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Does Perceived Safety Modify the Effectiveness of a Walking-Group Intervention Designed to Promote Physical Activity?

ABSTRACT: PURPOSE:To examine whether perceived safety modified the effectiveness of the Walk Your Heart to Health (WYHH) intervention in promoting physical activity and reducing central adiposity in predominantly non-Latino black (henceforth black) and Latino communities. DESIGN:Generalized estimation equations were used to assess modifying effects of perceived safety on the route and perceived neighborhood safety on (1) WYHH participation at 8 weeks and 32 weeks, (2) associations between participation and physical activity, and (3) associations between physical activity and central adiposity. SETTING:Community-based and faith-based organizations in black and Latino communities. PARTICIPANTS:There were 603 adults, aged 18 years and older, who were predominantly black, Latino, and female. MEASURES:Participation and physical activity (piezoelectric pedometer) were measured at each walking session. Perceived safety on the route (questionnaire), perceived neighborhood safety (questionnaire), and waist circumference were measured at baseline, 8 weeks, and 32 weeks. ANALYSIS:Secondary analysis of repeated measures using generalized estimation equations. RESULTS:Retention was 90% at 8 weeks and 64% at 32 weeks. Perceived safety on the route, but not perceived neighborhood safety, dampened participation at 8 weeks but not 32 weeks. Consistent participation in the intervention increased physical activity and reduced central adiposity irrespective of perceived safety on the walking route or perceived neighborhood safety. CONCLUSION:Efforts to improve safety in conjunction with interventions focused on increasing physical activity can work toward improving physical activity for blacks and Latinos, leading to a myriad of improved health outcomes including reduced central adiposity.

SUBMITTER: Kwarteng JL

PROVIDER: S-EPMC6091212 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Does Perceived Safety Modify the Effectiveness of a Walking-Group Intervention Designed to Promote Physical Activity?

Kwarteng Jamila L JL Schulz Amy J AJ Mentz Graciela B GB Israel Barbara A BA Shanks Trina R TR Perkins Denise White DW

American journal of health promotion : AJHP 20170319 2

<h4>Purpose</h4>To examine whether perceived safety modified the effectiveness of the Walk Your Heart to Health (WYHH) intervention in promoting physical activity and reducing central adiposity in predominantly non-Latino black (henceforth black) and Latino communities.<h4>Design</h4>Generalized estimation equations were used to assess modifying effects of perceived safety on the route and perceived neighborhood safety on (1) WYHH participation at 8 weeks and 32 weeks, (2) associations between p ...[more]

PMID: 28317385

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Project description:BackgroundPhysical inactivity is a major risk factor for many chronic diseases including diabetes, cardiovascular diseases and some cancers. It is estimated that, in Australia, physical inactivity contributes to 13,500 annual deaths and incurs an annual cost of AU$ 21 billion to the health care system. The cost of physical inactivity to the Western Australian (WA) economy is estimated to be about AU$ 2.1 billion. Increased burden of physical inactivity has motivated health professionals to seek cost effective intervention to promote physical activity. One such strategy is encouraging general practitioners (GPs) to advocate physical activity to the patients who are at high risk of developing chronic diseases associated with physical inactivity. This study intends to investigate the cost-effectiveness of a subsidy program for GP advice to promote physical activity.MethodologyThe percentage of population that could potentially move from insufficiently active to sufficiently active, on GP advice was drawn from the Western Australian (WA) Premier's Physical Activity Taskforce (PATF) survey in 2006. Population impact fractions (PIF) for diseases attributable to physical inactivity together with disability adjusted life years (DALYs) and health care expenditure were used to estimate the net cost of intervention for varying subsidies. Cost-effectiveness of subsidy programs were evaluated in terms of cost per DALY saved at different compliance rates.ResultsWith a 50% adherence to GP advice, an annual health care cost of AU$ 24 million could be potentially saved to the WA economy. A DALY can be saved at a cost of AU $ 11,000 with a AU$ 25 subsidy at a 50% compliance rate. Cost effectiveness of such a subsidy program decreases at higher subsidy and lower compliance rates.ConclusionImplementing a subsidy for GP advice could potentially reduce the burden of physical inactivity. However, the cost-effectiveness of a subsidy program for GP advice depends on the percentage of population who comply with GP advice.

Project description:ObjectivesTo develop We Walk, a theoretically informed, 12-week person-centred dyadic behaviour change intervention to increase physical activity (PA) in community-dwelling people with stroke (PWS) through outdoor walking.DesignThree-phase intervention development study. Phase 1: we reviewed literature on barriers and facilitators to PA after stroke and mapped them to the Behaviour Change Wheel and Theoretical Domains Framework to define intervention components. The Health Action Process Approach determined intervention structure underpinned by person-centred principles. Phase 2: stakeholder focus groups involving PWS, their companions and health professionals reviewed the draft intervention, and experts in behaviour change were consulted. Phase 3: informed by phases 1 and 2, the intervention and form of delivery were refined, with final review through patient and public involvement.SettingThree Scottish community rehabilitation stroke services.ParticipantsTwenty-three ambulatory community-dwelling PWS and their companions, thirty-seven health and exercise professionals, seven behaviour change experts.ResultsPhase 1 determined key intervention components: information about benefits of walking; developing motivation and confidence to walk; facilitating dyadic goal setting and making plans together; monitoring walking, overcoming challenges; and maintaining walking behaviour. Phase 2 review by stakeholder focus groups and behaviour change experts endorsed intervention components and structure, emphasising dyadic relational aspects as central to potential success. In phase 3, intervention content and handbooks for PWS and buddies were finalised. Healthcare professionals proposed third-sector delivery as most appropriate for intervention delivery. A detailed delivery manual was developed. Participants preferred facilitated face-to-face and telephone delivery.ConclusionsOur multilens intervention development approach ensured this novel intervention was evidence-informed, person-centred, theoretically coherent provided appropriate social support, and addressed issues of concern to PWS. This study established intervention components and structure and identified operational issues critical to future success. Future research will pilot and refine We Walk and evaluate acceptability, feasibility, effectiveness and cost-effectiveness.Trial registration numberISRCTN34488928.

Project description:BackgroundUsing community engagement approaches to develop and deliver interventions targeting small-scale physical environmental improvements in neighbourhoods is a potential strategy for increasing walking for transport. This study aimed to qualitatively assess community perceptions of the implementation and impact of the Fitter for Walking (FFW) intervention, which encouraged communities to work together to improve the street environment on local routes and promote walking for transport.MethodsFrom 155 FFW community projects, nineteen were selected to take part in a focus group/interview using specified criteria: geographical area; level of community involvement; intervention activities; and project progress. Participants were invited to take part via the project coordinator or lead member of the community group. A written guide was used to initiate and direct discussions through key topics. Deductive and inductive approaches were used to analyse the data and identify key themes relating to the barriers and facilitators for implementation and the perceived impact of the intervention.ResultsFourteen focus groups and five interviews were conducted with 86 community members. Themes were identified in relation to barriers (poor area reputation and regeneration areas; engaging the local community; and working with local authorities) and facilitators (provision of a coordinator/facilitator; strong local partnerships; and using a range of communication and engagement activities) for programme implementation. Participants perceived the main impacts to be improved physical and social environments. Increases in walking for transport were rarely specifically commented on, but participants did report increased street use.ConclusionsCommunity perspectives provided important insights into the barriers and facilitators for the implementation of the FFW intervention and its' potential impacts. Using community engagement approaches can lead to perceived improvements in the physical and social environment resulting in increased street use, which may lead to increases in walking for transport in the longer-term. Recommendations are provided for researchers, practitioners and policy makers in planning and delivering future interventions. Future research should determine optimal implementation strategies, investigate the relative importance of improving physical environments, social environments and using individual behaviour change strategies, and determine how physical and social environments interact to maximise intervention impact on walking for transport.

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Does Perceived Safety Modify the Effectiveness of a Walking-Group Intervention Designed to Promote Physical Activity?

Publications

Does Perceived Safety Modify the Effectiveness of a Walking-Group Intervention Designed to Promote Physical Activity?

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