Creating African-American Wellness Through Exercise

Study Overview
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Brief Summary
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The purpose of this study is to pilot-test a culturally-tailored, community-based educational program for African-Americans, focusing on how to use exercise and other self-management strategies to reduce depressive symptoms and improve health. This study will explore what type of additional support would encourage depressed African-Americans to exercise regularly. The investigators hypothesize that participants will report greater frequency of exercise and lower depression scores at the end of the program than they did at baseline. However, this study is not adequately powered to test this hypothesis - the main goal is to assess feasibility, acceptability and satisfaction of the pilot intervention.

Detailed Description
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Several studies have documented the effectiveness of exercise as a treatment for depression. However, these studies have used supervised exercise in medical school or university environments and have included mostly middle-class White populations. Little is known regarding how to translate these findings to real world settings or to minority populations. Exercise may be a particularly beneficial option for African-Americans suffering from depression. African-Americans face significant disparities in depression care. At least a part of these disparities are due to lack of trust in the healthcare system and negative attitudes toward antidepressants. Our goal is to pilot-test a culturally-tailored, community-based exercise support program for depressed African-Americans. We will recruit participants who screened positive for moderate depressive symptoms when they enrolled in the African-American Health Coalition's Free Exercise Card Program, but who are exercising less than 3 times per week. They will participate in a 6-week educational self-care group focusing on how to use exercise and other self-help tools to reduce depressive symptoms. Participants will be encouraged to create action plans regarding exercise and other healthy lifestyle changes. Groups will also provide culturally-tailored information about depression therapies, such as antidepressants and psychotherapy, and discuss strategies for obtaining quality health care.

Official Title
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Creating African-American Wellness Through Exercise: Community Driven Strategies to Improve Health

Conditions
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Depression

Intervention / Treatment
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* Behavioral: AAHC Exercise Program Support Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age African-American or of African-American descent Currently participating in the African-American Health Coalition Free Exercise-Card Program Experiencing moderate depressive symptoms, as indicated by a score of 10-20 on the Depression Scale of the Patient Health Questionnaire (PHQ-9. Exercising less than three times per week (for a minimum of 30 minutes per session) over the past month Exclusion Criteria: Actively suicidal If a health care provider, AAHC staff member, or an investigator feel that participation in the program may endanger the participant's health or safety. Known mental or cognitive impairments Known condition that precludes their ability to feasibly participate in a support group session.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AAHC Excercise Program Support Group<br>Participants taking part in the AAHC Exercise Program Support Group (the intervention). | Behavioral: AAHC Exercise Program Support Group<br>* 6-week community-based, culturally tailored support group program, focusing on exercise and healthy lifestyle habits. Groups will also include basic psychoeducation about depression and depression care. Groups will have up to 20 participants and will meet weekly for 2 hours. By the end of the program, participants will be encouraged to create a personalized action plan focusing on exercise and other healthy lifestyle choices.<br>* Other names: Self-care;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in depression severity, as measured by the Depression Scale of the Patient Health Questionnaire (PHQ-9) |  | Week 1 (pre-test) and week 6 (post-test) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of exercise using the International Physical Activity questionnaire(IPAQ). |  | Week 1 and Week 6 | 
| Attitudes about exercise, exercise self-efficacy and readiness to exercise using physical activity assessment scale (PAAS). |  | Week 1 and Week 6 | 
| Use of guideline-concordant depression therapies |  | week 1 and week 6 | 
| Acceptability of antidepressant therapy and counseling |  | week 1 and week 6 | 
| Depression self-care behaviors |  | week 1 and week 6 | 
| Satisfaction with program |  | week 6 | 
| Attendance to sessions |  | Each week for 6 weeks | 
| Depression care self-efficacy |  | week 1 and week 6 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, African Americans, Exercise, Culturally tailored intervention, Health disparities