A Will Without a Way: Barriers and Facilitators to Exercise During Pregnancy of Low-Income, African American Women
ABSTRACT The objective of the authors in this study was to identify pregnant, low-income African American women's barriers and facilitators to exercise during pregnancy. A series of six focus groups with pregnant African American women were audio-recorded and transcribed verbatim. Focus group transcripts were qualitatively analyzed for major themes and independently coded for barriers and facilitators to exercise during pregnancy. A total of 34 pregnant, African American women participated in six focus groups from June through October of 2007. The majority of women were single (94%), had only a high school education (67%), received Medicaid (100%) and had a mean body mass index of 33 kg/m(2). All participants believed that exercise was beneficial during their pregnancy. However, participants faced multiple barriers including: (1) individual, (2) information, (3) resource, and (4) socio-cultural. African American women also described two facilitators to increase exercise during pregnancy: (1) group exercise classes, and (2) increasing the number of safe, low-cost exercise facilities in their communities. African American women living in low socioeconomic communities face several barriers to exercise during pregnancy. Targeted interventions to overcome barriers and facilitate exercise for this patient population should focus on increasing education from providers regarding the type and frequency of exercise recommended during pregnancy, enhancing social support networks with group exercise programs, and providing affordable and convenient locations to exercise.
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ABSTRACT: Objective: Low socioeconomic status (SES) is a risk factor for type 2 diabetes and changes in diet and physical activity can prevent diabetes. We assessed the effectiveness and acceptability of community-based dietary and physical activity interventions among low-SES groups in the UK. Method: We searched relevant databases and web resources from 1990 to November 2009 to identify relevant published and grey literature using an iterative approach, focusing on UK studies. Results: Thirty-five relevant papers (nine quantitative, 23 qualitative and three mixed methods studies) were data extracted, quality assessed and synthesised using narrative synthesis and thematic analysis. The relationship between interventions and barriers and facilitators was also examined. Dietary/nutritional, food retail, physical activity and multi-component interventions demonstrated mixed effectiveness. Qualitative studies indicated a range of barriers and facilitators, which spanned pragmatic, social and psychological issues. The more effective interventions used a range of techniques to address some surface-level psychological and pragmatic concerns, however many deeper-level social, psychological and pragmatic concerns were not addressed. Conclusion: Evidence on the effectiveness of community-based dietary and physical activity interventions is inconclusive. A range of barriers and facilitators exist, some of which were addressed by interventions but some of which require consideration in future research.Preventive Medicine 02/2013; 56(5). DOI:10.1016/j.ypmed.2013.02.023 · 3.09 Impact Factor
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ABSTRACT: Avondale, a disadvantaged neighborhood in Cincinnati, lags behind on a number of indicators of child well-being. Childhood obesity has become increasingly prevalent, as one-third of Avondale's kindergarteners are obese or overweight. The study objective was to determine perceptions of the quantity of and obstacles to childhood physical activity in the Avondale community. Caregivers of children from two elementary schools were surveyed to assess their child's physical activity and barriers to being active. Three hundred and forty surveys were returned out of 1,047 for a response rate of 32 %. On school days, 41 % of caregivers reported that their children spent more than 2 h watching television, playing video games, or spending time on the computer. While over half of respondents reported that their children get more than 2 h of physical activity on school days, 14 % of children were reported to be physically active less than 1 h per day. Caregivers identified violence, cost of extracurricular activities, and lack of organized activities as barriers to their child's physical activity. The overwhelming majority of caregivers expressed interest in a program to make local playgrounds safer. In conclusion, children in Avondale are not participating in enough physical activity and are exposed to more screen time than is recommended by the AAP. Safety concerns were identified as a critical barrier to address in future advocacy efforts in this community. This project represents an important step toward increasing the physical activity of children in Avondale and engaging the local community.Journal of Community Health 12/2013; 39(3). DOI:10.1007/s10900-013-9794-6 · 1.28 Impact Factor
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ABSTRACT: Low-income women are at risk for excessive gestational weight gain. Inactive lifestyle and lack of regular moderate exercise may contribute to the risk of weight gain. This study was conducted to (1) determine the rate and characteristics of low-income pregnant women who exercised regularly and met the American College of Obstetricians and Gynecologists recommendation and (2) describe how these women spent time for other physical activities compared with those who did not exercise regularly. Medicaid-recipient or uninsured pregnant women (n = 816) were asked to complete a physical activity questionnaire at rural and urban county health departments located in North Carolina. Twenty percent of low-income women met the American College of Obstetricians and Gynecologists recommendation for moderate exercise (≥10 METs-h/wk [metabolic equivalent task-hours per week]). The women who met the recommendation spent 3 hours 45 minutes per week walking as exercise, whereas those who did not meet the recommendation spent 1 hour per week (P < .0001). Women who exercised regularly spent longer hours at work (4.25 vs 1.75 hours per day; P = .019) and on household tasks (5.25 vs 4.0 hours per day; P = .002) than women who did not exercise regularly. Time spent on domestic and occupation activities does not seem to prohibit low-income women from engaging in moderate exercise on a regular basis.The Journal of perinatal & neonatal nursing 01/2014; 28(1):17-25. DOI:10.1097/JPN.0000000000000000 · 1.10 Impact Factor