A Physical Activity Intervention in Older African Americans: The PAACE Pilot Randomized Controlled Trial

Abstract

Introduction: Older African Americans have low levels of physical activity, which increases the risk of aging-related health conditions. This study aimed to determine the effectiveness of, and satisfaction with, a community-engaged physical activity intervention targeting older African Americans. Methods: Fifty-six older African Americans were randomized to a successful aging group (SAG) or a physical activity group (PAG) for 12 wk. The PAG consisted of two weekly group exercise sessions and two to three home-based exercise sessions per week. The SAG consisted of weekly group educational sessions related to various aspects of healthy aging. Physical activity was measured by ActiGraph accelerometers and the Community Healthy Activities Model Program for Seniors Activities Questionnaire in both groups, and a Fitbit was continuously worn by PAG participants. Results: Group session attendance was 93% and 86% in the PAG and SAG, respectively. The increase in ActiGraph-derived steps per day (1085.3 ± 265.6 vs 34.7 ± 274.3; P = 0.008) and daily minutes of moderate-to-vigorous physical activity (MVPA; 6.2 ± 1.6 vs 0.3 ± 1.7; d = 0.68; P = 0.01), and self-reported Community Healthy Activities Model Program for Seniors Activities Questionnaire MVPA bouts (3.5 ± 0.77 vs 0.33 ± 0.79; P < 0.001) were significantly greater within the PAG than the SAG. ActiGraph-derived minutes of daily MVPA and steps as well as Fitbit-derived steps per day were significantly greater on days when PAG participants engaged in group sessions compared with days when they self-reported home-based exercise or no exercise (P < 0.016). Participants in both study arms reported high levels of satisfaction (>4-on 5-point Likert scale). Conclusions: The intervention increased physical activity, was well attended, and resulted in high satisfaction. Future studies should assess long-term sustainability in this population.

Exercise Effects on Cognition in Older African Americans: A Pilot Randomized Trial

“…The PAACE intervention was designed for participants to progressively reach moderate to vigorous intensity in 30-45min bouts. Accelerometer data show that while participants were engaging in 30 min of group-based MVPA, they only achieved 20 min of home-based MVPA (Newton et al, 2022). Therefore, participants in the intervention may not have been reaching the duration of MVPA per bout needed to stimulate positive cognitive changes.…”

“…Random assignment of participants was executed in a 1:1 ratio to either study group with the utilization of SAS, by the study statistician, to create covariate adaptive randomization (Hu and Hu, 2012). More details are published elsewhere (Newton et al, 2022).…”

“…For the final analyses, N = 28 was included for both randomization groups (two participants failed to return to the clinic and only had baseline data). We ran a power analysis to determine sample size for changes in step count (i.e., the primary goal of the study) (Newton et al, 2022). This power analysis showed that N = 28 provides 80% power to detect a 2,000 step count difference with 20% drop out and alpha = 0.05.…”