Many Americans are sedentary and would reduce their disease risk if they increased their levels of physical activity to 30 minutes of moderate activity most days of the week. This descriptive exploratory study addresses how to maximize adherence to a physical activity prescription. A sample of 14 older African American women enrolled in a walking intervention study participated in three focus-group discussions of barriers to and facilitators of walking. Focus groups were audiotaped, transcribed, and examined by three nurse researchers using analytic induction, content analysis, and grounded theory techniques. Women who participated in the focus-group discussions identified lack of family support, perceived or real family obligations, personal health status, and neighborhood safety as factors influencing adherence to physical activity. A necessary component of successful walking maintenance was the confidence and support of the woman's family. The most compelling reason for continued walking in this group was to help others.
"Doldren & Webb 2013 N = 40 AA women living in Broward County, FL; participants were aged 18–45 years, M age not reported. Dunn 2008 N = 14 AA women living in San Antonio, TX and surrounding areas, M age = 60.1 years. Eyler et al. 1998 Minority women from 5 different ethnic backgrounds living in California and Missouri, N of AA women not reported; participants were aged 40 years or older; M age not reported. "
[Show abstract][Hide abstract] ABSTRACT: A key aspect for researchers to consider when developing culturally appropriate physical activity (PA) interventions for African American (AA) women are the specific barriers AA women face that limit their participation in PA. Identification and critical examination of these barriers is the first step in developing comprehensive culturally relevant approaches to promote PA and help resolve PA-related health disparities in this underserved population. We conducted a systematic integrative literature review to identify barriers to PA among AA women. Five electronic databases were searched, and forty-two studies (twenty-seven qualitative, fourteen quantitative, one mixed method) published since 1990 (Range 1998-2013) in English language journals met inclusion criteria for review. Barriers were classified as intrapersonal, interpersonal, or environment/community according to their respective level of influence within our social ecological framework. Intrapersonal barriers included: lack of time, knowledge, and motivation; physical appearance concerns; health concerns; monetary cost of exercise facilities; and tiredness/fatigue. Interpersonal barriers included: family/caregiving responsibilities; lack of social support; and lack of a PA partner. Environmental barriers included: safety concerns; lack of facilities; weather concerns; lack of sidewalks; and lack of physically active AA role models. Results provide key leverage points for researchers to consider when developing culturally relevant PA interventions for AA women.
Women & Health 04/2015; 55(6). DOI:10.1080/03630242.2015.1039184 · 1.05 Impact Factor
"For example, in prior work, Dickson and others showed that, when other roles and responsibilities compete with self-care, decisions are affected (Dickson, McCauley, & Riegel, 2008; Dickson, Worrall- Carter, Kuhn, & Riegel, 2011). Others have described how roles and responsibilities linked to personal values and goals challenge preventive health behaviors (Bach Nielsen, Dyhr, Lauritzen, & Malterud, 2005; Cohen & Kataoka- Yahiro, 2009; Dunn, 2008) and treatment seeking (Turris & Johnson, 2008). "
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND:: Self-care of heart failure has been described as a naturalistic decision-making process, but the data available to defend this description are anecdotal. OBJECTIVES:: The aim of this study was to explore the process used by adults with chronic heart failure to make decisions about their symptoms. METHODS:: This was a secondary analysis of data obtained from four mixed methods studies. The full data set held qualitative data on 120 adults over the age of 18 years. For this analysis, maximum variation sampling was used to purposively select a subset of 36 of the qualitative interviews to reanalyze. RESULTS:: In this sample, equally distributed by gender, 56% Caucasian, between 40 and 98 years, the overarching theme was that decisions about self-care reflect a naturalistic decision-making process with components of situation awareness with mental simulation of a plausible course of action and an evaluation of the outcome of the action. In addition to situation awareness and mental simulation, three key factors were identified as influencing self-care decision making: (a) experience; (b) decision characteristics such as uncertainty, ambiguity, high stakes, urgency, illness, and involvement of others in the decision-making process; and (c) personal goals. DISCUSSION:: These results support naturalistic decision making as the process used by this sample of adults with heart failure to make decisions about self-care.
Nursing research 11/2012; 62(2). DOI:10.1097/NNR.0b013e318276250c · 1.36 Impact Factor
"Echoing findings in other studies (Dunn, 2008; Mier et al., 2007), our qualitative data indicated that Latino and Black participants preferred to exercise in supportive communities of people, and this was true of our Vietnamese participants as well. Evenson, Sarmiento, Tawney, Macon, and Ammerman (2003) reported that Latina women who knew others who exercised regularly were much more likely to exercise themselves. "
[Show abstract][Hide abstract] ABSTRACT: Many factors interact to create barriers to dietary and exercise plan adherence among medically underserved patients with chronic disease, but aspects related to culture and ethnicity are underexamined in the literature. Using both qualitative (n = 71) and quantitative (n = 297) data collected in a 4-year, multimethod study among patients with hypertension and/or diabetes, the authors explored differences in self-reported adherence to diet and exercise plans and self-reported daily diet and exercise practices across four ethnic groups-Whites, Blacks, Vietnamese, and Latinos-at a primary health care center in Massachusetts. Adherence to diet and exercise plans differed across ethnic groups even after controlling for key sociodemographic variables, with Vietnamese participants reporting the highest adherence. Food and exercise options were shaped by economic constraints as well as ethnic and cultural familiarity with certain foods and types of activity. These findings indicate that health care providers should consider ethnicity and economic status together to increase effectiveness in encouraging diverse populations with chronic disease to make healthy lifestyle changes.
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