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Biomedical subjects

Sara Wilcox

Publications and source records attributed to Sara Wilcox.

At least 19 recordsLinked to original sources
PubMed2006

Understanding physical activity participation in members of an African American church: a qualitative study.

Faith-based interventions hold promise for increasing physical activity (PA) and thereby reducing health disparities. This paper examines the perceived influences on PA participation, the link between spirituality and health behaviors and the role of the church in promoting PA in African Americans. Participants (n = 44) were adult members of African American churches in South Carolina. In preparation for a faith-based intervention, eight focus groups were conducted with sedentary or underactive participants. Groups were stratified by age (<55 years versus >or=55 years), geography and gender. Four general categories were determined from the focus groups: spirituality, barriers, enablers and desired PA programs. Personal, social, community and environmental barriers and enablers were described by both men and women, with no apparent differences by age. Additionally, both men and women mentioned aerobics, walking programs, sports and classes specifically for older adults as PA programs they would like available at church. This study provides useful information for understanding the attitudes and experiences with exercise among African Americans, and provides a foundation for promoting PA through interventions with this population by incorporating spirituality, culturally specific activities and social support within the church.

Adult↗
PubMed2006

Evaluation of a 12-week home-based walking intervention for breast cancer survivors.

GOALS OF WORK: To evaluate a 12-week home-based walking intervention among breast cancer survivors and to quantify changes in physical activity (PA) behaviors, body weight, and body composition in response to the intervention. PATIENTS AND METHODS: Breast cancer survivors that were in the posttreatment period were randomized to intervention (n=23) or wait-list usual care (n=13). PA was assessed by self-report, and in a study subsample (n=23), by an accelerometer. Intention to treat principles were employed to estimate the intervention effect on PA behaviors, body weight, and body composition. Intervention adherence was calculated as the proportion of exercise sessions completed relative to the number of exercise sessions recommended, as reported each week on walking logs. MAIN RESULTS: Thirty-four of 36 women randomized (94%) completed the study. Average intervention adherence over 12 weeks was 94%. Intervention participants reported a significantly greater increase in walking for exercise [+11.9 metabolic equivalent (MET)-h/week] over time than did usual care participants (+1.7 MET-h/week, p=0.01). Objective measures of activity also indicated that intervention participants increased their activity levels over time as compared to usual care participants [i.e., counts/min/day and steps/day (p< or =0.04)]. No significant changes in body weight or composition were observed. CONCLUSION: We found that a 12-week home-based walking intervention was safe and effective for increasing short-term PA levels in breast cancer survivors. Future studies are needed to assess the ability of brief interventions to facilitate the maintenance of increased activity levels and to produce favorable quality of life and risk factor outcomes.

Body Composition↗
PubMed2006

Perceived exercise barriers, enablers, and benefits among exercising and nonexercising adults with arthritis: results from a qualitative study.

OBJECTIVE: Rates of participation in regular exercise are lower among individuals with arthritis than those without arthritis. This study examined perceived exercise barriers, benefits, and enablers in exercising and nonexercising adults with arthritis. METHODS: Twelve focus groups were conducted with 68 adults with arthritis. Groups were segmented by exercise status, socioeconomic status, and race. Focus group discussions were transcribed verbatim and coded. NVivo software was used to extract themes for exercisers and nonexercisers. RESULTS: A wide range of physical, psychological, social, and environmental factors were perceived to influence exercise. Some of these factors were similar to those in general adult samples, whereas others were unique to individuals with chronic disease. Symptoms of arthritis were barriers to exercise, yet improvements in these outcomes were also seen as potential benefits of and motivations for exercise. Exercisers had experienced these benefits and were more likely to have adapted their exercise to accommodate the disease, whereas nonexercisers desired these benefits and were more likely to have stopped exercising since developing arthritis. Health care providers' advice to exercise and the availability of arthritis-specific programs were identified as needs. CONCLUSION: This study has implications for how to market exercise to individuals with arthritis and how communities and health care professionals can facilitate the uptake of exercise. These implications are discussed.

Adult↗
PubMed2006

The health-e-AME faith-based physical activity initiative: Description and baseline findings.

This article provides an overview of the development, implementation, and baseline findings from a statewide faith-based physical activity (PA) initiative. The 3-year program is training African Methodist Episcopal volunteers across South Carolina to implement programs to increase PA in their congregations. To date, 98 churches have been trained. Interviews done with a random sample (n = 39) indicated that 54% are implementing at least one PA program. The baseline telephone survey (N = 571) estimates that 27.8% of the population is regularly active, 54.9% underactive, and 17.3% sedentary. Baseline rates of regular PA were higher in those who were younger, healthier, and nonsmokers. Challenges to date have included obtaining rosters and implementing a large-scale program with limited resources. Interest in the program has been strong and supported by church leaders. Current efforts are on training additional churches and working with those already trained to support sustainability.

Adolescent↗
PubMed2006

Factors that influence exercise among adults with arthritis in three activity levels.

INTRODUCTION: Recent public health objectives emphasize the importance of exercise for reducing disability among people with arthritis. Despite the documented benefits of exercise, people with arthritis are less active than those without arthritis. The purpose of this study was to examine the factors that influence exercise participation among insufficiently active individuals with arthritis and to compare these factors with those identified by nonexercisers and regular exercisers with arthritis. METHODS: Forty-six individuals with arthritis were recruited from various community-based organizations to participate in seven focus groups segmented by exercise status and education. Trained moderators led each discussion using a standard guide. All focus group discussions were transcribed verbatim and coded. RESULTS: Pain was the most commonly mentioned barrier to exercise and limited exercise participation for nonexercisers and insufficiently active individuals. Paradoxically, insufficiently active individuals also identified exercise-related reductions in pain as a potential motivation for increasing exercise. Likewise, exercise-related reductions in pain were a motivation to continue exercising for the exerciser groups. Nonexercisers expressed that a reduction in pain was a possible outcome of exercise but were skeptical of its occurrence. Receiving tailored advice from a health care provider was consistently identified as an exercise enabler across the groups. CONCLUSION: Findings from this study indicate that potential strategies for increasing exercise participation include incorporating pain management strategies and coping skills into exercise interventions and ensuring that health care providers provide specific exercise advice to their patients with arthritis.

Adult↗
PubMed2006

Results of the first year of active for life: translation of 2 evidence-based physical activity programs for older adults into community settings.

OBJECTIVES: Translating efficacious interventions into practice within community settings is a major public health challenge. We evaluated the effects of 2 evidence-based physical activity interventions on self-reported physical activity and related outcomes in midlife and older adults. METHODS: Four community-based organizations implemented Active Choices, a 6-month, telephone-based program, and 5 implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active. Participants completed pretest and posttest surveys. RESULTS: Participants (n=838) were aged an average of 68.4 +/-9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys. Intent-to-treat analyses found statistically significant increases in moderate-to-vigorous physical activity and total physical activity, decreases in depressive symptoms and stress, increases in satisfaction with body appearance and function, and decreases in body mass index. CONCLUSIONS: The first year of Active for Life demonstrated that Active Choices and Active Living Every Day, 2 evidence-based physical activity programs, can be successfully translated into community settings with diverse populations. Further, the magnitudes of change in outcomes were similar to those reported in the efficacy trials.

Aged↗
PubMed2006

Health care provider advice for African American adults not meeting health behavior recommendations.

INTRODUCTION: Poor dietary habits and sedentary lifestyle contribute to excessive morbidity and mortality. Healthy People 2010 goals are for 85% of physicians to counsel their patients about physical activity and for 75% of physician office visits made by patients with cardiovascular disease, diabetes, or dyslipidemia to include dietary counseling. The purpose of this study was to 1) determine the rate of participant-reported health care provider advice for healthy lifestyle changes among African Americans who do not meet recommendations for physical activity, fruit and vegetable consumption, and healthy weight; 2) examine correlates of provider advice; and 3) assess the association between provider advice and stage of readiness for change for each of these health behaviors. METHODS: Data for this study were collected as part of a statewide faith-based physical activity program for African Americans. A stratified random sample of 20 African Methodist Episcopal churches in South Carolina was selected to participate in a telephone survey of members aged 18 years and older. The telephone survey, conducted over a 5-month period, asked participants a series of questions about sociodemographics, health status, physical activity, and nutrition. Analyses for moderate to vigorous physical activity, fruit and vegetable consumption, and weight loss were conducted separately. For each of these behaviors, logistic regression analyses were performed to examine the independent association of sex, age, body mass index, education, number of diagnosed diseases, perceived health, and stage of change with health care provider advice for health behaviors. RESULTS: A total of 572 church members (407 women, 165 men; mean age, 53.9 years; range, 18-102 years) completed the survey. Overall, participant-reported provider advice for lifestyle changes was 47.0% for physical activity, 38.7% for fruit and vegetable consumption, and 39.7% for weight. A greater number of diagnosed diseases and higher body mass index were independently associated with receiving advice to increase physical activity. A more advanced stage of change and a greater number of diagnosed diseases were independently associated with receiving advice for fruit and vegetable consumption. Body mass index, stage of change, and poorer perceived health were independently associated with receiving advice about weight. CONCLUSION: Health care provider advice appears to be based predominantly on comorbidities. Because of the preventive benefit of physical activity, fruit and vegetable consumption, and healthy weight, all health care providers are urged to increase counseling for all patients not meeting health behavior recommendations.

Adolescent↗
PubMed2006

Factors associated with physical activity among African-American men and women.

BACKGROUND: African Americans have lower rates of physical activity (PA) than Caucasians. Although correlates of PA have been studied in many populations, little is known about the influences on physical activity for African Americans, particularly African-American men. METHODS: Individuals were randomly selected from 20 church rosters and participated in a telephone survey (165 men, 407 women) in May to September 2003. Participants were classified according to whether they were meeting recommendations for moderate to vigorous physical activity, walking, and strength training. Sociodemographic, health, psychosocial, and physical environment correlates were also assessed. Mixed-model logistic regression analyses were conducted. RESULTS: For men, explained variance ranged from 20.8% to 33.3%. For women, the independent variables explained 10.8% to 23.2% of the variance in physical activity behavior. Significant positive correlates among men were employment, income, self-rating of health, PA self-efficacy, and PA enjoyment, and fruit and vegetable intake, with age as a negative correlate. Significant positive correlates among women were employment, education, income, self-rating of health, PA self-efficacy, PA enjoyment, fruit and vegetable intake, reporting PA programs at their church, and attempting weight loss. Negative correlates included age, number of chronic health conditions, and body mass index. CONCLUSIONS: Various factors influenced PA in men and women, suggesting a need for gender targeting in addition to cultural adaptations in PA interventions for African Americans.

Black or African American↗
PubMed2006

Outcome expectations and physical activity participation in two samples of older women.

Outcome expectations have received little study in physical activity (PA) research. This study examined whether initial outcome expectations and their achievement at 6 months (i.e. outcome realizations) predicted subsequent PA participation (7-12 months) in 118 older women. Initial outcome expectations were not associated with PA participation. Outcome realizations at 6 months, however, predicted subsequent PA participation (p < .05). Women with high expectations but low attainment had the lowest subsequent participation rates. Women with high attainment, regardless of expectations, had the highest rates. Findings replicate and extend an earlier study and argue for a more dynamic conceptualization of outcome expectations.

Adult Children↗
PubMed2006

Beliefs of low-income and rural older women regarding physical activity: you have to want to make your life better.

This study elicited perceptions about physical activity in 28 older rural and low-income women (27 were Caucasian) in four focus groups to identify factors that affected their physical activity levels. This population is greatly understudied and underserved. Overall, themes that surfaced across the groups were consistent with social cognitive theory. Prominent themes included outcome expectations about both physical and mental benefits; beliefs about the sources of motivation to be physically active, including both internal sources and external sources; barriers to being active; and the types of social environments important for physical activity. These findings provide useful information regarding the types of physical activity programs preferred by rural, low-income older women and ways to build self-efficacy and social support among members of this population group with regard to increasing physical activity.

Aged↗
PubMed2005

The Prevention Research Centers Healthy Aging Research Network.

BACKGROUND: The Prevention Research Centers Healthy Aging Research Network (PRC-HAN), funded by the Centers for Disease Control and Prevention's (CDC's) Healthy Aging program, was created in 2001 to help develop partnerships and create a research agenda that promotes healthy aging. The nine universities that participate in the network use their expertise in aging research to collaborate with their communities and other partners to develop and implement health promotion interventions for older adults at the individual, organizational, environmental, and policy levels. CONTEXT: The population of older adults in the United States is growing rapidly; approximately 20% of Americans will be aged 65 years or older by 2030. The health and economic impact of an aging society compel the CDC and the public health community to place increased emphasis on preventing unnecessary disease, disability, and injury among older Americans. METHODS: The PRC-HAN has a broad research agenda that addresses health-promoting skills and behaviors, disease and syndrome topics, and knowledge domains. The network chose physical activity for older adults as its initial focus for research and has initiated two networkwide projects: a comprehensive, multisite survey that collected information on the capacity, content, and accessibility of physical activity programs for older adults and a peer-reviewed publication that describes the role of public health in promoting physical activity among older adults. In addition to participating in the core research area, each network member works independently with its community committee on PRC-HAN activities. CONSEQUENCES: As a result, the network is 1) expanding prevention research for older adults and their communities; 2) promoting the translation and dissemination of findings to key stakeholders; 3) strengthening PRC-HAN capacity through partnerships and expanded funding; and 4) stimulating the adoption of policies and programs by engaging policymakers, planners, and practitioners. In 2003, the PRC-HAN initiated an internal evaluation to better define the network's contributions to healthy aging, formalize internal processes, and better equip itself to serve as a model for other PRC thematic networks. The PRC-HAN is conducting a pilot evaluation for eventual inclusion in the PRC national evaluation. INTERPRETATION: The PRC-HAN has established itself as an effective research network to promote healthy aging. It has developed trust and mutual respect among participants, forged strong ties to local communities, and shown the ability to combine its expertise in healthy aging with that of partners in national, state, and local organizations.

Aged↗
PubMed2005

Correlates of self-efficacy for physical activity in African American women.

This study examined the correlates of self-efficacy for physical activity in African American women. In bivariate analyses, self-efficacy was higher among women reporting fewer social role constraints, more positive perceptions of physically active women, more positive sense of community, better perceived health, and higher levels of physical activity. In a simultaneous multivariate model, more positive perceived health status (p = .001), higher physical activity level (p = .007), and lower social role constraint (p = .02) were independently associated with higher self-efficacy. Thus, physical activity interventions for African-American women should include strategies to decrease social role constraint and offer safe activities for women with health conditions hindering physical activity.

Adult↗
PubMed2005

A qualitative study of exercise in older African American and white women in rural South Carolina: perceptions, barriers, and motivations.

Six focus groups were conducted with underactive African American (n = 16) and white (n = 23) women aged 50 years and older, residing in a nonmetropolitan county in South Carolina, to examine perceptions, barriers, and motivators related to exercise. Transcripts were coded and codes were entered into NUD*IST to assist with organizing and reporting themes. Participants could not reach consensus on the frequency, intensity, and duration of exercise needed for older women, and emphasized that PA recommendations should consider age, health, and physical abilities. While benefits and barriers to exercise were similar to those found in other groups, the risk of "overdoing it," being "too old," and environmental barriers specific to rurality were unique. Exercise enablers were also similar to those found in other groups, but rural women discussed the role that the church played in supporting exercise. Other enablers included transportation, free facilities, and age-appropriate programs. Results indicate the need to tailor recommendations and advice to older women, and to consider the rural context in which they live.

Black or African American↗
PubMed2005

Race differences in cardiovascular and cortisol responses to an interpersonal challenge in women who are family caregivers.

OBJECTIVES: To examine race differences in psychosocial and psychophysiological responses to family caregiving. DESIGN: Participants completed paper-and-pencil surveys and were exposed to a laboratory-based interpersonal challenge that included a period of rest, an interpersonal challenge, and a period of recovery. SETTING: A university research laboratory. PARTICIPANTS: Sixteen Caucasian and 12 African-American postmenopausal (64 +/- 10 years) women who were caregivers to a family member with dementia. MEASURES: Psychosocial functioning included self-reported perceived stress, caregiver burden, social support, and caregiving meaning. Systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were measured every two minutes during the rest, challenge, and recovery. Salivary cortisol was measured at rest and 15-minutes post-challenge. RESULTS: There was a Race x Task interaction for SBP and HR but not DBP reactivity. African-American women showed greater reactivity than Caucasian women. The magnitude of this interaction was large. African-American women also reported greater caregiving from meaning than Caucasian women. In contrast, significantly more African Americans (58%) than Caucasians (14%) showed cortisol reactivity from rest to 15-minutes post-challenge. CONCLUSIONS: The differential pattern of physiologic responses is consistent with studies outside of the caregiving literature, and suggests that caregiving may be perceived as more effortful among Caucasian women and less controllable among African-American women.

Analysis of Variance↗
PubMed2004

A replicable process for redesigning ethnically relevant educational materials.

BACKGROUND: To serve the populations targeted by Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) effectively, healthcare providers need educational materials that are evidence based and ethnically relevant and can be easily incorporated into busy clinic settings. We describe a replicable process used to redesign and tailor physical activity and diet education materials for African American women in the southeastern United States. METHODS: The process consists of seven phases. Quantitative and qualitative analyses were used on data gathered in 2000 from two expert panels and eight focus groups. RESULTS: Expert panelists preferred materials perceived to be high quality, easy to understand, organized to facilitate use by healthcare providers, and with content relevant to African American women. Focus group participants were mostly concerned with the visual appeal and content of educational materials. They liked high-quality materials that are brief; avoid jargon and use simple language, bright colors, and photographs; and provide useful information that acknowledges the context of their lives, including their family roles. CONCLUSIONS: The redesign process can produce ethnically and culturally appropriate educational materials for use by WISEWOMAN providers and other healthcare providers in conjunction with cardiovascular (CVD) risk reduction and behavioral counseling. To be effective, materials must address the needs and concerns of both providers and patients.

Black or African American↗
PubMed2004

The effects of life events and interpersonal loss on exercise adherence in older adults.

Associations of life events and interpersonal loss with participation in home- and group-based exercise were studied in 97 older adults (64 % women, 70.2 +/- 4.1 years). Life events were assessed with a modified Social Readjustment Rating Scale at baseline and 6 and 12 months. Exercise logs and class-attendance records documented exercise participation. Participants experienced 3.62 +/- 3.56 unique life events over the course of the study, and 28 participants reported an interpersonal loss (5 men, 23 women). Number of life events was negatively associated with home-based exercise participation (p <.05); among women, this association approached significance (p =.06) for class-based exercise. Women who experienced an interpersonal loss had lower class-based participation than those who did not (p =.02), but home-based participation rates were unaffected. Life events, particularly interpersonal loss, appear to have a negative impact on exercise in women, and this effect appears greater for class-based than for home-based exercise.

Aged↗
PubMed2004

Correlates of strength training in older rural African American and Caucasian women.

This study examined factors influencing strength training (ST) in two convenience samples of older rural women. Focus group (FG) participants were 23 Caucasian and 16 African American women aged 67.5 +/- 9.2 years. Survey participants were 60 Caucasian and 42 African American women, aged 70.59 +/- 9.21 years. FG participants answered questions about the risks, benefits, and barriers to ST. Survey participants completed measures of demographics, physical activity (including ST), depression and stress, decisional balance for exercise (DBE), barriers to PA, and social support (SS). Regression modeling examined correlates of ST. FG participants identified physical health gains and improved appearance as ST benefits. African American women also included mental health benefits and "feeling good". Both Caucasian and African American groups named physical health problems as risks of ST. Caucasian women identified time constraints, lack of ST knowledge, physical health problems, lack of exercise facilities, and the cost of ST as barriers. African American women cited being "too tired", physical health problems, lack of support, and other family and work responsibilities. The linear regression model explained 23.2% of the variance in hours per week of ST; DBE and family SS were independent positive correlates. This study identified correlates to participation in ST in older rural women and provides a basis for developing ST interventions in this population.

Black or African American↗