Sisters in Motion: A Randomized Controlled Trial of a Faith-Based Physical Activity Intervention

Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA.
Journal of the American Geriatrics Society (Impact Factor: 4.57). 10/2010; 58(10):1863-9. DOI: 10.1111/j.1532-5415.2010.03082.x
Source: PubMed


To evaluate a faith-based intervention (Sisters in Motion) intended to increase walking in older, sedentary African-American women.
Randomized controlled trial using within-church randomization.
Three Los Angeles churches.
Sixty-two African-American women aged 60 and older who reported being active less than 30 minutes three times per week and walked less than 35,000 steps per week as measured using a baseline pedometer reading.
Intervention participants received a multicomponent curriculum including scripture readings, prayer, goal-setting, a community resource guide, and walking competitions. Intervention and control participants both participated in physical activity sessions.
The primary outcome was change in weekly steps walked as measured using the pedometer. Secondary outcomes included change in systolic blood pressure (SBP). Outcomes were assessed at baseline and 6 months after the intervention.
Eighty-five percent of participants attended at least six of eight sessions. Intervention participants averaged 12,727 steps per week at baseline, compared with 13,089 steps in controls. Mean baseline SBP was 156 mmHg for intervention participants and 147 mmHg for controls (P=.10). At 6 months, intervention participants had increased their weekly steps by 9,883 on average, compared with an increase of 2,426 for controls (P=.02); SBP decreased on average by 12.5 mmHg in intervention participants and only 1.5 mmHg in controls (P=.007).
The Sisters in Motion intervention led to an increase in walking and a decrease in SBP at 6 months. This is the first randomized controlled trial of a faith-based physical activity program to increase physical activity in older African-American women and represents an attractive approach to stimulate lifestyle change in this population.

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Available from: Mei Leng, Apr 15, 2014
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    • "Nevertheless, further exploration is needed to understand how much impact this fatalism has on walking as a potential barrier among Korean immigrants, and whether it can be changed into a positive attitude towards walking through innovative interventions, such as spiritually based interventions. In the African American population, church-based exercise programmes resulted in positive outcomes (Baruth et al., 2008; Duru et al., 2010). This study identified important topic areas of interest among Korean immigrant seniors that may be useful for stroke prevention education tailored for this specific demographic: causes of stroke, symptoms, emergency treatment and prevention measures. "
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    ABSTRACT: To gain better understanding of (i) beliefs and knowledge about stroke; (ii) attitudes about walking for stroke prevention; and (iii) barriers and facilitators to walking among Korean seniors for the cultural tailoring of a stroke prevention walking programme. Physical inactivity is a major risk factor for stroke. Korean immigrant seniors are one of the most sedentary ethnic groups in the United States. An explorative study using focus group data. Twenty-nine Korean immigrant seniors (64–90 years of age) who had been told by a doctor at least once that their blood pressure was elevated participated in 3 focus groups. Each focus group consisted of 8–11 participants. Focus group audiotapes were transcribed and analysed using standard content analysis methods. Participants identified physical and psychological imbalances (e.g. too much work and stress) as the primary causes of stroke. Restoring ‘balance’ was identified as a powerful means of stroke prevention. A subset of participants expressed that prevention may be beyond human control. Overall, participants acknowledged the importance of walking for stroke prevention, but described barriers such as lack of personal motivation and unsafe environment. Many participants believed that providing opportunities for socialisation while walking and combining walking with health information sessions would facilitate participation in and maintenance of a walking programme. Korean immigrant seniors believe strongly that imbalance is a primary cause of stroke. Restoring balance as a way to prevent stroke is culturally special among Koreans and provides a conceptual base in culturally tailoring our stroke prevention walking intervention for Korean immigrant seniors. A stroke prevention walking programme for Korean immigrant seniors may have greater impact by addressing beliefs about stroke causes and prevention such as physical and psychological imbalances and the importance of maintaining emotional well-being.
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    • "Although previous studies have identified lack of motivation as a primary barrier to physical activity among older minority women (Eyler et al., 1998; Juarbe, Turok, & P erez-Stable, 2002; Wilcox, 2002), this was not a major perceived barrier among our female participants. Other reported barriers and facilitators to walking are consistent with previous research, such as chronic conditions and pain as walking barriers and health benefit, safe neighborhoods, and social context (e.g., having others to exercise with) as walking facilitators (Belza et al., 2004; Duru, Sarkisian, Leng, & Mangione, 2010; Kowal & Fortier, 2007; Mathews et al., 2010; O'Brien Cousins, 2000). Our findings support the following conclusion from Pudrovska's study on gender differences in internal health locus of control: women, especially older women, have higher internal health locus of control beliefs than men (Pudrovska, 2015). "
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    ABSTRACT: Objective: To inform the development of a tailored behavioral stroke risk reduction intervention for ethnic minority seniors, we sought to explore gender differences in perceptions of stroke prevention and physical activity (walking). Methods: In collaboration with community-based organizations, we conducted 12 mixed-gender focus groups of African American, Latino, Chinese, and Korean seniors aged 60 years and older with a history of hypertension (89 women and 42 men). Transcripts were coded and recurring topics compared by gender. Results: Women expressed beliefs that differed from men in 4 topic areas: 1) stroke-related interest, 2) barriers to walking, 3) facilitators to walking, and 4) health behavior change attitudes. Compared with men, women were more interested in their role in response to a stroke and post-stroke care. Women described walking as an acceptable form of exercise, but cited neighborhood safety and pain as walking barriers. Fear of nursing home placement and weight loss were identified as walking facilitators. Women were more prone than men to express active/control attitudes toward health behavior change. Conclusions: Older ethnic minority women, a high-risk population for stroke, may be more receptive to behavioral interventions that address the gender-specific themes identified by this study.
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    • "Based on sample size/power analytic methods for repeated measures analysis [47, 48], using a 2-sided test with a type I error of 0.05, and a type II error of 0.2 (power 80 %), and assuming an average 2.7 data points per subject and an auto-correlation at 0.2 level, after adjusting for clustering, the effective sample size will be 96 subjects in each arm, which will enable us to detect effect sizes as small as 581 steps/day (far below a clinically meaningful increase of 5000 steps/day [49]) and 5.3 mm Hg. A decrease of 5 mm Hg substantially decreases stroke risk [50] and is comparable to effect sizes observed in walking interventions of similar intensity [51]. "
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