Effectiveness of a Walking Group Intervention to Promote Physical Activity and Cardiovascular Health in Predominantly Non-Hispanic Black and Hispanic Urban Neighborhoods

Abstract

Objectives The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health (WYHH) intervention, one component of the multilevel CATCH:PATH intervention designed to promote physical activity and reduce cardiovascular risk (CVR) among non-Hispanic Black (NHB) and Hispanic residents of Detroit, Michigan. The study was designed and implemented using a community-based participatory research approach that actively engaged community residents, health service providers and academic researchers. It was implemented between 2009–2012. Methods WYHH was a 32 week Community-Health Promoter (CHP)-facilitated walking group intervention. Groups met three times per week at community-based or faith-based organizations, and walked for 45–90 minutes (increasing over time). The study used a cluster randomized control design to evaluate effectiveness of WYHH, with participants randomized into intervention or lagged intervention (control) groups. Psychosocial, clinical, and anthropometric data were collected at baseline, 8 and 32 weeks, and pedometer step data tracked using uploadable peiso-electric pedometers. Results Participants in the intervention group increased steps significantly more during the initial 8 week intervention period, compared to the control group (β=2004.5, p=0.000). Increases in physical activity were associated with reductions in systolic blood pressure, fasting blood glucose, total cholesterol, waist circumference and BMI at 8 weeks, and maintained at 32 weeks. Conclusion The WYHH CHP-facilitated walking group intervention was associated with significant reductions in multiple indicators of CVR among predominantly Hispanic and NHB participants in a low-to-moderate income urban community. Such interventions can contribute to reductions in racial, ethnic and socioeconomic inequities in cardiovascular mortality.

Leader Behaviors, Group Cohesion, and Participation in a Walking Group Program

“…32 The WYHH intervention was a multi-site cluster randomized controlled study with a lagged intervention group. It was conducted in Detroit, Mich. where residents experience excess mortality due to cardiovascular disease compared to the state and the nation.…”

“…The Clinical Trials registration number is NCT02036593. For further detail on the WYHH intervention, see Schulz AJ et al 32 …”

“…physical activity adherence) among predominantly non-Hispanic Black and Hispanic adults participating in Walk Your Heart to Health (WYHH), a walking group program in low-to-moderate income communities in Detroit, Mich. WYHH is part of a larger study, Community Approaches to Cardiovascular Health, designed to increase active living and improve heart health among Detroit residents at increased risk for cardiovascular disease. 31, 32 This study was conducted by the Healthy Environments Partnership (HEP), a community-based participatory research partnership established in 2000 to examine and develop interventions to reduce cardiovascular inequities in Detroit. HEP is overseen by a Steering Committee, which meets monthly and is responsible for oversight of all aspects of the Partnership’s work (see Acknowledgements for a list of partner organizations) Previously published results from the WYHH intervention have demonstrated its effectiveness in increasing physical activity and reducing multiple indicators of cardiovascular risk.…”

“…HEP is overseen by a Steering Committee, which meets monthly and is responsible for oversight of all aspects of the Partnership’s work (see Acknowledgements for a list of partner organizations) Previously published results from the WYHH intervention have demonstrated its effectiveness in increasing physical activity and reducing multiple indicators of cardiovascular risk. 32 The current study investigates the role of leader behaviors and group cohesion in shaping adherence to the WYHH intervention. Specifically, the hypotheses that group leader behaviors and group cohesion were positively associated with participation in WYHH, and that associations between group leader behaviors and participation in WYHH were mediated by group cohesion, were tested.…”

Smart devices and healthy aging

“…Several clinical trials of tracking food intake or recording the number of steps made per day using a pedometer have resulted in successful weight loss [26,27]. However, the impact of food management applications on permanent behavioral change toward diet and activity is doubtful [28,29].…”