Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 4, 2019
Open Peer Review Period: Mar 7, 2019 - May 2, 2019
Date Accepted: Dec 16, 2019
(closed for review but you can still tweet)
Feasibility of a Walking Intervention Supplemented with mHealth Tools in Low-active Urban African American Women with Asthma
ABSTRACT
Background:
Asthma outcomes are worse among less physically active adults. African American women experience disparities in both physical inactivity and asthma relative to their Caucasian counterparts. We implemented a modified evidence-based walking intervention supplemented with mHealth technologies to help address barriers to physical activity.
Objective:
Assess the feasibility of a 7-week walking intervention modified for African American women with asthma and supplemented with mHealth tools.
Methods:
African American women with sub-optimally controlled asthma were identified from a health system serving primarily low-income minorities. At a baseline data collection visit, participants performed spirometry, incremental shuttle walk test, completed questionnaires, and were given an accelerometer to wear and return 1 week later. Participants received an intervention manual and attended three in-person group sessions over seven weeks led by a nurse interventionist in a community setting. The supplemental mHealth tools included a wearable activity tracker device (Fitbit Charge HR) and text messages related to physical activity and asthma three times per week. A secure web-based research platform, iCardia, was used to obtain Fitbit data in real-time (wear time, physical activity, sedentary time) and send text-messages. The feasibility of the intervention was assessed in the domains of recruitment capability, acceptability/suitability (adherence, retention, engagement, text messaging, acceptability, complaints/concerns) and preliminary outcome effects on physical activity behavior (change in steps, duration, and intensity) and asthma measures (control, quality of life).
Results:
Twenty-two women were approached, ten were eligible and seven consented and enrolled in the study. All seven participants completed the study. Group session attendance was 71%, 86% and 86%, respectively across the three sessions. All participants that attended the group sessions completed evaluations at each group session. The women reported being satisfied or very satisfied with aspects of the program (e.g. location, time and materials). Participants had no concerns about using the Fitbit device and felt comfortable charging and syncing the device with the Fitbit App. Participants wore their Fitbit for at least 10 hours per day almost 90% of the 49 intervention days. There was an increase in MVPA from baseline (19±14 minutes/week) to a peak of 27±17 minutes/week at week 6. A slight increase in step count was observed from week 1 (8926± 2156) to week 6 (9325± 2505).
Conclusions:
A 7-week community-based walking intervention tailored for African American women with asthma and supplemented with mHealth tools was feasible and showed modest improvements in MVPA and daily step counts. These findings support the conduct of a pilot trial to collect additional data on feasibility and estimate the efficacy of the intervention on asthma and physical activity outcomes. Clinical Trial: N/A
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