Influence of Demographic, Psychosocial, Physiological and Sociocultural Variables on Exercise Adherence Among African Americans Enrolled in the Fit 4 Life Study

Abstract

Exercise adherence is fundamental in the management of hypertension and other chronic diseases. The purpose of this study was two-fold. The first purpose was to examine patterns of adherence and to describe the influences of demographic, psychosocial, physiological, and sociocultural variables on adherence among African Americans enrolled in the Fit 4 Life study. The second purpose was to determine follow-up exercise behaviors of participants previously enrolled in the Fit 4 Life study. A mixed-methods approach was used with questionnaires and semi-structured interviews. A total of 75 African Americans (mean age = 51.8) who were previously enrolled in the Fit 4 Life study completed a several measures, which included a demographic questionnaire, psychosocial measures (SOC - Short Form; EBBS; BARSE; MHLC - Form C; SLS), and physiological tests (e.g., BMI, blood pressure, fasting glucose, cholesterol). Nine semi-structured interviews were conducted with exercise adherers (n = 5) and non-adherers (n = 4) who returned the questionnaires. Interviews were analyzed using thematic analysis and resulted in the emergence of four themes, and 10 associated subthemes, which described the participants' perceptions of exercise, their environment, and how these elements influence exercise behavior. The major themes were: benefits, barriers, facilitators, African American. Analysis revealed that adherers were able to identify greater physical activity benefits, and developed strategies to overcome barriers to exercise, including finding sources of social support outside of their friends and family. Adherers were also more likely to view self-efficacy as a benefit of exercise, as well as view exercise as an opportunity to focus on themselves. Through a series of chi-square analyses and independent samples t-tests, quantitative results revealed that adherers lived in smaller households and worked part-time. Adherers also had lower diastolic blood pressures, weighed less, had lower resting metabolic rates, less fat mass, and lower BMIs than non-adherers. Finally, adherers perceived fewer barriers to exercise, and had greater life satisfaction than non-adherers.