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Process evaluation of a culturally-tailored physical activity intervention in African-American mother-daughter dyads.

ABSTRACT: The purpose of this study was to describe process evaluation data including intervention fidelity, dosage, quality, participant responsiveness, and program reach for the Mothers And dauGhters daNcing togEther Trial (MAGNET) in Springfield, MA, in Spring 2013 and 2014. Seventy-six mother-daughter dyads were randomized to the mother-daughter group (CH-M, n = 28), the child-only group (CH, n = 25), or the health education group (CON, n = 23). CH-M consisted of 60 min of moderate-to-vigorous culturally-tailored dance classes for dyads. CH consisted of dance classes for the child. All groups received homework tutoring and weekly health newsletters. Process evaluation data were assessed at each intervention session (three days/week, 6-months) with semi-structured questionnaires by researchers. CH dance classes were slightly longer (58.2 ± 3.5 min) than CH-M (54.4 ± 5.5 min). In both groups, participants spent the majority of the dance intervention in light intensity physical activity (PA). Participants in the CH-M group enjoyed participating in MAGNET > 90% of the time. Mothers (92%) indicated that they wanted to continue dance as a form of PA. Mothers expressed that transportation, time commitment, and assessments were barriers to participation. Participants suggested future interventions should include longer intervention length and more communications between research staff and mothers. The MAGNET intervention matched the originally intended program in most aspects. A lower intervention dose was delivered to the CH-M group potentially due to barriers described by mothers. Because mother-daughter interventions have shown minimal effects on increasing PA, it is imperative that researchers utilize process evaluation data to shape future studies.

SUBMITTER: Burkart S

PROVIDER: S-EPMC5577404 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Process evaluation of a culturally-tailored physical activity intervention in African-American mother-daughter dyads.

Burkart Sarah S St Laurent Christine W CW Alhassan Sofiya S

Preventive medicine reports 20170818

The purpose of this study was to describe process evaluation data including intervention fidelity, dosage, quality, participant responsiveness, and program reach for the Mothers And dauGhters daNcing togEther Trial (MAGNET) in Springfield, MA, in Spring 2013 and 2014. Seventy-six mother-daughter dyads were randomized to the mother-daughter group (CH-M, n = 28), the child-only group (CH, n = 25), or the health education group (CON, n = 23). CH-M consisted of 60 min of moderate-to-vigorous cultura ...[more]

PMID: 28879073

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Project description:BackgroundAfrican American youth (aged 8-14 years) do not adhere to national dietary and physical activity guidelines. Nonadherence to these recommendations contributes to disproportionate rates of obesity compared with their white counterparts. Culturally tailored electronic health (eHealth) solutions are needed to communicate nutrition and physical activity messages that resonate with this target population.ObjectiveThis study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African American mother-child dyads.MethodsStatistical analysis included paired sample t tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska's Stages of Change toward the following 4 behaviors were assessed with pre- and posttest surveys: (1) fruit and vegetable selection on my plate, (2) meal preparation, (3) fruit and vegetable selection outside of home, and (4) physical activity. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes.ResultsA final sample size of 93 mother-child dyads completed the study. Mothers reported significant improvement from precontemplation or contemplation stages to preparation or action stages for (1) fruit and vegetable selection on her plate (P=.03), (2) meal preparation for her family (P=.01), (3) fruit and vegetable selection outside the home (P<.001), and (4) physical activity (P<.001). Significant improvements were found in knowledge, stage of change, and self-efficacy for the 4 target behaviors of interest (P<.001). Children's open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos.ConclusionsCulturally adapted cartoons that incorporate tailored preferences by African American families, such as race or demography, may help increase adherence to target health behaviors when developing eHealth behavior solutions.

Project description:BackgroundRegular aerobic physical activity (PA) is an important component of healthy aging. However, only 27%-40% of African American women achieve national PA guidelines. Available data also show a clear decline in PA as African American women transition from young adulthood (ie, 25-44 years) into midlife. This decline in PA during midlife coincides with an increased risk for African American women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary African American women during midlife.ObjectiveThis study aims to examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among African American women aged 24-49 years, among a slightly older sample of midlife African American women aged 50-65 years.MethodsA single-arm pretest-posttest study design was implemented. In total, 20 insufficiently active African American (ie, ≤60 min per week of PA) women between the ages of 50-65 years participated in the 4-month feasibility trial. The Smart Walk intervention was delivered through the study Smart Walk smartphone app and text messages. Features available on the Smart Walk app include personal profile pages, multimedia PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and social cognitive theory mediators targeted by the intervention (ie, self-regulation, behavioral capability, outcome expectations, self-efficacy, and social support) were assessed at baseline and at 4 months. Feasibility and acceptability were assessed using a postintervention 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- and postintervention changes in the PA and social cognitive theory variables. The effect size estimates were calculated using the Pearson r test statistic.ResultsParticipants increased moderate-to-vigorous PA (median 30 minutes per week increase; r=0.503; P=.002) and reported improvements in 2 theoretical mediators (self-regulation: r=0.397; P=.01; behavioral capability: r=0.440; P=.006). Nearly all participants (14/15, 93% completing the satisfaction survey) indicated that they would recommend the intervention to a friend. Participants' suggestions for improving the intervention included enhancing the intervention's provisions of social support for PA.ConclusionsThe results provide preliminary support for the feasibility of the smartphone-based approach to increase PA among midlife African American women. However, before larger-scale implementation among midlife African American women, enhancements to the social support components of the intervention are warranted.Trial registrationClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355.

Project description:Background/objectiveParents shape children's early experiences with food, influencing what is served, children's food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers' infant feeding practices.MethodsPrimiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not).ResultsRP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2-0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe.ConclusionsResponsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls.Trial registrationSleep SAAF: A Strong African American Families Study. www.Clinicaltrialsgov NCT03505203. Registered 3 April 2018.

Dataset Information

Process evaluation of a culturally-tailored physical activity intervention in African-American mother-daughter dyads.

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Process evaluation of a culturally-tailored physical activity intervention in African-American mother-daughter dyads.

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