014 Jan 16;11:130169. Epub 2014 Jan 16.

University of Massachusetts Medical School, Worcester, Massachusetts.

Introduction: Innovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women.

Methods: A mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes.

Results: Twenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter).

Conclusion: Incorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population.
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http://dx.doi.org/10.5888/pcd11.130169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899848PMC
January 2014

Physical activity and quality of life among university students: exploring self-efficacy, self-esteem, and affect as potential mediators.

Qual Life Res 2014 Mar 9;23(2):659-67. Epub 2013 Aug 9.

University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA,

Purpose: Physical activity (PA) has been shown to enhance quality of life (QOL) in older adults. Findings from these studies indicate that the relationship between PA and QOL is indirect and likely mediated by variables such as physical self-esteem, exercise self-efficacy, and affect. As PA varies greatly by age, the purpose of the current study is to extend this area of research to young adults and explore the complex relationship between PA and QOL in this target population.

Methods: Data were collected via anonymous questionnaire from N = 590 undergraduate students. PA was assessed with the Godin Leisure Time Exercise Questionnaire, and QOL was assessed by the Satisfaction with Life Scale. Path analysis was used to test the relationship between PA and QOL, with mediators of exercise self-efficacy, physical self-esteem, and affect.

Results: The PA model (RMSEA = .03, CFI = .99) accounted for 25 % of the variance in QOL. PA had positive direct effects on exercise self-efficacy (β = .28, P < .001), physical self-esteem (β = .10, P < .001), positive affect (β = .10, P < .05), and negative affect (β = .08, P < .05). Physical self-esteem was found to be the most powerful mediating variable on QOL (β = .30, P < .001), followed by positive affect (β = .27, P < .001) and negative affect (β = .14, P < .001).

Conclusion: Physical self-esteem and, to a lesser extent, positive affect emerged as integral components in the link between PA and QOL. Findings suggest that health education programs designed to promote regular PA and increase physical self-esteem may be effective in improving QOL in young adults.
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http://dx.doi.org/10.1007/s11136-013-0492-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049193PMC
March 2014