Midlife African American Women's Maintenance of Lifestyle Physical Activity

Saturday, 29 July 2017: 8:50 AM

JoEllen Wilbur, PhD, RN, FAAN
Lynne Braun, PhD, APN, FAAN
Susan Buchholz, PhD, RN, ANP-BC, FAANP
Arlene Miller, PhD, RN, FAAN
College of Nursing, Rush University, Chicago, IL, USA


Group interventions combining guidance, self-management, and ongoing support effectively increase physical activity in African-American women, but little is known about long-term maintenance. Maintenance of physical activity is commonly defined as participant achievement of a pre-prescribed level of physical activity at 2 points of time often at the end of the intervention and 6 months later (Kahlert, 2015). Examination of 14 physical activity interventions with African American women revealed only three examined maintenance after cessation of the intervention with all reporting a return toward baseline or low retention. The 48-week Women’s Lifestyle Physical Activity program designed to increase adherence to physical activity included six nurse led group meetings guided by Social Cognitive Theory (Wilbur et al., 2016). They were held every five weeks at six community healthcare facilities. In addition, there were three accompanying telephone conditions delivered between group meetings (group meeting + 11 motivation interviewing calls, group meeting + 11 motivational automated calls, group meeting only). Personal calls were brief motivational interviews and automated calls provided motivation tips. Findings showed high retention during the intervention phase (90%) with significant improvement in physical activity measured at 48 weeks. These effects did not differ by condition. The purpose of this study is to determine midlife African American women’s maintenance of physical activity one to three years after completion of the Women’s Lifestyle Physical Activity program and to determine if maintenance differed by telephone condition.


A longitudinal design was used. During the 48-week intervention phase the three telephone conditions were delivered in groups of 13-17 midlife women (total 18 groups). Assessment of long-term maintenance of adherence to physical activity began 1 year after the first group completed the intervention. Over the following six months long-term assessment was completed for each group in the order in which each group completed the intervention. By doing this data were systematically collected with most women participating in long-term assessment from one to three years after completing the intervention. All 288 women who began the intervention received a follow-up survey that included the self-report Community Healthy Activity Model Program for Seniors (CHAMPS) questionnaire covering minutes per week of reported moderate-vigorous (MV) physical activity, M-V leisure time physical activity and walking. The survey was conducted by mail, phone or in person.


254 women (88.2%) completed the follow-up survey. Linear growth analyses showed that increases in self-reported physical activity were sustained at follow-up across all three measures: total moderate-vigorous physical activity (MV physical activity; p<.001), leisure MV physical activity (p<.001), and walking (p<.001). After a sharp increase between baseline and 24 weeks, level of physical activity remained stable through the remainder of the 48-week intervention as well as during long-term maintenance. Minutes of physical activity changed by less than ±2 minutes per month during long-term maintenance. None of the effects varied by intervention condition.


Group meetings are a powerful component of physical activity interventions that have sustained physical activity into an extended maintenance phase. Although increases in physical activity during the intervention were confirmed by objective accelerometer measures, long-term follow outcomes were limited by reliance on self-report measures of physical activity. Future studies should verify these results using objective measures of physical activity.