Physical Activity-Related Experiences, Counseling Expectations, Personal Responsibility, and Altruism among Urban African American Women with Type 2 Diabetes

Abstract

Purpose The purpose of this study was to explore physical activity-related experiences, perceptions, and counseling expectations among urban, underactive, African American women with type 2 diabetes. Methods Participants were recruited via flyers and endocrinologist referral. A professional, African American female moderator led two focus groups among 11 participants. Focus groups were conducted in a video- and audio-equipped focus group room in the evening hours. Using a content-based stepped analytic approach, two raters independently analyzed data and collaborated to compare results and finalize themes. Results Competing priorities and lack of motivation were perceived as significant barriers to physical activity. Physical activity-related counseling expectations (i.e. physician encouragement) and experiences (physician advice giving) were inconsistent. Participants expressed a high degree of physical activity-related health responsibility. Altruistic intentions were high relative to helping others incorporate healthy lifestyle changes. Conclusions When counseling women about physical activity, diabetes educators should acknowledge and provide support and resources to help women incorporate more physical activity into their regular routines and enhance motivation for physical activity. Educators should also couple physical activity-related advice with encouragement and support. Due to high levels of altruism, educators should consider implementing group- and/or peer-based physical activity interventions in this patient group.

Identification of patient-centered outcomes among African American women with type 2 diabetes

“…However, we anticipated some of them, due to our previous work [15] and others [20] documenting negative diabetes-related emotions and altruistic intentions [16] among African American women with Type 2 diabetes. For example, as part of the first session of the lifestyle intervention, we allotted time for participants to describe and elaborate on their emotions immediately following diagnosis.…”

“…Here, we describe its use in identifying patient-centered outcomes among African American women with Type 2 diabetes enrolled in a lifestyle intervention. In the discussion, we describe how we addressed and prioritized some of these outcomes during implementation, based on both patient-centered outcomes shared during the exercise and our previous work among the target group [15, 16]. …”

Racial/Ethnic Differences in Midlife Women's Attitudes Toward Physical Activity

“…5–12 Studies have frequently excluded Asians, and the few studies among Asians were limited to a sub-ethnic group of Asians (eg, Asian Indian, Korean, Lebanese-American) in a specific geographical area. 4, 9, 11, 13–15 Many of the studies on racial/ethnic-specific attitudes toward physical activity have focused on African Americans or Hispanics, 16–19 and many have been conducted among those with specific diseases (eg, diabetes and cardiovascular disease). 16, 17, 20, 21 …”

“…[5][6][7][8][9][10][11][12] Studies have frequently excluded Asians, and the few studies among Asians were limited to a subethnic group of Asians (eg, Asian Indian, Korean) in a specific geographical area. 4,9,11,[13][14][15] Many of the studies on racial/ethnic-specific attitudes toward physical activity have focused on African Americans or Hispanics, [16][17][18][19] and many have been conducted among those with specific diseases (eg, diabetes and cardiovascular disease). 16,17,20,21 Despite these limitations in the studies on midlife women's attitudes toward physical activity, researchers agree that specific racial/ethnic groups have racial/ethnic-specific attitudes toward physical activity.…”

“…4,9,11,[13][14][15] Many of the studies on racial/ethnic-specific attitudes toward physical activity have focused on African Americans or Hispanics, [16][17][18][19] and many have been conducted among those with specific diseases (eg, diabetes and cardiovascular disease). 16,17,20,21 Despite these limitations in the studies on midlife women's attitudes toward physical activity, researchers agree that specific racial/ethnic groups have racial/ethnic-specific attitudes toward physical activity. 19,22,23 For example, Mex-ican Americans were reported to view physical activity as prescriptive and significant in retaining health and regarded family responsibilities and attitudes as factors that positively or negatively influenced their physical activity.…”