JMIR Publications

ABSTRACT

Background:

Performing regular aerobic physical activity (PA) is an important component for healthy aging. Yet, only 27-40% of African American (AA) women achieve national PA guidelines. Available data also show clear decline in PA as AA women transition from young adulthood (i.e., 25-44 years) into midlife. This decline of PA among during midlife coincides with increased risk for AA women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary AA women during midlife.

Objective:

To examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among AA women aged 24-49, among a slightly older sample of midlife AA women aged 50-65.

Methods:

A single-arm pre-posttest study design was implemented. Twenty insufficiently active AA (i.e., >60 minutes/week of PA) women between the ages of 50 and 65 years participated in the 4-month feasibility trial. The intervention, entitled Smart Walk, was delivered through the study Smart Walk smartphone application and text messages. Features available on the Smart Walk app include: personal profile pages, multi-media PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and Social Cognitive Theory (SCT) mediators targeted by the intervention (i.e., self-regulation, behavioral capability, outcome expectations, self-efficacy, social support) were assessed at baseline and 4-months. Feasibility and acceptability were assessed using a post-intervention intervention satisfaction survey that included multiple choice and open-ended questions evaluating participant perceptions of the intervention and suggestions for intervention improvement. Wilcoxon signed-rank tests were used to examine pre-post intervention changes in PA and SCT variables. Effect size estimates were calculated using the Pearson r test statistic.

Results:

Participants increased in moderate-to-vigorous PA (median 30 minutes/week increase, r =1.0, p=.002) and reported improvements in two theoretical mediators (self-regulation, r=.397, p=.012; behavioral capability, r=.440, p=.006). Nearly all participants (93%) indicated they would recommend intervention to a friend. Participant suggestions for improving the intervention included enhancing the intervention’s provisions of social support for PA.

Conclusions:

Results provide preliminary support for feasibility of the smartphone-based approach to increase PA among middle-aged AA women. However, prior to larger scale implementation among midlife AA women, enhancements to the social support components of the intervention are warranted.