Determinants of Physical Activity Among Black Women During Pregnancy.

OBJECTIVE: To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN: Longitudinal cohort. SETTING: Medical center obstetric clinic. PARTICIPANTS: Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS: Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS: Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.

A study protocol for e-PainSupport: The use of a digital application for reporting pain and pain management in home hospice.

High pain intensity is commonly experienced by patients with serious advanced illness. Impediments to improving pain intensity in home hospice include poor adherence to a pain management regimen due to caregivers' lack of knowledge and self-efficacy (confidence) in administering analgesics. e-PainSupport is a self-administered, digital application directly linked to patients' medical records. It has three elements: Education Module, Patient Pain Record, and the Pain Summary for Nurses. This study will test the effects of e-PainSupport on pain intensity when used by patients, caregivers, and nurses. The study's specific aims are as follows: Aim 1, compare the effects of e-PainSupport to a standard care condition, controlling for covariates (role [patient or caregiver], age, sex, ethnicity, education, and patient's diagnosis), on clinical improvement in pain intensity (primary outcome) and significant improvement on a pain intensity scale (secondary outcome); Aim 2, examine the mediating effects of patient and caregiver knowledge, self-efficacy, and adherence on change in pain intensity during 2 weeks, controlling for covariates and treatment condition; and Aim 3, identify nurses' perceptions of the use of e-PainSupport, including facilitators for and barriers to integration into agency workflow and benefits for patients. Participants (132 triads of patients, caregivers, and hospice nurses) will be recruited from Midwest hospice agencies. Patient and caregiver outcomes will be assessed at baseline and 2 weeks later. Data will be analyzed with multilevel modeling. Post-intervention, semi-structured interviews with nurses in the e-PainSupport condition will be analyzed using qualitative content analysis to identify perceived practice changes. e-PainSupport has the potential to facilitate nurse-patient communication and improve hospice patient pain management.

e-PainSupport: A Digital Pain Management Application for Home Hospice Care.

e-PainSupport is a digital pain management application (app) designed to facilitate better pain management in hospice. Early testing revealed caregivers found it was easy to use and successful in communicating patient pain and caregiver administration of analgesics to hospice nurses. However, caregiver knowledge of analgesic management remained low. The purpose of this study was to enhance e-PainSupport by (a) adapting and integrating an evidence-based pain educational intervention; (b) increasing ease of accessing and navigating the app; and (c) facilitating app communication with agency electronic health records (EHRs). An advisory board method, including two key stakeholder groups (an expert panel and a caregiver advisory board), guided the adaptation of an evidence-based pain educational intervention. Further, stakeholders recommended format changes to increase app usability. Study staff worked with four hospice agencies to facilitate app communication with EHRs. While modification to the e-PainSupport app to integrate a pain educational intervention and facilitate usability was successful, EHR integration was challenging. Future evaluation is needed to evaluate the effects of e-PainSupport on pain intensity among home hospice patients.

Overcoming Pandemic-Related Challenges in Recruitment and Screening: Strategies and Representation of Older Women With Cardiovascular Disease for a Multidomain Lifestyle Trial to Prevent Cognitive Decline.

BACKGROUND: Recruiting participants with cardiovascular disease into research during the COVID-19 pandemic was challenging, particularly those at risk of health disparities. OBJECTIVE: During the pandemic, 12 cohorts of older women with cardiovascular disease were recruited from cardiology clinics into a lifestyle intervention trial to prevent cognitive decline. Objectives were to (a) describe the results of modified recruitment/screening strategies to overcome pandemic-related challenges and (b) evaluate differences in age, race, and ethnicity between patients recruited/randomized, recruited/not randomized (entered recruitment but not randomized because of being ineligible or not interested), and not recruited (clinic patients who met preliminary criteria but did not enter recruitment). METHODS: This was a cross-sectional descriptive analysis. In-person study strategies proposed before the COVID-19 pandemic were modified before study onset (September 2020). Women 65 years or older with cardiovascular disease were recruited from cardiology clinics by clinicians, posted flyers, and letters mailed to patients randomly selected from electronic health record data extractions. Patients were classified as recruited/randomized, recruited/not randomized, and not recruited. RESULTS: Of 5719 patients potentially eligible, 1689 patients entered recruitment via referral (49.1%), posted flyers (0.5%), or mailed letters (50.3%), and 253 patients were successfully recruited/randomized. Recruited/randomized participants were, on average, 72.4 years old (range, 65-90 years old), non-Hispanic White (54.2%), non-Hispanic Black (38.3%), Hispanic/Latinx (1.6%), and other/not reported (5.1%). The recruited/randomized group was significantly younger with fewer patients of Hispanic/Latinx ethnicity compared with those not recruited. CONCLUSIONS: During the pandemic, all recruitment/screening goals were met using modified strategies. Differences in sociodemographic representation indicate a need for tailored strategies.

DNP-PhD Collaboration in NINR-Funded Physical Activity Trials: A Series of Case Studies.

Collaboration between Doctor of Nursing Practice (DNP) scholars and Doctor of Philosophy (PhD) scholars is crucial to efficiently advance and disseminate nursing science. Also, DNP-PhD collaboration can help achieve priorities outlined in the recent National Institute of Nursing Research (NINR) Strategic Plan. The purpose of this series of case studies is to describe exemplars of ongoing DNP-PhD collaborations across three NINR-funded trials (1 completed, 2 ongoing) testing physical activity interventions for women at risk for cardiovascular disease. In our three physical activity intervention trials for women, we categorized examples of DNP-PhD collaboration by the four phases of the team-based research model (development, conceptualization, implementation, and translation). Across all three trials, DNP and PhD scholars contributed successfully to all phases of research in an iterative manner. Future work should focus on expanding DNP-PhD collaboration in behavioral trials, which can inform adapted, contemporary models of iterative DNP-PhD collaboration.

Grandmothers residing with grandchildren: Social determinants of health, health behaviors, and health outcomes.

The purpose of this study was to explore the associations between social determinants of health, health behaviors, and physical and mental health among African American and Hispanic caregiving grandmothers. We use cross-sectional secondary data from the Chicago Community Adult Health Study, originally designed to understand the health of individual households based on residential context. In a multivariate regression model, discrimination, parental stress, and physical health problems were significantly associated with depressive symptoms in caregiving grandmothers. Considering the multiple sources of stress experienced by this grandmother sample, researchers should develop and strengthen contextually relevant interventions for improving the health of caregiving grandmothers. Healthcare providers must be equipped with skills to address caregiving grandmothers' unique needs related to stress. Finally, policy makers should promote the development of legislation that can positively influence caregiving grandmothers and their families. Expanding the lens through which caregiving grandmothers living in minoritized communities are viewed can catalyze meaningful change.

Effects of the COVID-19 pandemic on recruitment for the working women walking program.

The global pandemic of coronavirus disease 2019 (COVID-19) affected many aspects of randomized controlled trials, including recruiting and screening participants. The purpose of this paper is to (a) describe adjustments to recruitment and screening due to COVID-19, (b) compare the proportional recruitment outcomes (not completed, ineligible, and eligible) at three screening stages (telephone, health assessment, and physical activity assessment) pre- and post-COVID-19 onset, and (c) compare baseline demographic characteristics pre- and post-COVID-19 onset in the Working Women Walking program. The design is a cross-sectional descriptive analysis of recruitment and screening data from a 52-week sequential multiple assignment randomized trial (SMART). Participants were women 18-70 years employed at a large urban medical center. Recruitment strategies shifted from in-person and electronic to electronic only post-COVID-19 onset. In-person eligibility screening for health and physical activity assessments continued post-COVID-19 onset with Centers for Disease Control and Prevention precautions. Of those who expressed interest in the study pre- and post-COVID-19 onset (n = 485 & n = 269 respectively), 40% (n = 194) met all eligibility criteria pre-COVID-19 onset, and 45.7% (n = 123) post-COVID-19 onset. Although there were differences in the proportions of participants who completed or were eligible for some of the screening stages, the final eligibility rates did not differ significantly pre-COVID-19 versus post-COVID-19 onset. Examination of differences in participant demographics between pre- and post-COVID-19 onset revealed a significant decrease in the percentage of Black women recruited into the study from pre- to post-COVID-19 onset. Studies recruiting participants into physical activity studies should explore the impact of historical factors on recruitment.

Latin Dance and Working Memory: The Mediating Effects of Physical Activity Among Middle-Aged and Older Latinos.

Background: Physical activity (PA) is a promising method to improve cognition among middle-aged and older adults. Latinos are at high risk for cognitive decline and engaging in low levels of PA. Culturally relevant PA interventions for middle-aged and older Latinos are critically needed to reduce risk of cognitive decline. We examined changes in cognitive performance among middle-aged and older Latinos participating in the BAILAMOS™ dance program or a health education group and compared the mediating effects of PA between group assignment and change in cognitive domains. Methods: Our 8-month randomized controlled trial tested BAILAMOS™, a 4-month Latin dance program followed by a 4-month maintenance phase. A total of 333 older Latinos aged 55+ were randomized to either BAILAMOS™, or to a health education control group. Neuropsychological tests were administered, scores were converted to z-scores, and specific domains (i.e., executive function, episodic memory, and working memory) were derived. Self-reported PA was assessed, and we reported categories of total PA, total leisure PA, and moderate-to-vigorous PA as minutes/week. A series of ANCOVAs tested changes in cognitive domains at 4 and 8 months. A mediation analysis tested the mediating effects of each PA category between group assignment and a significant change in cognition score. Results: The ANCOVAs found significant improvement in working memory scores among participants in the dance group at month 8 [F (1,328) = 5.79, p = 0.017, d = 0.20], but not in executive functioning [F (2,328) = 0.229, p = 0.80, Cohen's d = 0.07] or episodic memory [F (2,328) = 0.241, p = 0.78, Cohen's d = 0.05]. Follow-up mediation models found that total PA mediated the relationship between group assignment and working memory, in favor of the dance group (ß = 0.027, 95% CI [0.0000, 0.0705]). Similarly, total leisure PA was found to mediate this relationship [ß = 0.035, 95% CI (0.0041, 0.0807)]. Conclusion: A 4-month Latin dance program followed by a 4-month maintenance phase improved working memory among middle-aged and older Latinos. Improvements in working memory were mediated by participation in leisure PA. Our results support the current literature that leisure time PA influences cognition and highlight the importance of culturally relevant PA modalities for Latinos. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT01988233].

BAILA: A Randomized Controlled Trial of Latin Dancing to Increase Physical Activity in Spanish-Speaking Older Latinos.

BACKGROUND: Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA. PURPOSE: To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group. METHODS: Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood. RESULTS: A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects. CONCLUSIONS: The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives. CLINICAL TRIAL INFORMATION: NCT01988233.

Effects of Home-Based Exercise on Frailty in Patients With End-Stage Renal Disease: Systematic Review.

BACKGROUND: New or worsening frailty is a common problem in patients with end-stage renal disease (ESRD) during the prolonged time awaiting kidney transplantation. Structured physical activity in the dialysis setting has been shown to mitigate frailty, but little is known about the benefits of home-based exercise. The purpose of this systematic review was to summarize the effects of home-based exercise interventions on indicators of frailty (weakness, slowness, low physical activity, perceived exhaustion, and shrinking) among patients diagnosed with ESRD. METHODS: We searched PubMed, MEDLINE, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar using Medical Subject Heading terms and free text keywords including kidney failure, exercise, and frailty. We identified 13 relevant articles (eight randomized controlled trials, five quasi-experimental studies). RESULTS: Our review found potential effectiveness of home-based exercise interventions on mitigating or preventing selected indicators of frailty (e.g., weakness, slowness, low physical activity, perceived exhaustion), particularly when the interventions combined aerobic walking, resistance exercise, and behavioral components and were delivered for at least 6 months. However, no published studies measured the effect of home-based exercise interventions on frailty as a whole. CONCLUSIONS: While existing studies suggest likely benefits of home-based exercise interventions among patients with ESRD, future research is warranted to develop and test home-based physical activity interventions that address all indicators of frailty.

Physical Activity and Cognitive Function in African American Older Adults Living With HIV.

The purpose of the current study was to investigate the association between self-reported physical activity (minutes/week) and cognitive functioning in a sample of African American older adults living with HIV. A secondary analysis of baseline data collected from clinically stable African American older adults living with HIV (aged >50 years; N = 124) enrolled in the Rush Center of Excellence on Disparities in HIV and Aging study was conducted. Participants completed a battery of 19 cognitive function tests that were used to create summary scores of global cognition and five cognitive domains. Physical activity was measured using a modified self-report questionnaire derived from a national health survey. Average self-reported number of weekly minutes spent in light physical activity was 290.6 minutes and for moderate/vigorous physical activity was 314.67 minutes. Number of weekly minutes of light physical activity was significantly positively associated with visuospatial ability; however, no associations were found between moderate/vigorous physical activity and any cognitive domain. Contrary to expectations, our findings do not support a relationship between moderate/vigorous physical activity and cognitive function in African American older adults living with HIV. [Journal of Gerontological Nursing, 47(12), 27-34.].

The Feasibility of a Lifestyle Physical Activity Intervention for Black Women with Asthma.

BACKGROUND: Black women are disproportionately affected by both physical inactivity and asthma. Lifestyle physical activity (PA) interventions targeted for Black women with asthma are lacking. OBJECTIVE: To assess the feasibility and acceptability as well as preliminary effects of a lifestyle PA intervention culturally tailored for Black women with asthma. METHODS: Black women (age 18-70 years) with uncontrolled asthma (Asthma Control Test <20) were recruited. Outcome assessments at baseline and 24 weeks included measures of: feasibility and acceptability, asthma control, quality of life, health care use, and PA levels. Participants were randomized to the intervention (asthma education, Fitbit, monthly group sessions, text messages, individual step goals, and study manual) or enhanced usual care (EUC) (asthma education plus Fitbit) group. RESULTS: Of the 53 women randomized (EUC = 28; intervention = 25), 92% remained in the intervention (23 of 25) and 76% completing the 24-week outcome assessment. Overall intervention satisfaction (mean score, 6.88 of 7) and individual components were high at 24 weeks. Mean change in asthma control questionnaire between groups was not significant at 24 weeks (intervention = -0.41 vs EUC = 0.03 [P = .08]; effect size = -0.38) but approached clinical significance (0.5). At 24 weeks, more women receiving the intervention had controlled asthma compared with EUC (36.84% vs 9.52%; P = .04). Clinically significant improvements (0.5) in quality of life were found in the intervention group (mean change: intervention = 0.58 vs EUC = 0.10; P = .10) at 24 weeks. CONCLUSIONS: A culturally tailored lifestyle PA intervention is feasible and demonstrates improvements in asthma control and quality of life among Black women with asthma. These preliminary findings support the need for PA lifestyle interventions in urban Black women with asthma.

Critical Care Nurses' Physical and Mental Health, Worksite Wellness Support, and Medical Errors.

BACKGROUND: Critical care nurses experience higher rates of mental distress and poor health than other nurses, adversely affecting health care quality and safety. It is not known, however, how critical care nurses' overall health affects the occurrence of medical errors. OBJECTIVE: To examine the associations among critical care nurses' physical and mental health, perception of workplace wellness support, and self-reported medical errors. METHODS: This survey-based study used a cross-sectional, descriptive correlational design. A random sample of 2500 members of the American Association of Critical-Care Nurses was recruited to participate in the study. The outcomes of interest were level of overall health, symptoms of depression and anxiety, stress, burnout, perceived worksite wellness support, and medical errors. RESULTS: A total of 771 critical care nurses participated in the study. Nurses in poor physical and mental health reported significantly more medical errors than nurses in better health (odds ratio [95% CI]: 1.31 [0.96-1.78] for physical health, 1.62 [1.17-2.29] for depressive symptoms). Nurses who perceived that their worksite was very supportive of their well-being were twice as likely to have better physical health (odds ratio [95% CI], 2.16 [1.33-3.52]; 55.8%). CONCLUSION: Hospital leaders and health care systems need to prioritize the health of their nurses by resolving system issues, building wellness cultures, and providing evidence-based wellness support and programming, which will ultimately increase the quality of patient care and reduce the incidence of preventable medical errors.

Views on Exercise Among Black Women During Pregnancy.

OBJECTIVE: To describe and understand exercise practices, beliefs about exercise, support for exercise, barriers to exercise, and preferences for a group exercise program in the context of individual and environmental factors among Black women during pregnancy. DESIGN: Mixed-methods design. SETTING: Large university-affiliated urban midwifery practice. PARTICIPANTS: Fourteen Black women who were pregnant. METHODS: We conducted semistructured interviews to determine participants' exercise practices, beliefs about exercise while pregnant, exercise support and barriers, and preferences for a group pregnancy exercise program. Participants also completed self-report measures for exercise, neighborhood environment, symptoms of depression, and sociodemographic characteristics. We used matrices to facilitate integrated analysis of the interview and self-report data to determine areas of concordance and discordance among the data sources and to note patterns in the data. RESULTS: We identified and described themes that represented concepts in our data: Exercise Misinformation and Folklore, Supportfor Exercise While Pregnant, Barriers to Exercise While Pregnant, Perceived Health Benefits, and Exercise Program Preferences. Data diverged for some participants on neighborhood as a barrier to exercise. Except for the two participants with high levels of symptoms of depression, data converged regarding symptoms of depression as a barrier to exercise. CONCLUSION: Health care providers can successfully promote exercise if they provide education about exercise during pregnancy, help pregnant women overcome barriers to exercise, prompt women to exercise with partners for tangible and social support while pregnant, and refer women to exercise programs for pregnant women if available.

Self-Efficacy, Outcome Expectations, Group Social Support, and Adherence to Physical Activity in African American Women.

BACKGROUND: African American women have lower levels of leisure time physical activity compared to White American women. Interventions to improve physical activity have mixed benefits for African American women, even when guided by theory. Understanding how theoretical constructs used in physical activity interventions relate to changing behavior may provide direction for more successful interventions. OBJECTIVE: The study aimed to examine the relationships among social cognitive constructs (self-efficacy, social support from group behavioral meetings, outcome expectations/realizations), and change in physical activity from baseline to 48 weeks in African American women participating in a lifestyle physical activity program. METHODS: A secondary data analysis of longitudinal data using a correlational design was conducted using data from a 48-week physical activity randomized controlled trial (RCT). The RCT included a group behavioral meeting component with one of three telephone intervention conditions (no calls, personal motivation calls, or automated motivational calls) randomly assigned across six community healthcare sites. The participants were 260 sedentary, midlife African American women with no major signs or symptoms of cardiovascular disease who completed baseline and 48-week assessments of the RCT. Measures included self-efficacy for change in overcoming barriers to physical activity at 24 weeks, physical and psychological outcome realizations at 24 weeks, social support from group behavioral meetings at 24 weeks, and physical activity (self-report and device-measured) change from baseline to 48 weeks. RESULTS: In a hierarchical regression model predicting change in self-reported time spent in weekly moderate-vigorous physical activity at 48 weeks, psychological outcome realizations at 24 weeks were significant positive predictors. In a hierarchical regression model for change in device-measured daily steps at 48 weeks, a self-efficacy change at 24 weeks was a significant positive predictor. DISCUSSION: Attention should be given to increasing self-efficacy to overcome physical activity barriers and achieve self-identified physical and psychological outcomes in physical activity programs.

Development and Feasibility of an Obesity Prevention Intervention for Black Adolescent Daughters and Their Mothers.

Black female adolescents and women have disproportionately higher rates of obesity than their racial/ethnic counterparts. There is an urgent need to address obesity prevention in Black adolescent females through interventions that enhance lifestyle physical activity and improve dietary behaviors. Middle adolescence presents an important opportunity to strengthen the daughter-mother bond and improve healthy behaviors such as physical activity and dietary intake. Because of the intersection of adolescent development, culture and structural racism, it is essential to include mothers; however, this approach is understudied in the literature. This pre-pilot proof of concept study, Black Girls Move, was conducted using a 12-week pre-post within-subjects design to assess feasibility of conducting and delivering the BGM intervention, program satisfaction, and ability to obtain outcome measures in Black ninth and tenth grade daughters and their mothers. Twenty-two dyads were recruited and 14 dyads completed baseline assessments; however, only eight daughters and their mothers attended the first session and remained for the entire study. All dyads had valid objective and self-reported physical activity data. However, two of eight daughters and one mother provided self-reported dietary data that were considered invalid. All individual sessions were rated highly. Excellent attendance, retention, and satisfaction among participants suggest that we succeeded in developing an accepted, culturally relevant intervention. This lifestyle intervention would be strengthened by modifications to recruitment and retention, as well as incorporation of a computerized dietary assessment tool, a tailored dietary app for self-monitoring, and increased photo-based and group homework activities.

A study protocol for MindMoves: A lifestyle physical activity and cognitive training intervention to prevent cognitive impairment in older women with cardiovascular disease.

INTRODUCTION: Cognitive impairment (CI) and cardiovascular disease (CVD) disproportionately affect women compared to men, and CVD increases risk of CI. Physical activity and cognitive training can improve cognition in older adults and may have additive or synergistic effects. However, no combined intervention has targeted women with CVD or utilized a sustainable lifestyle approach. The purpose of the trial is to evaluate efficacy of MindMoves, a 24-week multimodal physical activity and cognitive training intervention, on cognition and serum biomarkers in older women with CVD. Three serum biomarkers (brain-derived neurotrophic factor [BDNF], vascular endothelial growth factor [VEGF], and insulin-like growth factor 1 [IGF-1]) were selected as a priori hypothesized indicators of the effects of physical activity and/or cognitive training on cognition. METHODS: The study design is a randomized controlled trial with a 2 × 2 factorial design, to determine independent and combined efficacies of Mind (tablet-based cognitive training) and Move (lifestyle physical activity with goal-setting and group meetings) on change in cognition (primary outcome) and serum biomarkers (secondary outcomes). We will recruit 254 women aged ≥65 years with CVD and without CI from cardiology clinics. Women will be randomized to one of four conditions: (1) Mind, (2) Move, (3) MindMoves, or (4) usual care. Data will be obtained from participants at baseline, 24, 48, and 72 weeks. DISCUSSION: This study will test efficacy of a lifestyle-focused intervention to prevent or delay cognitive impairment in older women with CVD and may identify relevant serum biomarkers that could be used as early indicators of intervention response.

The Feasibility of a Combined Lifestyle Physical Activity and Cognitive Training Intervention to Prevent Cognitive Impairment in Older Women With Cardiovascular Disease.

BACKGROUND: Cognitive impairment disproportionately affects older women with cardiovascular disease (CVD). Physical activity (PA) and cognitive training (CT) may have synergistic effects in combined interventions. However, no combined intervention has targeted women with CVD or utilized a sustainable and preferable lifestyle approach. The purpose was to test feasibility and acceptability of the 24-week MindMoves program, a lifestyle intervention that combined PA and CT developed for older women with CVD. METHODS: The PA component included goal setting with Fitbits and 5 behavioral group meetings. The CT component was evidence-based BrainHQ delivered on a tablet in three 30-minute weekly sessions. Participants included 10 women aged ≥65 years with CVD. Exclusion criteria were cognitive impairment, regular PA, and CT use. Measures were feasibility (recruitment, attendance, participation, retention, and acceptability), change in PA (Fitbit min/steps), and change in cognitive function (NIH Toolbox®). RESULTS: Of the 10 participants, 70% attended ≥4/5 group meetings, and overall attendance was 76%. Participants completed 2.3/3 CT sessions weekly. Participant retention was 100%. Over 90% of participants rated MindMoves with the highest levels of satisfaction. Participants had significant improvements in steps, light PA, and moderate PA, and there was a trend for improved cognition. CONCLUSIONS: Findings support testing MindMoves in an efficacy trial.