Outcomes of a Home-based Walking Program for African American Women

Although physical inactivity is common among women regardless of ethnic background, the prevalence is much greater in African American women compared to White American women (33.9% vs. 21.6%). The purpose of this study was to compare the effectiveness at 24 and 48 weeks of a home-based moderate-intensity walking intervention enhanced by behavioral strategies targeted and tailored to midlife, low to moderate income, urban African American women (Enhanced Treatment, ET), as compared to a Standard Treatment (ST) on adherence, physical activity, aerobic fitness and body composition. Using a quasi-experimental design, treatments were randomly assigned to one of two federally qualified community health centers located in predominately African American low-come communities. Participants included 281 sedentary, healthy, women (156 ET, 125 ST) aged 40-65 who were recruited within a 3-mile radius of the centers and beyond through social networking. Both treatments had a common orientation video filmed in the community with community women. The ET intervention was guided by the Interaction Model of Client Health Behavior. Previously successful strategies based on Social Cognitive Theory and the Transtheoretical Model were incorporated. The ET had 4 targeted workshops followed by weekly tailored telephone calls over 24 weeks. Generalized linear mixed models tested the effects of the treatments on adherence (walking logs, heart rate monitors, telephone response system), self-reported physical activity, aerobic fitness (time on treadmill), and body composition (BMI, waist circumference) over time. Seventy percent of the women were obese or extremely obese. Adherence and completed assessments were higher in the ET than the ST group. Adherence in the ET group was related to the number of workshops attended (r2=.58) and tailored telephone calls (r2=.25) completed. Both treatment groups increased fitness, maintained weight and had modest positive changes in waist circumference. Limitations included random assignment of the interventions to sites and no objective measure of lifestyle activity. Findings suggest the potentially powerful impact of workshop group support on increasing adherence in African American women.