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.

The mediating effects of motivation on the relations between occupational stress and physical activity among underresourced afterschool program staff.

OBJECTIVE: Guided by Self-Determination Theory, this study aimed to examine the potential mediating effects of autonomous and controlled motivations on physical activity (PA) experiences of afterschool program (ASP) staff with occupational stress. METHOD: A total of 58 ASP staff provided full data. Staff occupational stress and self-determination motivations for PA were assessed. Participants' daily moderate-to-vigorous physical activity (MVPA) was measured using accelerometer wear. A path analysis was used to address the research purpose. RESULTS: Occupational stress negatively and indirectly predicted daily MVPA which was mediated by controlled motivation (ß = - 4.15, p <.05). Autonomous motivation directly and positively predicted daily MVPA across all types and levels of ASP staff occupational stress (ß = 9.93, p =.01). CONCLUSIONS: Autonomous motivation is a powerful predictor of staff PA levels despite the degree to which they experience stress. In contrast, controlled motivations are more vulnerable to occupational stress, and can lead to lower MVPA. TRIAL REGISTRATION: Connect Through PLAY: A Staff-based Physical Activity Intervention for Middle School Youth (Connect). https://clinicaltrials.gov/ct2/show/NCT03732144 . Registered 11/06/2018. REGISTRATION NUMBER: NCT03732144.

Changing trajectory of daily physical activity levels among at-risk adolescents: influences of motivational mechanisms.

BACKGROUND: Guided by Self-Determination Theory (SDT), the purpose of this study was to determine changes in the 16-week moderate-to-vigorous physical activity (MVPA) trajectory of underserved adolescents who participated in the Connect through PLAY afterschool program intervention and the effects of changes in participating adolescents' intrinsic and autonomous extrinsic motivations on their MVPA trajectory over the 16-week intervention. METHODS: A subsample of 113 adolescents (56.64% female; 61.06% African American; average age = 11.29) provided complete data throughout the 16-week intervention were examined. Adolescents' objective daily MVPA was measured using 7- day accelerometer data. Changes in adolescents' intrinsic motivation and autonomous extrinsic motivation were assessed using subscales from the Intrinsic Motivation Inventory [1] and the Treatment Self-Regulation Questionnaire [2] respectively. A hierarchical linear model was built and tested to address the research aims. RESULTS: The results of hierarchical linear models showed that, on average, youth daily MVPA increased 6.36 minutes in each 8-week period. Intrinsic motivation change, but not autonomous extrinsic motivation, was a positive and significant level-2 predictor of daily MVPA changes. CONCLUSION: The findings provide significant evidence suggesting a benefit of integrating SDT-based approaches and further suggest that nurturing intrinsic motivation can be an effective approach to supporting youth daily MVPA in under-resourced afterschool programs. TRIAL REGISTRATION: Connect Through PLAY: A Staff-based Physical Activity Intervention for Middle School Youth (Connect). https://clinicaltrials.gov/ct2/show/NCT03732144 . Registered November 6th, 2018.

The influence of social support, social affiliation and intrinsic motivation for increasing underserved youth's physical activity: A social climate-based intervention study.

The purpose of this study was to investigate the influences of intrinsic motivation, social affiliation orientations and reciprocal social support for physical activity (PA) on underserved youths' afterschool period moderate-to-vigorous (MVPA) changing trajectories across the 16-week Connect through PLAY intervention, a social-motivational climate intervention. A total of 113 youth (61.06% African American, 56.64% girls) provided full data. Youths' intrinsic motivation, social affiliation orientations and social support were measured by youth responses to a set of surveys at baseline and post-intervention. Youths' afterschool period MVPA was measured using data from 7-day ActiGraph accelerometer wear at baseline, midpoint and post-intervention. Hierarchical linear modelling analysis found that youth daily afterschool period (3pm-6pm) MVPA increased, on average, 37.94 min across the 16-week intervention. Increases in intrinsic motivation, social affiliation orientations and social support were positive predictors of youth afterschool MVPA changing trajectory. The findings clarify the contributions that a social-motivational climate intervention can have on youth afterschool period MVPA through increasing youth intrinsic motivation, social affiliation and reciprocal social support.

An overview of the Together Everyone Achieves More Physical Activity (TEAM-PA) trial to increase physical activity among African American women.

BACKGROUND: The Together Everyone Achieves More Physical Activity (TEAM-PA) trial is a randomized controlled trial testing the efficacy of a group-based intervention for increasing physical activity (PA) among insufficiently active African American women. DESIGN: The TEAM-PA trial uses a group cohort design, is implemented at community sites, and will involve 360 African American women. The trial compares a 10-week group-based intervention vs. a standard group-delivered PA comparison program. Measures include minutes of total PA/day using 7-day accelerometer estimates (primary outcome), and body mass index, blood pressure, waist circumference, walking speed, sedentary behavior, light physical activity, and the percentage achieving ≥150 min of moderate to vigorous PA/week (secondary outcomes) at baseline, post-intervention, and 6-months post-intervention. INTERVENTION: The intervention integrates elements from Social Cognitive Theory, Self-Determination Theory, Group Dynamics Theory, and a focus on collectivism to evaluate different components of social affiliation (relatedness, reciprocal support, group cohesion, and collective efficacy). The intervention integrates shared goal-setting via Fitbits, group-based problem-solving, peer-to-peer positive communication, friendly competition, and cultural topics related to collectivism. Compared to the standard group-delivered PA program, participants in the intervention are expected to show greater improvements from baseline to post- and 6-month follow-up on minutes of total PA/day and secondary outcomes. Social affiliation variables (vs. individual-level factors) will be evaluated as mediators of the treatment effect. IMPLICATIONS: The results of the TEAM-PA trial will determine the efficacy of the intervention and identify which aspects of social affiliation are most strongly related to increased PA among African American women. TRIAL REGISTRATION: This study was registered on Clinicaltrials.gov (# NCT05519696) in August 2022 prior to initial participant enrollment.

Holistic Functioning from a Developmental Perspective: A New Synthesis with a Focus on a Multi-tiered System Support Structure.

While research in specific academic disciplines has individually advanced knowledge and practice for promoting multiple aspects of health and well-being in children and adolescents, still missing is an understanding of the interconnectedness of many critical aspects of development and how to intentionally weave these factors to advance a more holistic approach. The need for a more holistic and inclusive approach to child and adolescent development is increasingly evident to promote long-term health and well-being as the overall percentage of children, adolescents, and adults who suffer from mental health disorders is increasing. To address this issue, our authorship team consists of researchers in the areas of developmental psychology, neuroscience, motor development, exercise science, and mental health. The collective ideas outlined in this paper are aligned to address the need to remove disciplinary-specific boundaries and elucidate synergistic linkages across multiple research domains that support holistic development and lifespan health and wellness. We propose a conceptual framework that comprehensively addresses the integration of physical, cognitive, psychological, social, and emotional domains of child and adolescent development. In addition, we also provide a holistic preventative approach that is aligned with a contemporary intervention structure (i.e., Multi-tiered Systems of Support) to promote, from a developmental perspective, positive trajectories of health and well-being across childhood and adolescence.

Self-control and cooperation in childhood as antecedents of less moral disengagement in adolescence.

Moral disengagement is a social cognition people use to engage in wrongdoings even when they know it is wrong. However, little is known about the antecedents that predict moral disengagement. The current study focuses on the development of self-control and cooperation during middle childhood as two antecedents of moral disengagement among 1,103 children (50% female; 77% White, 12% Black, 6% Hispanic, and 5% other). Children's self-control at age 8 and growth in self-control from age 8 to 11 were positively linked to adolescents seeing themselves as having self-control at age 15, which then predicted less moral disengagement at age 18. Children's cooperation at age 8 also was positively linked to adolescents' self-views of cooperation at age 15, which in turn, was associated with less moral disengagement at age 18. These findings demonstrate the potential of self-control and cooperation as intrapersonal and interpersonal strengths during middle childhood for mitigating moral disengagement 10 years later.

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.

The Importance of Addressing Multilevel Transactional Influences of Childhood Obesity to Inform Future Health Behavior Interventions.

We provide a transactional model of health for understanding the early risk of obesity in youth. This model argues that positive health is construed through the choices and actions that youth take within the range of resources and constraints of their biological and contextual situations across time. Social, cognitive, affective, and behavioral regulatory/motivational processes within the child mediate the relation between life experiences and health outcomes and obesity pathways are influenced by cumulative risk or protective processes for health promotion/compromising behaviors influencing health. We provide evidence-based examples of multilevel approaches to obesity prevention and treatment and highlight recommendations for future health behavior interventions.

Results from "Developing Real Incentives and Volition for Exercise" (DRIVE): A pilot randomized controlled trial for promoting physical activity in African American women.

OBJECTIVE: Motivation is a barrier to physical activity (PA) among African American (AA) women, but past studies have implemented a "one-size-fits-all" approach and have not addressed differences in autonomous motivation. This pilot randomized controlled trial assessed the preliminary efficacy of "Developing Real Incentives and Volition for Exercise," a community- and theory-based intervention, which evaluated whether a motivationally matched (vs. a nonmatched) intervention increases daily total PA. METHOD: In total, 68 AA women (50.72 ± 13.66 years; 86.8% with obesity) were randomized to an 8-week challenge-focused program (targeted toward high autonomous motivation) or rewards-focused program (targeted toward low autonomous motivation). Randomization was stratified by baseline autonomous motivation. FitBits were used during the intervention to promote self-monitoring (both programs) and social connectedness (challenge program only). RESULTS: Both programs retained ≥ 80% of participants. Process evaluation revealed high attendance, dose, and fidelity (both programs). However, contrary to expectations, across all motivational levels (low and high autonomous), the challenge-focused intervention resulted in a greater increase in total daily PA (primary outcome), with an average increase of 17.9 min in the challenge-focused intervention versus an average decrease of 8.55 min in the rewards-focused intervention. An exploratory follow-up analysis revealed that engagement with the FitBit mobile app predicted greater PA at postintervention in the challenge-focused program. CONCLUSIONS: A team-based approach targeting social connectedness, enjoyment of PA, and positive intragroup competition is a promising approach for promoting PA among AA women. These findings are used to guide a discussion on best practices for engaging AA women in future behavioral interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An overview of the Connect through PLAY trial to increase physical activity in underserved adolescents.

BACKGROUND: The Connect through Positive Leisure Activities for Youth (Connect through PLAY) trial is a prospective, randomized controlled trial implemented within pre-existing afterschool programs (ASPs) comparing a staff-based social development physical activity (PA) program to a health curriculum active control. The efficacy trial aims to improve staff capacity for implementing effective physical activity (PA) programming within ASPs serving underserved youth (minority, low-income) through enhancing the influence of ASP staff as key change agents and addressing the social development needs of adolescents. DESIGN AND SETTING: The 5-year cluster randomized trial will involve 30 ASPs that are randomized to either the Connect through PLAY intervention or the active health curriculum control. INTERVENTION: The Connect through PLAY intervention employs a novel theoretical framework that targets three key social mechanisms for increased and sustained PA of staff and youth including youth-peer connections/friendships, group belonging, and staff-youth connections. All components of the intervention are designed to improve staff capacity for facilitating a PA context that supports these social mechanisms and increases the influence of ASP staff as positive PA role models and agents of change. Compared to control sites, ASPs receiving Connect through PLAY are expected to show greater improvements from baseline to post- and 6-month follow-up on youth PA, staff PA, and social mechanisms. IMPLICATIONS: The results of the Connect through PLAY trial will demonstrate the efficacy of the intervention and will assist in developing a model of training, motivating, and empowering ASP staff to address social mechanisms that promote youth PA.

Evaluating Experiences of Stress and Coping Among African American Women During the COVID-19 Pandemic to Inform Future Interventions.

BACKGROUND: African American (AA) women experience disproportionate levels of chronic disease, which is theorized to be driven by greater exposure to acute and chronic stress. The coronavirus (COVID-19) pandemic has further exacerbated existing health disparities among AA communities. Understanding how AA women have experienced and responded to stress during the pandemic may help to inform how future interventions can better address physical and mental well-being in AA communities. AIMS: Drawing from stress and coping models and an ecological framework, the present study conducted a theory-based qualitative assessment of stress-related experiences during the pandemic among a cohort of AA women, including (1) sources of stress, (2) coping strategies, (3) perceptions of health-related behaviors, (4) the role of community, and (5) recommendations for future interventions. METHOD: After completing a group-based physical activity intervention program during the COVID-19 pandemic, a cohort of AA women (N =17, Mage= 49.3 ± 11.24) completed individual interviews. Sessions were conducted by phone, audiotaped, transcribed, and coded by independent raters (rs = .71-.73). Themes were identified using deductive and inductive approaches. RESULTS: Among sources of stress directly related to the pandemic, being at home, getting sick, and homeschooling/parenting were the most frequently discussed themes. Participants engaged in active coping (problem and emotion-focused), with health behaviors, social support, and religion/spirituality, emerging as frequently discussed themes. Although some participants reported passive coping strategies (e.g., avoidance), this approach was less pronounced. CONCLUSIONS: These qualitative results are used to guide suggestions for future interventions that jointly address stress and health-related behaviors in order to improve translation of research into practice and policy for future pandemics and disasters.

A Qualitative Study of Stress and Coping to Inform the LEADS Health Promotion Trial for African American Adolescents with Overweight and Obesity.

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.

Moderating Effects of Parental Feeding Practices and Emotional Eating on Dietary Intake among Overweight African American Adolescents.

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child's weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = -0.331, SE = 0.162, p = 0.043), and concern (B = -0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.

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.

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.

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.

The development of cooperation and self-control in middle childhood: Associations with earlier maternal and paternal parenting.

Developmental theories and previous research have emphasized the significance of cooperation and self-control in middle childhood. The present study extends previous research by examining (a) the growth of cooperation and self-control as well as the relations between them in middle childhood (third to sixth grade) and (b) the extent to which mothers' and fathers' parenting during early childhood (54 months and first grade) was associated with children's cooperation and self-control. The sample included 705 children (51% female, 86% White) and their mothers, fathers, and teachers in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD). Children, on average, exhibited increases in self-control but not cooperation from third to sixth grade though the increases were smaller for children who had higher self-control or cooperation at third grade. Children who exhibited higher self-control at third grade tended to exhibit higher cooperation at third grade; similar positive associations emerged for the changes in self-control and cooperation over time. In addition, if a child exhibited higher self-control at one time point relative to their typical average level, they tended to also exhibit higher cooperation at the same time point relative to their typical average level. However, these relative deviations within person were not associated over time. Lastly, maternal and paternal sensitive and stimulating parenting in early childhood was positively associated with children's cooperation and self-control in middle childhood. Overall, our findings shed light on the growth of and the relations between cooperation and self-control in middle childhood and highlight the role of maternal and paternal parenting in early childhood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Brief Mindfulness-Based Intervention (bMBI) to Reduce Teacher Stress and Burnout.

Teacher stress and burnout contribute to attrition and stress-related health concerns. Despite some positive effects, previous mindfulness-based interventions (MBI) have failed to incorporate key elements of methodological rigor and have included large dosages despite research suggesting that such dosages are iatrogenic. The current study demonstrates the efficacy of a brief MBI (bMBI; four sessions, six total hours) to reduce self-reported stress, burnout, and depression, and suggests the bMBI can protect against deleterious impacts to physiological functioning. The study informs the design and implementation of future MBIs, including strategies for reducing intervention dosages, in order to improve effectiveness and maximize cost-effectiveness.

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.