Johns Hopkins Discussion Leader

 Summary:

Self-reported data from 2000-2014 from the National Health Interview Survey showed that African American women are some of the least physically active demographic groups in the United States.  According to the published survey, only 36% of African American women achieve the national guidelines for aerobic physical activity (150 minutes per week of moderate-intensity, 75 minutes of vigorous, or a combination equivalent of the two intensities).  The low physical activity within AA women are concerning because this group also has high reporting of cardiovascular disease and obesity.  This study took twenty-five sedentary and obese AA women who enrolled in a series of three focus groups conducted over a six week period to see if Social Cognitive Theory can be culturally tailored to design a physical activity program specifically for these women.  Each focus group was designed to target specific Social Cognitive Theory constructs, and each woman attended all three focus groups in sequential order, for the questions and group discussion were designed to build off the prior session.  Focus group one was on the theoretical constructs of behavioral capability and outcome expectations, focus group two centered on exploring the constructs of self-regulation and self-efficacy, while focus group three targeted social support.  

Analysis:

Findings were, a number of participants reported not knowing how much physical activity was needed to receive health benefits, didn’t understand the differences between physical activity and exercise itself, and being uncomfortable with physical activity due to embarrassment and teasing from other children during childhood.  However, by the end of focus group three there was a consensus that exercise was just a more structured form of physical activity, and that physical activity could consist of a variety of activities.  The women also agreed that receiving a structured plan would provide knowledge and skills to be more physically active.  The women were very happy about the benefits of more physical activity, such as reduced stress, improved sleep, and reducing the risk for chronic diseases.  

Gaining an understanding of women’s previous experiences with physical activity allows researchers to better design activities to leverage more positive experiences, and negate the negative experiences.  Barriers to physical activity were lack of time due to family and caretaking responsibilities, busy work schedules, fatigue, hair care, and extreme heat (for this study was done in Arizona).  The study worked with the women to try and solve these problems, finding that some of these barriers were not actual barriers, but excuses, and that finding self-monitoring, goal setting, and self-reward could hold them accountable to staying active.  

It is difficult for women balancing work, family, and trying to make time for their own self-care needs.  The findings of this study suggest that traditional cultural norms are evolving, and that physical activity is becoming recognized as important behavior in the AA community.  AA women even found that increased physical activity gave them more energy to perform everyday tasks, and set good examples for their family.  

Questions:

1. After reviewing this study, it sounds to me that a lot of the initial problems are due to lack of education around physical activity.  What are some helpful ways to reduce misinformation and promote more knowledge around physical activity?  

2. Social Cognitive Theory states that humans learn by directly observing others within contexts of social interactions.  How can one best take this theory to promote and maintain a healthy lifestyle?

3. Mindset seemed to be a barrier for participants in this study.  As a researcher, what might you suggest to reduce that hurdle?

Reference:

Joseph, R. P., Ainsworth, B. E., Mathis, L., Hooker, S. P., & Keller, C. (2017). Utility of social cognitive theory in intervention design for promoting physical activity among African-American women: a qualitative study. American Journal of health behavior, 41(5), 518-533.