A Church-Based Intervention to Change Attitudes about Physical Activity among Black Adolescent Girls: A Feasibility Study

Physical inactivity among Black adolescent girls contributes to many chronic health conditions including obesity, type 2 diabetes, and cardiovascular disease, which are higher in Black women than White women (American Heart Association, 2011). Kimm et al. (2006) found that physical activity in girls deceased significantly between elementary and high school years. LaFontaine (2008) found that physical activity in adolescent girls decreased from 42% in 1991 to 33% in 2005. Over half (56%) of Black adolescent girls do not participate in any leisure-time physical activity and are significantly less likely to participate in organized sports than White girls (LaFontaine, 2008). Only 22% of Black adolescent girls participate in physical activity at least 60 min a day on 5 or more days of the week, and only 10% participate in physical activity 7 days a week (Centers for Disease Control and Prevention [CDC], 2010). Physical inactivity among Black adolescent girls places them at increased risk of developing chronic health conditions later in life (CDC, 2008). The literature indicates that a key focus for many intervention studies aimed at children and adolescents are school-based approaches (Beets, Beighle, Erwin, & Huberty, 2009; Neumark-Sztainer, Story, Hannan, & Rex, 2003; Pate et al., 2005; Robbins, Gretebeck, Kazanis, & Pender, 2006; Stevens et al., 2005; Young, Phillips, Yu, & Haythornthwaite, 2006). Many school-based interventions have resulted in little to no change in physical activity outside the school setting (Pate & O’Neill, 2009). Moreover, there have been few studies conducted in Black adolescent girls. Therefore, future research is needed to identify effective and culturally appropriate interventions for this population. Further explorations of physical activity programs that are community-based and faith-based are needed that extend physical activity programs beyond the school setting and traditional academic term (Barry, Sutherland, & Harris, 2006; Bopp, Wilcox, Laken, & McClorin, 2009; Whitt-Glover, Hogan, Lang, & Heil, 2008). The few studies (Go Girls!, GEM, and Barbeau) that were conducted in Black girls revealed no statistically significant results regarding increased physical activity (Barbeau et al., 2007; Resnicow, Taylor, Baskin, & McCarty, 2005; Rochon et al., 2003). However, these studies offer some insight for consideration in designing future studies aimed at increasing physical activity of adolescent girls. Barbeau et al. (2007) found a need for physical activity programs to be offered at various times throughout the day. The Girls Health Enrichment Multisite Studies (GEMS) supported the feasibility and the importance of a culturally relevant focus in designing program for preadolescent African American girls (ages 8–10) and their parents/caregiv-ers (Rochon et al., 2003). Physical inactivity is higher in minorities than in Whites, but a clear explanation for these differences remain unknown (CDC, 2010). Therefore, considering cultural differences in designing physical activity interventions for Black adolescent girls may be warranted. Culture is defined by Boyington et al. (2008) as the unique shared values, beliefs, and practices of a group, and can influence the behaviors of individuals by affecting their thoughts, feelings, acceptance, and adoption of health education messages. Interventions that have been culturally tailored have been shown to be more effective when they were specifically designed for the populations they serve (Belgrave et al., 2004; Corneille, Ashcraft, & Belgrave, 2005; Dowda et al., 2004). Health promoting programs in Black churches have proven to be beneficial and effective in meeting the needs of the Black community and reducing health disparities (Bopp et al., 2007; Isaac, Rowland, & Blackwell, 2007). Churches can play an important role in health promotion efforts, such as promoting physical activity because of their central role in spiritual guidance, communication, social support, and networking (Isaac et al., 2007). The Theory of Reasoned Action (TRA) was the guiding framework for this study. The theory hypothesizes that an individual’s intention to engage in a given behavior is the most immediate predictor of that behavior (Montano & Kasprzyk, 2002). Intention mediates the effects of attitudes and subjective norms, which are perceived social pressures to participate or not to participate in a behavior (Hagger, Chatzisarantis, & Biddle, 2002). A person who has a favorable attitude toward a behavior is more likely to have stronger intentions to change that behavior. Intentions are influenced by social expectations (family and friends influence) and individual attitudes (Ajzen & Fishbein, 1980; Dishman et al., 2006). Therefore, strategies for changing the attitudes of Black adolescent girls toward being more physically active were based on the TRA (Ajzen & Fish-bein, 1980). Other studies support that the more positive attitude a person have toward a behavior, the more likely they are to engage in it (Lewis-Moss, Paschal, Redmond, Green, & Carmack, 2008; Lewis-Moss, Paschal, Sly, Roberts, & Wernick, 2009; Schneider & Graham, 2009). Strategies were directed at changing attitudes (Lewis-Moss et al., 2009; Nelson, Benson, & Jensen, 2009) through self-monitoring, presenting physical activity as an enjoyable process, setting goals regarding physical activity, and increasing knowledge regarding the need and importance of physical activity.