Shop Talk: A Qualitative Study to Understand Peer Health-related Communication Among Black Men at the Barbershop.

BACKGROUND: While successful health promotion efforts among Black men have been implemented at barbershops, the focus has largely been on outcomes as opposed to the processes by which outcomes are produced. An understanding of processes can be leveraged in the design and implementation of future efforts to improve the health of Black men. PURPOSE: The objectives of the present study were to: (i) understand peer-derived sources of health-related support at the barbershop and (ii) understand the role of the barbershop in promoting health among Black men. METHODS: Seven focus groups were conducted at barbershops used predominately by Black men. Each focus group lasted between 45 and 60 min. Using a thematic approach, each focus group was independently coded by two coders using a codebook derived from an inductive and deductive approach. The results were confirmed with members of the community advisory board. RESULTS: Three themes emerged: (i) dynamic and candid exchange of health-related support at the barbershop; (ii) tailored forms of health-related and judgment-free communication that provide encouragement and increase motivation; and (iii) characteristics of a supportive environment at the barbershop that facilitate health-related communication. CONCLUSIONS: The findings of the present study offer a potential pathway for public health efforts seeking to improve health among Black men. Those interested in designing and implementing these efforts can create tailored programs for Black men by recognizing and leveraging the unique dynamics of health-related conversations at the barbershop.

For many Black men, barbershops are more than just a place for a haircut. Barbershops are community hubs that have transformed into safe places for difficult conversations about health. The goal of our study was to understand how Black men communicate about health at the barbershop. To address this goal, we conducted focus groups among the true experts­Black men. We asked them: (i) how do Black men communicate about health at the barbershop? (ii) what do Black men communicate about health at the barbershop? and (iii) what about the barbershop facilitates these conversations? These men indicated that barbershops are a place where Black men can openly and dynamically provide health support to one another through role modeling, passing of wisdom, and passive testimonials. They said their conversations about health are often judgment-free and tailored to provide encouragement and motivation. Finally, they said that the supportive atmosphere of the barbershop facilitates these types of conversations. Although barbershops have been sources of health-related support for Black men for generations, the findings from this study can be used by those developing health promotion programs (in partnership with barbershops) to promote health among Black men.

Compounding effects of stress on diet, physical activity, and wellbeing among African American parents: a qualitative study to inform the LEADS health promotion trial.

The purpose of the study was to conduct in-depth qualitative interviews to understand the lived experiences of African American parents of overweight adolescents who had previously participated in a family-based weight loss program and to utilize these insights to inform the essential elements of the LEADS trial, an integrated resilience stress management and health promotion intervention. Participants (N = 30) were African American parents and/or caregivers (96.7% female; Mage = 49.73, SD = 10.88; MBMI = 37.63, SD = 8.21) of adolescents with overweight and/or obesity. Interviews were transcribed and coded using inductive and deductive approaches for themes by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. Prominent stress themes included caregiver responsibilities, work, interpersonal family conflict, and physical and emotional consequences of chronic stress. Participants also noted decreases in physical activity and poor food choices due to stress. Coping mechanisms included prayer/meditation, church social support, and talking with family/partner. Results highlight the importance of mitigating stress among African American parents through stress management and cultural/familial resilience approaches to increase the likelihood of engagement in behavioral strategies in health promotion programs. Future studies should assess the utility of incorporating stress management components and health promotion techniques to improve health outcomes among African American families.

Buffering effects of protective factors on light and moderate-to-vigorous physical activity among african american women.

Physical activity (PA) plays an integral role in reducing risk for the leading causes of death and has also been shown to buffer stress. Based on the stress-buffering hypothesis, the present study examined whether protective factors (self-efficacy and informal social control) buffered the effects of perceived stress on PA over time. Secondary data analyses of female African American caregivers (N = 143) were conducted using data from the Families Improving Together (FIT) trial. Validated measures of stressors and protective factors were assessed at baseline. Light PA and moderate-to-vigorous PA were assessed using seven-day accelerometry estimates over sixteen weeks. Multilevel growth modeling was used to assess whether protective factors moderated the effects of perceived stress on PA outcomes across 16 weeks. There was a significant two-way interaction between informal social control and time (B = 0.40, SE = 0.17, p = .019) such that higher informal social control was positively associated with MVPA over time. There was a marginal three-way interaction (B = -18.90, SE = 10.31, p = .067) such that stress was associated with greater LPA at baseline under conditions of high but not low self-efficacy. This study provides preliminary support that social factors may be important for maintaining MVPA regardless of stress levels, while cognitive resources may be more important to target for influencing LPA engagement under conditions of high stress.

Engagement With Tailored Physical Activity Content: Secondary Findings From the Families Improving Together for Weight Loss Randomized Controlled Trial.

BACKGROUND: Web-based tailored interventions offer rich opportunities for improved access to and personalization of behavioral interventions. However, despite the promise of this approach, the engagement and underrepresentation of minority groups remain major issues. OBJECTIVE: This study evaluated whether engagement (log-in status and log-in duration) with different types of tailored behavioral content from the Families Improving Together for weight loss web-based intervention was associated with changes in moderate to vigorous physical activity (MVPA) among African American families with overweight or obesity. METHODS: Parent-adolescent dyads were randomized to a web-based tailored intervention or web-based health education comparison program. The web-based intervention (N=119) was completed by parents and targeted 6 weight-related behaviors to support their adolescent children's weight loss goals (session contents included energy balance, fast food, fruits and vegetables, physical activity [PA], sedentary behavior, and sweetened beverages). MVPA was measured using accelerometers at baseline and after the intervention. RESULTS: Using a hierarchical approach, the log-in status and duration for each web-based session were used to evaluate the additive effects of engagement with different types of tailored behavioral content on MVPA after the web-based intervention. Among parents, logging in to the PA session was not associated with greater MVPA (B=-12.561, 95% CI -18.759 to -6.367), but MVPA increased with greater log-in duration for the PA (B=0.008, 95% CI 0.004-0.012) and sedentary behavior (B= 0.008, 95% CI 0.004-0.012) sessions. These results suggest that parents who logged in to the PA session had lower MVPA, but MVPA increased with greater log-in duration for the PA and sedentary behavior sessions. These associations remained even after accounting for engagement with other content sessions. However, these engagement effects did not translate to the adolescents. CONCLUSIONS: The results of this study highlight the need to disentangle the impact of engagement with different tailored content to improve the efficacy of tailored web-based interventions, especially for promoting PA in African American families. TRIAL REGISTRATION: ClinicalTrials.gov NCT01796067; https://clinicaltrials.gov/ct2/show/NCT01796067.

Improving Recruitment, Retention, and Cultural Saliency of Health Promotion Efforts Targeting African American Men: A Scoping Review.

BACKGROUND: When health promotion efforts intend to include African American men, they experience challenges with recruitment and retention, in addition to limited cultural saliency-interventions that do not align the cultural preferences and experiences of the target population produce less effective results. PURPOSE: This scoping review provides an understanding of (a) how health promotion efforts among African American men are developed and implemented, in addition to the (b) main outcomes, (c) retention rates, and (d) methodological rigor of those efforts. METHODS: The following databases were used: PubMed, EMBASE (Ovid), PsycINFO (EBSCO), CINAHL (EBSCO), Web of Science (Clarivate), and ProQuest. Included studies were restricted to those: (a) conducted among African American men and (b) reported the effects of a health promotion intervention. Interventions using single-group pre-post study, post-test-only study, non-randomized controlled trial, and randomized controlled trial (RCT) study designs were included. RESULTS: The results indicate that varying degrees of customization in the design and implementation of health promotion efforts targeting African American can improve recruitment, retention, and health-related outcomes. Results draw attention to the need for community input when designing and implementing efforts targeting these men. CONCLUSIONS: These results indicate that opportunities exist to innovate health promotion efforts among African American men, such as the intentional incorporation of the community's values, perspectives, and preferences in the effort (i.e., cultural saliency) and explicitly indicating how the efforts were culturally tailored to improve saliency. Opportunities also exist to innovate health promotion efforts among African American men based on literature-derived best practices.

The Results of the Families Improving Together (FIT) for Weight Loss Randomized Trial in Overweight African American Adolescents.

BACKGROUND: Few intervention studies have integrated cultural tailoring, parenting, behavioral, and motivational strategies to address African American adolescent weight loss. PURPOSE: The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort study testing the efficacy of a cultural tailoring, positive parenting, and motivational intervention for weight loss in overweight African American adolescents (N = 241 adolescent/caregiver dyads). METHODS: The trial tested an 8-week face-to-face group motivational plus family weight loss program (M + FWL) compared with a comprehensive health education control program. Participants were then rerandomized to an 8-week tailored or control online program to test the added effects of the online intervention on reducing body mass index and improving physical activity (moderate-to-vigorous physical activity [MVPA], light physical activity [LPA]), and diet. RESULTS: There were no significant intervention effects for body mass index or diet. There was a significant effect of the group M + FWL intervention on parent LPA at 16 weeks (B = 33.017, SE = 13.115, p = .012). Parents in the group M + FWL intervention showed an increase in LPA, whereas parents in the comprehensive health education group showed a decrease in LPA. Secondary analyses using complier average causal effects showed a significant intervention effect at 16 weeks for parents on MVPA and a similar trend for adolescents. CONCLUSIONS: While the intervention showed some impact on physical activity, additional strategies are needed to impact weight loss among overweight African American adolescents.

Individual differences in the effects of the ACTION-PAC intervention: an application of personalized medicine in the prevention and treatment of obesity.

There is an increased interest in the use of personalized medicine approaches in the prevention or treatment of obesity, however, few studies have used these approaches to identify individual differences in treatment effects. The current study demonstrates the use of the predicted individual treatment effects framework to test for individual differences in the effects of the ACTION-PAC intervention, which targeted the treatment and prevention of obesity in a high school setting. We show how methods for personalized medicine can be used to test for significant individual differences in responses to an intervention and we discuss the potential and limitations of these methods. In our example, 25% of students in the preventive intervention, were predicted to have their BMI z-score reduced by 0.39 or greater, while at other end of the spectrum, 25% were predicted to have their BMI z-score increased by 0.09 or more. In this paper, we demonstrate and discuss the process of using methods for personalized medicine with interventions targeting adiposity and discuss the lessons learned from this application. Ultimately, these methods have the potential to be useful for clinicians and clients in choosing between treatment options, however they are limited in their ability to help researchers understand the mechanisms underlying these predictions.

The Moderating Effects of Social Support and Stress on Physical Activity in African American Women.

BACKGROUND: African American women participate in less physical activity (PA), have higher rates of chronic disease, and report higher perceived stress relative to other race and sex demographic groups. PURPOSE: Based on the stress-buffering hypothesis, this study tested the hypothesis that social support would buffer the negative effects of perceived stress on moderate-to-vigorous PA (MVPA) under high, but not low, perceived stress. METHODS: Participants were 143 African American women (mean [M] age = 43.94, standard deviation [SD] = 8.62; M body mass index = 37.94, SD = 8.11) enrolled in the Families Improving Together (FIT) for Weight Loss Trial. Average daily minutes of MVPA were obtained via 7 day accelerometer estimates at baseline and 8 and 16 weeks. RESULTS: A multilevel growth model demonstrated a significant three-way interaction between stress, social support, and time (B = -0.31, standard error [SE] = 0.14, p = .03). Simple slopes analyses revealed that, at baseline, among participants with high social support (+1 SD), stress was positively associated with greater MVPA (B = 0.49, SE = 0.18, p = .008), whereas among participants with low social support (-1 SD), stress was not significantly associated with MVPA (B = -0.04, SE = 0.14, p = .81). However, at 8 and 16 weeks, stress was not significantly associated with MVPA for either high or low support groups. CONCLUSIONS: Findings highlight the importance of integrating constructs of stress and social support into future physical activity intervention programs for African American women and the need to evaluate changes in stress and social support longitudinally.

Interaction of Neighborhood and Genetic Risk on Waist Circumference in African-American Adults: A Longitudinal Study.

BACKGROUND: Understanding determinants of metabolic risk has become a national priority given the increasingly high prevalence rate of this condition among U.S. adults. PURPOSE: This study's aim was to assess the impact of gene-by-neighborhood social environment interactions on waist circumference (WC) as a primary marker of metabolic risk in underserved African-American adults. Based on a dual-risk model, it was hypothesized that those with the highest genetic risk and who experienced negative neighborhood environment conditions would demonstrate higher WC than those with fewer risk factors. METHODS: This study utilized a subsample of participants from the Positive Action for Today's Health environmental intervention to improve access and safety for walking in higher-crime neighborhoods, who were willing to provide buccal swab samples for genotyping stress-related genetic pathways. Assessments were conducted with 228 African-American adults at baseline, 12, 18, and 24 months. RESULTS: Analyses indicated three significant gene-by-environment interactions on WC outcomes within the sympathetic nervous system (SNS) genetic pathway. Two interactions supported the dual-risk hypotheses, including the SNS genetic risk-by-neighborhood social life interaction (b = -0.11, t(618) = -2.02, p = .04), and SNS genetic risk-by-informal social control interaction (b = -0.51, t(618) = -1.95, p = .05) on WC outcomes. These interactions indicated that higher genetic risk and lower social-environmental supports were associated with higher WC. There was also one significant SNS genetic risk-by-neighborhood satisfaction interaction (b = 1.48, t(618) = 2.23, p = .02) on WC that was inconsistent with the dual-risk pattern. CONCLUSIONS: Findings indicate that neighborhood and genetic factors dually influence metabolic risk and that these relations may be complex and warrant further study. TRIAL REGISTRATION: NCT01025726.

Effects of Parenting and Perceived Stress on BMI in African American Adolescents.

OBJECTIVE: This study set out to examine the role of parenting practices in protecting or exacerbating the negative effects of parent and adolescent stress on adolescent body mass index (BMI) over time. Separate longitudinal models were conducted to evaluate how parenting practices interacted with parental perceived stress and adolescent perceived stress in predicting adolescent BMI. METHODS: Baseline data were collected from 148 African American adolescents (Mage = 12.93, SD = 1.75; Mz-BMI = 0.78, SD = 0.50; MBMI%-ile = 96.7, SD = 3.90) and their caregivers (Mage = 44.45, SD = 8.65; MBMI = 37.63, SD = 8.21) enrolled in the Families Improving Together for Weight Loss trial. Adolescents self-reported their perceptions of caregiver parenting style and feeding practices. Both caregivers and adolescents self-reported their perceptions of chronic stress. BMI for parents and adolescents was assessed objectively at baseline and 16 weeks post-intervention. RESULTS: Hierarchical regression models predicting adolescent BMI z-score (z-BMI) indicated a significant interaction between parental perceived stress and parental pressure to eat. Simple slopes analyses demonstrated that for those parents that exhibit higher pressure to eat, parent stress was positively associated with adolescent z-BMI. CONCLUSIONS: These findings provide preliminary support suggesting that certain parenting practices interact with chronic stress on adolescent weight-related outcomes and that future interventions may consider integrating these factors.

Associations of parenting factors and weight related outcomes in African American adolescents with overweight and obesity.

This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16 years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity.

The role of parental support for youth physical activity transportation and community-level poverty in the healthy communities study.

This study evaluates whether parental provision of transportation for physical activity is associated with child/adolescent moderate-to-vigorous physical activity, while also evaluating community-level poverty. Self- and parental-reported surveys were administered with parents/caregivers and children in the Healthy Communities Study (N = 5138). Associations between individual-level demographics, community-level poverty, parental provision of transportation for physical activity, and moderate-to-vigorous physical activity were examined in multi-level models. Even when accounting for community-level poverty, which was significantly associated with lower moderate-to-vigorous physical activity, parental provision of transportation for physical activity was positively associated with greater moderate-to-vigorous physical activity. This study provides evidence for the importance of considering multiple systems of influence (e.g., community and individual factors) and considering how gaps in physical activity transportation for youth can be addressed in future health policies.

Connect through PLAY: a randomized-controlled trial in afterschool programs to increase adolescents' physical activity.

The current study is a randomized controlled trial to test a novel 10-week climate-based intervention within pre-existing afterschool programs, designed to increase moderate-to-vigorous physical activity (MVPA) in underserved (low-income, minority status) middle school youth by addressing youth social developmental needs. Participants (n = 167; 56% female; 62% Black; 50% overweight/obese) enrolled in 6 middle schools were randomized to either the Connect through PLAY intervention or a wait-list control. Process evaluation measures (i.e., observations of external evaluators; staff surveys) indicated that essential elements were implemented with fidelity, and staff endorsed implementation ease/feasibility and acceptability. Regression analysis demonstrated that participation in the intervention (vs. control) was associated with an increase of 8.17 min of daily accelerometry-measured MVPA (56 min of additional weekly MVPA) at post-intervention controlling for baseline MVPA, school, gender, and weight status. The results provide support for social-motivational climate-based interventions for increasing MVPA in underserved youth that can inform future school-based health initiatives.Trial Registration: NCT03850821: https://clinicaltrials.gov/ct2/show/study/NCT03850821?term=NCT03850821&rank=1.

The Feasibility and Acceptability of the Developing Real Incentives and Volition for Exercise (DRIVE) Program: A Pilot Study for Promoting Physical Activity in African American Women.

Background. The purpose of the current article is to demonstrate how formative process evaluation was used in a pilot study to optimize the design and implementation of two motivationally targeted community-based physical activity (PA) interventions for inactive African American women. Method. Fifteen African American women (M age: 41.6 years) were randomized to a challenge-focused program targeted toward high autonomous motivation or a rewards-focused program targeted toward low autonomous motivation. The challenge-focused program targeted enjoyment and valuation of PA and a team-based positive social climate through competitive intergroup activities and team-based goals, whereas the rewards-focused program targeted PA interest, competency, and partner-based social support through a walking program, individual-based goals with financial incentives, and partner-based action-plans. Results. Feedback from participants revealed high levels of acceptability of essential elements. Average weekly attendance exceeded the a priori goal of ≥75% of members in attendance each week. External systematic observation demonstrated that session content dose was ≥93% in both programs. Facilitator-level fidelity exceeded the a priori goal of averaging ≥3 on a 4-point scale for behavioral skills, communication, autonomy support, and session content. The process evaluation also revealed areas for improvement, including facilitator-level social support and behavioral skills at the group-level. Process data collected through FitBits revealed that participants were engaged in self-monitoring PA during the 6-week programs. Conclusions. The formative process evaluation demonstrated adequate levels of feasibility and acceptability and also provided key insights into adjustments needed before proceeding with implementing the motivationally targeted group-based programs in a larger randomized study.

Web-Based Program Exposure and Retention in the Families Improving Together for Weight Loss Trial.

BACKGROUND: Interventions that incorporate behavioral skills training and parental involvement have been effective for promoting weight loss among middle and upper class youth; however, few studies have produced similar weight loss effects in underserved ethnic minority youth. PURPOSE: This study examined whether online program exposure (in both an online tailored intervention and an online health education comparison program) predicted greater retention among African American youth and their parents in the Families Improving Together (FIT) for Weight Loss trial. METHODS: Parent-adolescent dyads (N = 125) were randomized to either an online tailored intervention program (n = 63) or an online health education comparison program (n = 62). Paradata including login data were used to determine the number of sessions viewed (0-8) and the number of minutes spent online per session. Study retention, defined as collection of adolescent anthropometric measures at 6 months postintervention, was the outcome. RESULTS: Logistic regression analyses showed a significant effect for login rate on retention (OR = 1.21, 95% CI [1.04, 1.39]). Total number of sessions viewed, child age, child sex, parent age, and parent sex accounted for 11% of the variance in retention at 6 months post- intervention. Participants who were retained spent a significantly greater number of minutes during each session (M = 12.99, SD = 11.63) than participants who were not retained (M = 7.77, SD = 11.19), t(123) = 2.24, p = .027, d = 0.45. CONCLUSIONS: The use of paradata from online interventions is a novel and feasible approach for examining exposure in web-based interventions and program retention in underserved ethnic minority families. TRIAL REGISTRATION: ClinicalTrials.gov NCT01796067. Registered January 23, 2013.

Secondary benefits of the families improving together (FIT) for weight loss trial on cognitive and social factors in African American adolescents.

BACKGROUND: Although weight loss is an important primary outcome in obesity interventions, family-based interventions may have cascading ripple effects that extend to other aspects of health and well-being. Identifying these secondary benefits may be useful for understanding how to best engage underserved African American families in weight loss. The present research examines whether African American adolescents and parents perceive secondary benefits from participating in a family-based weight-loss intervention, including secondary health, social, or cognitive benefits. METHODS: Qualitative data were obtained from families participating in the group-based intervention of the Families Improving Together (FIT) for Weight Loss trial. During the final week of the face-to-face motivational and family-based intervention program, families completed a guided open-ended group discussion about changes they experienced from participating (14 groups, N = 41 adolescents and 41 parents). Sessions were audiotaped, transcribed, and coded by independent pairs of raters using both inductive and deductive approaches. Guided by the multi-theoretical framework for the FIT trial, some themes were determined prior to coding using a deductive approach, including: (a) health outcomes (e.g., monitoring strategies for diet and physical activity), (b) social outcomes (e.g., involvement in family support, group support, autonomy support, family bonding, positive communication) and (c) cognitive outcomes (e.g., expression of self-confidence through self-efficacy, self-regulation, establishment of long-term goals). In addition to these pre-determined themes, the coding process included an inductive assessment, allowing for unexpected themes to surface as well around positive self-talk, relapse prevention, and monitoring strategies for different types of weight-related behaviors. RESULTS: Across both adolescents and parents, the cognitive outcomes were the most frequently discussed outcomes, including self-regulation, monitoring strategies for diet, establishing long-term goals, and ultimate relapse prevention. Parents made a greater number of comments about the social outcomes, including family support, group support, self-efficacy, and family connectedness, whereas adolescents made a greater number of comments about positive family communication. CONCLUSIONS: The results provide preliminary support for the positive secondary effects of weight loss programs on improving both cognitive and social well-being in underserved African American adolescents. TRIAL REGISTRATION: ClinicalTrials.gov # NCT01796067. https://clinicaltrials.gov/ct2/show/NCT01796067?term=NCT01796067&rank=1 The trial was registered on February 21, 2013 and the first participant was enrolled July 12, 2013.

Associations Between Parenting Factors, Motivation, and Physical Activity in Overweight African American Adolescents.

Background: Positive parenting practices and environmental supports have been linked to physical activity (PA) levels in youth, yet factors associated with positive parenting styles have been understudied in African American adolescents. Purpose: This study expands on previous literature by examining associations between motivation, parenting factors associated with Self-Determination Theory's psychological needs (competence, autonomy, and relatedness) including authoritative parenting, autonomy support and emotional and tangible support, and adolescent moderate-to-vigorous PA (MVPA) and light PA (LPA). Methods: Participants were African American adolescents (N = 148; Mage = 13.6 years; MBMI% = 96.6) and their care-givers (Mage = 43.4 years; MBMI = 37.4) enrolled in the Families Improving Together for Weight Loss trial. Parenting factors were measured using self-report surveys, and PA minutes were measured using 7-day accelerometry estimates. Results: Regression analyses indicated that overall models for MVPA (F(11,134) = 4.35; R2 = 0.26) and LPA (F(11,134) = 5.84, R2 = 0.32) were significant. Adolescent motivation for PA (B = 0.58, SE = 0.16) was positively associated with MVPA minutes. Authoritative parenting (B = 15.71, SE = 4.38) and tangible support (B = 8.53, SE = 4.02) were positively associated with adolescent LPA minutes. Unexpectedly, emotional support was negatively associated with both MVPA (B = -0.47, SE = 0.17) and LPA (B = -11.22, SE = 4.79), with follow-up analyses showing this relationship stronger in males. Conclusion: Findings highlight the importance of adolescent motivation for PA onMVPA and positive parenting styles and tangible supports on adolescent LPA in overweight African American youth. Recommendations for integrating these factors within the context of intervention studies are discussed.

Project SHINE: effects of a randomized family-based health promotion program on the physical activity of African American parents.

This study examined the effects of a family-based health promotion intervention on the moderate-to-vigorous physical activity (MVPA), light physical activity, sedentary behavior, and fruit and vegetable intake of African American parents. Eighty-nine African American parents (41.5 ± 8.5 years; 92% females; 74% obese; 64% < $40 K income) and adolescents (12.5 ± 1.4 years; 61% girls; 48% obese) were randomized to a 6-week behavioral skills plus positive parenting and peer monitoring intervention grounded in social cognitive, self-determination, and family systems theories or a general health comparison program. Parents wore accelerometers for 7 days and completed three 24-h dietary recalls at baseline and post-intervention. Multilevel regression models (controlling for baseline variables) demonstrated a significantly greater increase in parent MVPA for those in the intervention versus comparison condition (b = 9.44, SE = 4.26, p < 0.05). There were no other significant effects. Family-based approaches that include African American parents and youth may increase parent MVPA and hold promise for preventing chronic diseases.

Longitudinal relationships between self-concept for physical activity and neighborhood social life as predictors of physical activity among older African American adults.

BACKGROUND: Engaging in regular physical activity (PA) as an older adult has been associated with numerous physical and mental health benefits. The aim of this study is to directly compare how individual-level cognitive factors (self-efficacy for PA, self-determined motivation for PA, self-concept for PA) and neighborhood perceptions of the social factors (neighborhood satisfaction, neighborhood social life) impact moderate-to-vigorous physical activity (MVPA) longitudinally among older African American adults. METHODS: Data were analyzed from a sub-set of older African American adults (N = 224, M age = 63.23 years, SD = 8.74, 63.23% female, M Body Mass Index = 32.01, SD = 7.52) enrolled in the Positive Action for Today's Health trial. MVPA was assessed using 7-day accelerometry-estimates and psychosocial data (self-efficacy for PA, self-determined motivation for PA, self-concept for PA, neighborhood satisfaction, neighborhood social life) were collected at baseline, 12-, 18-, and 24-months. RESULTS: Multilevel growth modeling was used to examine within- and between-person effects of individual-level cognitive and social environmental factors on MVPA. At the between-person level, self-concept (b = 0.872, SE = 0.239, p < 0.001), and neighborhood social life (b = 0.826, SE = 0.176, p < 0.001) predicted greater MVPA, whereas neighborhood satisfaction predicted lower MVPA (b = -0.422, SE = 0.172, p = 0.015). Among the between-person effects, only average social life was moderated by time (b = 0.361, SE = 0.147, p = 0.014), indicating that the impact of a relatively positive social life on MVPA increased across time. At the within-person level, positive increases in self-concept (b = 0.294, SE = 0.145, p = 0.043) and neighborhood social life (b = 0.270, SE = 0.113, p = 0.017) were associated with increased MVPA. CONCLUSIONS: These results suggest that people with a higher average self-concept for PA and a more positive social life engaged in greater average MVPA. Additionally, changes in perceptions of one's neighborhood social life and one's self-concept for PA were associated with greater MVPA over 2 years. These factors may be particularly relevant for future interventions targeting long-term change and maintenance of MVPA in older African Americans. TRIAL REGISTRATION: ClinicalTrials.Gov # NCT01025726 registered 1 December 2009.