“It was just for us”: qualitative evaluation of an exercise intervention for African-American couples

Abstract Background Promoting long-term exercise adherence should be a key focus for health and fitness professionals working to reduce obesity and cardiometabolic health disparities, and all-cause mortality in inactive African-American (AA) adults. Data have suggested that romantic partners can improve long-term exercise adherence and that this dyadic approach should be examined in exercise interventions. Therefore, the purpose of this study was to conduct a qualitative evaluation of a pilot exercise intervention conducted in older AA couples. Methods Two semi-structured focus groups were utilized to compare participants’ perceptions of and experiences during the pilot intervention across two randomly assigned treatment conditions (exercising together with partner [ET; n = 8] versus exercising separately [ES: n = 6]). Participants (mean age: 64.7 ± 6.8 years) of a previous 12-week pilot exercise intervention (walking ≥3 days/week, 30 min/day plus supervised resistance training 2 days/week) were interviewed. Verbatim transcripts were coded using an open coding approach. Results Three key themes (intervention value/benefits, intervention difficulties, and suggested improvements) emerged. Although all couples identified health and relationship benefits of the intervention, some differences surfaced within themes across the two intervention groups. Conclusions Overall, these qualitative data suggest that couples had a positive experience while participating in the pilot study. In addition, key learning points to improve the intervention were identified including a more gradual transition to independent exercise, more flexibility training, and the incorporation of tangential education. These data will help investigators continue to develop the intervention, which is ultimately designed to promote long-term exercise adherence to reduce cardiometabolic health disparities in the AA community.

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Abstract P186: “It Was Just For Us”: Qualitative Evaluation Of An Exercise Intervention For Older African-american Couples

Circulation ◽

10.1161/circ.143.suppl_1.p186 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Lyndsey M Hornbuckle ◽

Cristina S Barroso ◽

Amy Rauer ◽

Chloe S Jones ◽

Kerri M Winters-Stone

Keyword(s):

African American ◽

Health Disparities ◽

Process Evaluation ◽

Exercise Intervention ◽

Exercise Adherence ◽

Qualitative Evaluation ◽

Romantic Partners ◽

Cardiometabolic Health ◽

Exercise Interventions

Introduction: Promoting long-term exercise adherence should be a key focus for health and fitness professionals working to reduce obesity and cardiometabolic health disparities, and all-cause mortality in inactive African-American (AA) adults. Data have suggested that romantic partners can improve long-term exercise adherence and that this dyadic approach should be examined in exercise interventions. Therefore, the purpose of this study was to conduct a qualitative process evaluation of a pilot exercise intervention conducted in older AA couples. The intervention itself examined whether exercising together influenced exercise adherence and cardiometabolic risk. Methods: Two semi-structured focus groups were utilized to compare experiences across two randomly assigned treatment conditions (exercising together with partner [ET: n=8] versus exercising separately [ES: n=6]). Participants (mean age: 64.7±6.8 years; body mass index 30.4±4.8 kg/m 2 ) of a previous 12-week pilot exercise intervention (walking ≥3 days/week, 30 minutes/day plus supervised resistance training 2 days/week) were interviewed. Investigators used guidelines for process evaluation and the context of the intervention to design the focus group guide. Verbatim transcripts were coded using an open coding approach. Results: Three key themes emerged (Table 1). Although all couples identified health and relationship benefits of the intervention, some differences surfaced within themes across the two intervention groups. Conclusions: These data will help investigators continue to develop the intervention, which is ultimately designed to promote long-term exercise adherence to reduce cardiometabolic health disparities in the AA community.

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Abstract P311: Engagement of a Community Advisory Board Informs an Exercise Intervention in Older African-American Couples

Circulation ◽

10.1161/circ.141.suppl_1.p311 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Lyndsey M Hornbuckle ◽

Amy Rauer

Keyword(s):

Health Disparities ◽

Community Engagement ◽

Local Community ◽

Exercise Intervention ◽

Exercise Adherence ◽

Advisory Board ◽

Cultural Relevance ◽

Community Advisory Board ◽

Cardiometabolic Disease ◽

Cardiometabolic Health

Introduction: Older African-Americans (AA) are vulnerable to cardiometabolic health disparities. As physical inactivity is highly prevalent in this population and regular exercise can help mitigate cardiometabolic disease, collaborations between the local community and academic researchers are needed to create sustainable exercise interventions. To this end, the current investigators formed a community advisory board (CAB) to consult on an interdisciplinary pilot intervention study that would examine the effects of couples-based resistance training plus walking on: 1) exercise adherence; 2) cardiometabolic risk factors (abdominal obesity, blood pressure, insulin resistance, hemoglobin A1c, high-density lipoprotein and total cholesterol, triglycerides, C-reactive protein, fibrinogen); and 3) the provision of partner support and receptivity to partner health influence in older AA romantic couples. Hypothesis: CAB consultation would enhance the proposed pilot study methods and facilitate community engagement. Methods: Seven local community members/leaders with a stake in the health of the AA community were invited to participate in two CAB meetings. In the meetings, investigators proposed ideas to pilot a novel exercise intervention in older AA couples and solicited input in four key areas: 1) priority health concerns of the target population; 2) the proposed study protocol; 3) cultural relevance; 4) and sustainability. Recorded responses were summarized and coded using a qualitative thematic analysis approach. Results: Multiple themes surfaced within each of the four focus areas including confirmation of the need to study cardiometabolic disease risk (e.g. hypertension, diabetes) in this population, potential recruitment challenges and suggestions to relax exclusion criteria, exclusion of potentially beneficial program components (e.g. flexibility training, education), the need for culturally-specific adaptations (e.g. incorporating music, providing AA role models), and long-term community engagement (i.e. future efforts to launch the intervention at the community level). Investigators made multiple study modifications per CAB recommendations. Conclusions: CAB feedback suggested the proposed intervention would be well-received and considered both beneficial and relevant by the community. CAB-recommended study modifications underscore the value of a community-partnered approach to intervention design that promotes cultural relevance and sustainability. These characteristics support the ultimate goal of reducing cardiometabolic health disparities in AA communities. Although the investigators recognize the current method deviates from true community-based participatory research that originates within a community, the model presented is beneficial as it engages the community in the developmental stage of evidence-based research.

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801 LONG-TERM DIET AND EXERCISE INTERVENTION REDUCES CRP LEVELS IN SEDENTARY AFRICAN-AMERICAN ADULTS

Journal of Hypertension ◽

10.1097/01.hjh.0000420833.71342.39 ◽

2012 ◽

Vol 30 ◽

pp. e232

Author(s):

Praveen Veerabhadrappa ◽

Keith Diaz ◽

Michael Brown

Keyword(s):

African American ◽

Exercise Intervention ◽

African American Adults ◽

Diet And Exercise ◽

Diet And Exercise Intervention

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Multicomponent Physical Exercise in Older Adults after Hospitalization: A Randomized Controlled Trial Comparing Short- vs. Long-Term Group-Based Interventions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020666 ◽

2020 ◽

Vol 17 (2) ◽

pp. 666 ◽

Cited By ~ 2

Author(s):

Iñaki Echeverria ◽

Maria Amasene ◽

Miriam Urquiza ◽

Idoia Labayen ◽

Pilar Anaut ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Exercise ◽

Nutritional Status ◽

Physical Function ◽

Mixed Model ◽

Exercise Intervention ◽

Exercise Interventions ◽

Positive Effects

Multicomponent physical exercise is effective in curbing the effect of hospitalization in older adults. However, it is not well established which characteristics of the exercise interventions would optimize intervention sustainability and efficacy. This study compared the effects of two group-based multicomponent exercise interventions of different lengths in older adults after hospitalization. Fifty-five participants were randomly assigned to a short-term group-based branch (SGB, n = 27) or to a long-term group-based branch (LGB, n = 28). The SGB participated in a six-week multicomponent group-based exercise-training program followed by 18 weeks of home-based exercise. The LGB completed 12 weeks of each phase. Physical function, physical activity, quality of life, anthropometrics, and nutritional status were assessed at baseline, after 12 weeks, and after 24 weeks of intervention. Both groups improved physical function and nutritional status and increased physical activity after 12 weeks of intervention (paired student’s t-test, p < 0.01), and maintained the positive effects during the following 12 weeks. No group-by-time interaction was observed in any of the studied variables using mixed-model ANOVA. Based on these findings, we determined that 6 weeks of a group-based exercise intervention caused similar functional and nutritional benefits to a longer group-based intervention of 12 weeks when both are continued at home until 24 weeks.

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An Exercise Programme for Smoking Cessation: Perceptions of the Fit2quit Trial Intervention

The Journal of Smoking Cessation ◽

10.1017/jsc.2014.16 ◽

2014 ◽

Vol 11 (3) ◽

pp. 135-142 ◽

Cited By ~ 2

Author(s):

Vaughan Roberts ◽

Leila Pfaeffli Dale ◽

Enid Dorey ◽

Christopher Bullen ◽

Ralph Maddison

Keyword(s):

Smoking Cessation ◽

Exercise Intervention ◽

Intervention Group ◽

Qualitative Evaluation ◽

Exercise Programme ◽

Telephone Counselling ◽

Exercise Interventions ◽

Support Person ◽

Face To Face ◽

Call Schedule

Introduction: Few trials of exercise interventions for smoking cessation have included a qualitative evaluation of the intervention from the participants' perspective.Aims: To determine the perceptions of participants who received a 6-month telephone counselling exercise intervention to aid smoking cessation.Methods: Participants in the Fit2Quit study intervention group were asked to take part in a semi-structured phone interview. All interviews were digitally recorded and transcribed verbatim, and a general inductive approach to data analysis was followed.Results/Findings: Twenty participants from the intervention group completed an interview. The following themes emerged from the analyses: (1) The support people were genuinely interested in what I was achieving, (2) new awareness, new attitude, new lifestyle: I could see the benefits, (3) lack of time, willpower and money stopped me from changing and (4) I would have preferred a “more hands on” approach: Recommendations for future programmes.Conclusions: A telephone counselling intervention to enhance exercise for smoking cessation was well received. Aspects of the intervention, particularly the provision of support and encouragement from the participant support person, were beneficial. Suggested improvements were greater tailoring of the call schedule, greater face-to-face contact and provision of a buddy system or support group. Such improvements may increase adherence and, therefore, effectiveness of exercise interventions for smoking cessation.

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From Supervised to Unsupervised Exercise: Factors Associated with Exercise Adherence

Journal of Aging and Physical Activity ◽

10.1123/japa.11.3.351 ◽

2003 ◽

Vol 11 (3) ◽

pp. 351-368 ◽

Cited By ~ 25

Author(s):

Miriam C. Morey ◽

Patricia M. Dubbert ◽

Martha E. Doyle ◽

Helga MacAller ◽

Gail M. Crowley ◽

...

Keyword(s):

Behavioral Change ◽

Functional Limitations ◽

Exercise Adherence ◽

Chronic Illnesses ◽

Exercise Interventions ◽

Future Studies ◽

Factors Associated ◽

Home Based

Getting older adults to initiate and maintain long-term exercise is an important public health mandate. This study is an analysis of a clinical trial of 112 sedentary adults, age 65–90 years, randomly assigned to 1 of 2 exercise interventions. We examined predictors and patterns of adherence of the 6-month home-based component of the trial. Telephone follow-up and diaries were used to assess adherence. Adherence to weekend exercise during the supervised phase of the program was the strongest predictor of subsequent home-based adherence. Adherence appeared stable throughout the intervention, indicating that adherence or nonadherence was established from the outset. The authors conclude that nonadherence can be identified early in the behavioral-change process. Future studies should focus on developing strategies for adults with chronic illnesses, depressive symptoms, and functional limitations who are nonadherent early on as they initiate and attempt to maintain exercise.

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Reach Out to Enhance Wellness Home-Based Diet-Exercise Intervention Promotes Reproducible and Sustainable Long-Term Improvements in Health Behaviors, Body Weight, and Physical Functioning in Older, Overweight/Obese Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2011.40.0895 ◽

2012 ◽

Vol 30 (19) ◽

pp. 2354-2361 ◽

Cited By ~ 124

Author(s):

Wendy Demark-Wahnefried ◽

Miriam C. Morey ◽

Richard Sloane ◽

Denise C. Snyder ◽

Paige E. Miller ◽

...

Keyword(s):

Cancer Survivors ◽

Exercise Intervention ◽

Short Form ◽

Functional Decline ◽

The United States ◽

Telephone Counseling ◽

Exercise Interventions ◽

Intervention Delivery ◽

Prostate Cancer Survivors

Purpose Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity, but few have assessed adherence and health outcomes long term. Methods Between July 2005 and May 2007, the Reach Out to Enhance Wellness (RENEW) trial accrued 641 locoregionally staged, long-term (≥ 5 years from diagnosis) colorectal, breast, and prostate cancer survivors in the United States (21 states), Canada, and the United Kingdom. All participants were sedentary (< 150 minutes of physical activity [PA] a week), overweight or obese (body mass index, 25 to 40 kg/m2), and over age 65 years. The trial tested a diet-exercise intervention delivered via mailed print materials and telephone counseling. RENEW used a wait-list control, cross-over design (ie, participants received the year-long intervention immediately or after a 1-year delay), which allowed the opportunity to assess program efficacy (previously reported primary outcome), durability, and reproducibility (reported herein). Measures included diet quality (DQ), PA, BMI, and physical function (PF). Results No significant relapse was observed in the immediate-intervention arm for DQ, PA, and BMI; however, rates of functional decline increased when the intervention ceased. From year 1 to year 2, significant improvements were observed in the delayed-intervention arm; mean change scores in behaviors and BMI and PF slopes were as follows: DQ score, 5.2 (95% CI, 3.4 to 7.0); PA, 45.8 min/wk (95% CI, 26.9 to 64.6 min/wk); BMI, −0.56 (95% CI, −0.75 to −0.36); and Short Form-36 PF, −1.02 versus −5.52 (P < .001 for all measures). Overall, both arms experienced significant improvements in DQ, PA, and BMI from baseline to 2-year follow-up (P < .001). Conclusion Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss. These changes positively reorient functional decline trajectories during intervention delivery.

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