Redefining Racial Residential Segregation and Its Association with Physical Activity among African Americans 50 years and Older: A Mixed Methods Approach

Physical inactivity is one of the factors contributing to disproportionate disease rates among older African Americans. Previous literature indicates that older African Americans are more likely to live in racially segregated neighborhoods and that racial residential segregation is associated with limited opportunities for physical activity. A cross-sectional mixed methods study was conducted guided by the concept of therapeutic landscapes. Multilevel regression analyses demonstrated that racial residential segregation was associated with more minutes of physical activity and greater odds of meeting physical activity recommendations. Qualitative interviews revealed the following physical activity related themes: aging of the neighborhood, knowing your neighbors, feeling of safety, and neighborhood racial identity. Perceptions of social cohesion enhanced participants’ physical activity, offering a plausible explanation to the higher rates of physical activity found in this population. Understanding how social cohesion operates within racially segregated neighborhoods can help to inform the design of effective interventions for this population.

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Feasibility of a Lifestyle Physical Activity Intervention to Prevent Memory Loss in Older Women With Cardiovascular Disease: A Mixed-Methods Approach

Canadian Journal of Nursing Research ◽

10.1177/0844562119856233 ◽

2019 ◽

pp. 084456211985623 ◽

Cited By ~ 1

Author(s):

Shannon Halloway ◽

JoEllen Wilbur ◽

Michael E. Schoeny ◽

Lynne T. Braun ◽

Neelum T. Aggarwal ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Mixed Methods ◽

Physical Activity Intervention ◽

Memory Loss ◽

Post Intervention ◽

Mixed Methods Approach ◽

High Satisfaction ◽

Post Test ◽

Lifestyle Physical Activity

Background Memory loss in older age affects women more than men and cardiovascular disease is a leading risk factor. Physical activity can improve memory in healthy older adults; however, few physical activity interventions have targeted women with cardiovascular disease, and none utilized lifestyle approaches. Purpose The purpose of this study was to examine feasibility, acceptability, and preliminary effects of a 24-week lifestyle physical activity intervention (physical activity prescription, five group meetings, and nine motivational interviewing calls). Methods A sequential mixed-methods approach was used. Participants were 18 sedentary women ≥65 years with cardiovascular disease and without cognitive impairment recruited in August 2017. Feasibility, acceptability, self-reported health, accelerometer-assessed physical activity, and neurocognitive memory tests were measured using a pre-post test design. Two post-intervention focus groups ( n = 8) were conducted in June 2018. Concept analysis was used to identify barriers/motivators of intervention participation. Results Meeting attendance was >72% and retention was 94%. Participants rated the program with high satisfaction. There were significant improvements at 24 weeks in self-rated physical health, objective daily steps, and estimated cardiorespiratory fitness ( d = .30–.64). Focus group themes generated recommendations for modifying the intervention. Conclusion Findings support adapting the intervention further for women with cardiovascular disease and testing it in an efficacy trial.

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Generating and Applying a Physical Activity Model for an Underserved Community: A Mixed Methods Approach

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000561018.57032.98 ◽

2019 ◽

Vol 51 (Supplement) ◽

pp. 171

Author(s):

Kori Hahn ◽

Kara Hamilton ◽

Shewanee Howard-Baptiste ◽

Melissa Powell ◽

Mia Faragalli ◽

...

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Activity Model ◽

Mixed Methods Approach ◽

Underserved Community

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The physically active lifestyle of Flemish secondary school teachers: A mixed-methods approach towards developing a physical activity intervention

Health Education Journal ◽

10.1177/0017896914536376 ◽

2014 ◽

Vol 74 (3) ◽

pp. 326-339 ◽

Cited By ~ 3

Author(s):

Inge Bogaert ◽

Kristine De Martelaer ◽

Benedicte Deforche ◽

Peter Clarys ◽

Evert Zinzen

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Secondary School ◽

Physical Activity Intervention ◽

Secondary School Teachers ◽

School Teachers ◽

Active Lifestyle ◽

Physically Active ◽

Mixed Methods Approach

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Investigating best practices of district-wide physical activity programmatic efforts in US schools– a mixed-methods approach

BMC Public Health ◽

10.1186/s12889-018-5889-4 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Christina D. Economos ◽

Megan P. Mueller ◽

Nicole Schultz ◽

Julie Gervis ◽

Gabrielle F. Miller ◽

...

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Best Practices ◽

Mixed Methods Approach

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Healthy Weight Services in England before, during and after pregnancy: a mixed methods approach

10.21203/rs.2.20767/v2 ◽

2020 ◽

Author(s):

Frankie Fair ◽

Katie Marvin-Dowle ◽

Madelynne Arden ◽

Hora Soltani

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Mixed Methods ◽

Body Mass ◽

Service Provision ◽

Qualitative Data ◽

Overweight And Obesity ◽

Healthy Weight ◽

Mixed Methods Approach ◽

National Guidance

Abstract Background: Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England. This project explored and mapped healthy weight service availability at different stages of the childbearing cycle.Methods: A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data. Results: A total of 88 participants responded to the survey. All services were offered most frequently during pregnancy; with healthy eating and/or weight management services offered more often than physical activity services. Few services were targeted specifically at women with a raised body mass index. There was a high degree of inconsistency of service provision in different geographical areas. Several themes were identified from qualitative data including "equity and variation in service provision", "need for rigorous evaluation", "facilitators” to encourage better access or more effective service provision, including prioritisation, a change in focus and co-design of services, "barriers" encountered including financial and time obstacles, poor communication and insufficiently clear strategic national guidance and "the need for additional support”.Conclusions: There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. There is a need for more robust evaluation of services to ensure they are fit for purpose. An urgent need for clear national guidance so that healthcare providers can more effectively assist mothers achieve a healthy weight gain was identified. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use.

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Abstract MP58: Racial Residential Segregation is Associated With Worse Cardiovascular Health in African American Adults: The Jackson Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.mp58 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Sharrelle Barber ◽

Kiarri Kershaw ◽

Xu Wang ◽

Mario Sims ◽

Julianne Nelson ◽

...

Keyword(s):

African American ◽

African Americans ◽

Residential Segregation ◽

Cardiovascular Health ◽

Jackson Heart Study ◽

Racial Residential Segregation ◽

African American Adults ◽

Heart Study ◽

Neighborhood Environments ◽

The Impact

Introduction: Racial residential segregation results in increased exposure to adverse neighborhood environments for African Americans; however, the impact of segregation on ideal cardiovascular health (CVH) has not been examined in large, socioeconomically diverse African American samples. Using a novel spatial measure of neighborhood-level racial residential segregation, we examined the association between segregation and ideal CVH in the Jackson Heart Study (JHS). Hypothesis: Racial residential segregation will be associated with worse cardiovascular health among African American adults. Methods: The sample included 4,354 men and women ages 21-93 from the baseline exam of the JHS (2000-2004). Racial residential segregation was assessed at the census-tract level. Data on racial composition (% African American) from the 2000 US Census was used to calculate the local G i * statistic- a spatially-weighted z-score that represents how much a neighborhood’s racial/ethnic composition deviates from the larger metropolitan area. Ideal CVH was assessed using the AHA Life’s Simple Seven (LS7) index which includes 3 behavioral (nutrition, physical activity, and smoking) and 4 biological (systolic BP, glucose, BMI, and cholesterol) metrics of CVH. Multivariable regression models were used to test associations between segregation and the LS7 index continuously (range: 0-14) and categorically (Inadequate: 0-4; Average: 5-9; and Optimal: 10-14). Covariates included age, sex, income, education, and insurance status. Results: The average LS7 summary score was 7.03 (±2.1) and was lowest in the most racially segregated neighborhood environments (High Segregation: 6.88 ±2.1 vs. Low Segregation: 7.55 ±2.1). The prevalence of inadequate CVH was higher in racially segregated neighborhoods (12.3%) compared to neighborhoods that were the least segregated (6.9%). After adjusting for key socio-demographic characteristics, racial residential segregation was inversely associated with ideal CVH (B=-0.041 ±0.02, p=0.0146). Moreover, a 1-SD unit increase in segregation was associated with a 6% increased odds of having inadequate CVH (OR: 1.06, 95% CI: 1.00-1.12, p=0.0461). Conclusion: In conclusion, African Americans in racially segregated neighborhoods are less likely to achieve ideal CVH even after accounting for individual-level factors. Policies aimed at restricting housing segregation/discrimination and/or structural interventions designed to improve neighborhood environments may be viable strategies to improving CVH in this at-risk population.

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