Abstract
African American Women (AAW) are disproportionately impacted by both physical inactivity and asthma. The aims of this study were to: 1) understand barriers to physical activity among AAW with asthma; 2) obtain feedback from AAW on an evidence-based walking intervention; and 3) modify the intervention using input from AAW with asthma. Focus groups and interviews were conducted with sedentary AAW with uncontrolled asthma to identify barriers to walking. Women also suggestions for tailoring an existing walking intervention. Qualitative data were coded using domains from the Behavior Change Wheel and guided modifications of the existing walking intervention to tailor the content for sedentary AAW with asthma. Six focus groups (2-4 /group) and five interviews were completed. Women (n=20) represented an obese (37 kg/m2 ± 11), middle-aged (46 years ± 15) and low-income population. Barriers to physical activity were mapped to 8 theoretical domains: 1) Limited physical capability; 2) Lack of knowledge; 3) Lack of self-monitoring skills; 4) Complex decision making processes; 5) Lack of areas to walk; 6) Lack of social support; 7) Beliefs about consequences; 8) Beliefs about capability. To target these barriers, the existing walking intervention was modified to include an asthma education session, text messages, monthly group meetings, a walking session and informational materials. AAW with asthma reported unique barriers to engaging in physical activity. An assessment of the feasibility, acceptability and efficacy of a modified intervention that addresses these barriers is warranted to address physical inactivity and poor asthma outcomes among AAW with asthma.
Highlights
Engaging in regular physical activity has well-known health benefits, yet only 48% of Americans achieve recommended levels (≥150 minutes/week of moderate-vigorous physical activity) (Physical Activity Guidelines for Americans, 2008)
Using focus groups with African American women with asthma, we identified several unique barriers to engaging in physical activity that were modified in the physical activity program
This study is unique as it examines barriers to physical activity in a vulnerable segment of the asthma population that is not well represented in prior research—low income African American women with asthma—and adapts an intervention to target the barriers in a theoryinformed manner
Summary
Engaging in regular physical activity has well-known health benefits, yet only 48% of Americans achieve recommended levels (≥150 minutes/week of moderate-vigorous physical activity) (Physical Activity Guidelines for Americans, 2008). Based on the negative effects of physical inactivity on asthma and data that demonstrate the safety of and improved asthma clinical outcomes with physical activity, guidelines recommend patients with asthma engage in low to moderate intensity exercise at least 2 times per week (Carson et al, 2013; Durstine, Moore, Painter, & Roberts, 2009; Garcia-Aymerich, Varraso, Antó, & Camargo, 2009; Mendes et al, 2011; Nici et al, 2006). Despite the benefits of physical activity in asthma and guideline recommendations, individuals with asthma, women, are less likely to engage in physical activity than those without asthma (Avallone & McLeish, 2013; Durstine et al, 2009; Ford, Heath, Mannino, & Redd, 2003; Global Initiative for Asthma [GINA], 2006; Nici et al, 2006; van ‘T Hul et al, 2016)
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