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1.  Women’s Walking Program for African American women: Expectations and recommendations from participants as experts 
Women & health  2011;51(6):566-582.
Effective interventions that increase adherence to physical activity (PA) are important for African American (AA) women because generally they are less active and more obese compared to white American women. The purpose of this study was to elicit from women who began a 12-month PA program between 2002 and 2005: 1) their recollections of outcome expectations and barriers, 2) feedback on program components, and 3) suggestions for program change. In 2007, we conducted qualitative post-intervention focus group interviews with women who had participated in the enhanced treatment group. Thirty-three AA women aged 44–69 years at the time of the study participated in one of four focus groups held at their community intervention site. Focus groups were formed on the basis of low (walked < 50% of expected walks) versus high (walked ≥50% of expected walks) adherence and low (0–2) versus high (3–4) attendance at the four workshops held during the 6-month adoption phase. Audio-taped sessions were transcribed and coded independently and then uploaded into NVivo7 for final coding and data analysis. Suggestions for future program components included a lifestyle PA prescription, pedometers for self-monitoring, ongoing group support and automated telephone support. Focus group participants can serve as experts to assist in content development for improving program effectiveness.
doi:10.1080/03630242.2011.606357
PMCID: PMC3293370  PMID: 21973111
African American; Physical Activity; Qualitative Methods
2.  Neighborhood Characteristics, Adherence to Walking, and Depressive Symptoms in Midlife African American Women 
Journal of Women's Health  2009;18(8):1201-1210.
Abstract
Background
African American women have more symptoms of depressed mood than white women. Adverse neighborhood conditions may contribute to these symptoms. Although reductions in depressive symptoms with physical activity have been demonstrated in white adults, little research has examined the mental health benefits of physical activity in African American women. Further, it is unknown whether physical activity can offset the effects of living in disadvantaged neighborhoods on depressive symptoms. The purpose of this study was to examine the relationships among neighborhood characteristics, adherence to a physical activity intervention, and change over time in depressive symptoms in midlife African American women.
Methods
Two hundred seventy-eight women participated in a home-based, 24-week moderate-intensity walking intervention. Either a minimal treatment (MT) or enhanced treatment (ET) version of the intervention was randomly assigned to one of the two community health centers. Walking adherence was measured as the percentage of prescribed walks completed. Objective and perceived measures of neighborhood deterioration and crime were included.
Results
Adjusting for demographics, body mass index (BMI), and depressive symptoms at baseline, walking adherence and objective neighborhood deterioration were associated with significantly lower depressive symptoms, whereas perceived neighborhood deterioration was associated with significantly higher depressive symptoms at 24 weeks.
Conclusions
Adherence to walking as well as aspects of the environment may influence depressive symptoms in African American women. In addition to supporting active lifestyles, improving neighborhood conditions may also promote mental health among African American women.
doi:10.1089/jwh.2008.1168
PMCID: PMC2825683  PMID: 19630546
3.  Neighborhood Environment and Adherence to a Walking Intervention in African-American Women 
This secondary analysis examined relationships between the environment and adherence to a walking intervention among 252 urban and suburban midlife African-American women. Participants received an enhanced or minimal behavioral intervention. Walking adherence was measured as the percentage of prescribed walks completed. Objective measures of the women’s neighborhoods included: walkability (land use mix, street intersection density, housing unit density, public transit stop density), aesthetics (physical deterioration, industrial land use), availability of outdoor (recreational open space) and indoor (recreation centers, shopping malls) walking facilities/spaces, and safety (violent crime incidents). Ordinary least squares regression estimated relationships. We found presence of one and especially both types of indoor walking facilities were associated with greater adherence. No associations were found between adherence and the other environmental variables. The effect of the enhanced intervention on adherence did not differ by environmental characteristics. Aspects of the environment may influence African-American women who want to be more active.
doi:10.1177/1090198108321249
PMCID: PMC2726823  PMID: 18669878
African Americans; Neighborhood; Walking

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