Results of a Culturally Tailored Smartphone-Delivered Physical Activity Intervention Among Midlife African American Women: Feasibility Trial (Preprint)
Authors: Joseph Rodney P , Ainsworth Barbara E , Hollingshead Kevin , Todd Michael , Keller Colleen 
Published: January 2021

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 <i>Smart Walk</i> intervention was delivered through the study <i>Smart Walk</i> smartphone app and text messages. Features available on the <i>Smart Walk</i> 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 <i>r</i> test statistic.

RESULTS

Participants increased moderate-to-vigorous PA (median 30 minutes per week increase; <i>r</i>=0.503; <i>P</i>=.002) and reported improvements in 2 theoretical mediators (self-regulation: <i>r</i>=0.397; <i>P</i>=.01; behavioral capability: <i>r</i>=0.440; <i>P</i>=.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.

CLINICALTRIAL

ClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355