African-American (AA) women experience the highest incidence of metabolic syndrome (MetS). MetS is associated with obesity and contributes significantly to the progression of type 2 diabetes and cardiovascular disease, two chronic illnesses that create a significant burden on the nation's health care system. Physical activity (PA) decreases the risk of MetS, obesity, type 2 diabetes, and cardiovascular disease;yet, AA women are the least active segment of the population.The purpose of the proposed 4-week feasibility study is to test a newly developed, Internet-based, PA intervention, Yogic Dance (YD), and whether or not YD digital videos can influence sedentary lifestyle behaviors in AA women (ages 35-64) at risk for or with MetS. The primary aim of this study is to determine the acceptability and feasibility of the YD intervention. Specifically, the study will examine (a) rate of participant eligibility, accrual, attrition, and reasons for attrition;(b) feasibility of usingthe Internet to assess study participation and to deliver the YD intervention;(c) feasibility of usinga commercially available accelerometer to objectively measure PA;(d) acceptability of the structured YD intervention;and (e) any other benefits and/or limitations of the study. The secondary aim of this study is to determine if there is a difference in PA after participating in te YD intervention. The study will use a single group, mixed-methods design underpinned by social constructivist theory and Pender's Health Promotion Model. Study participants will be drawn from both a rural university-centered AA community and a large urban AA community. After completing in-person screening and baseline measures, consented participants will engage in a 4-week Internet-based video intervention choreographed and produced by the applicant under the direction of skilled PA, dance, and yoga practitioners. Participants will be guided toward setting achievable goals to increase PA incrementally and will record daily YD participation using an online PA diary. Study participation will be assessed by frequency of YD Web site login attempts and reviewing of YD videos of three unique YD postures. To measure PA objectively, participants will use waist-worn FitbitTM accelerometers that have the capability of uploading these data to the YD study Web site for analysis. All recruited participants will be invited to participate in a focus group to gather their perceptions of barriers to and benefits from YD, the experiences of yoga and dance in their daily lives, and acceptability of using the YD intervention. In addition, descriptive/frequency data derived from the rates of participant eligibility, accrual, attrition, and the number of completed study measures will be calculated. Determination of whether or not there is an effect of YD on PA will be done using dependent t-tests that compare baseline PA to post-intervention PA as measured by online PA diaries and accelerometer data. Focus group data will be analyzed using content/thematic analysis with triangulation and will form a foundation for a program of research exploring the complex problems and facilitators that influence PA in AA women.

Public Health Relevance

African American (AA) women experience the highest incidence of metabolic syndrome (MetS), a group of risk factors that results from overweight/obesity related to sedentary lifestyle and leads to chronic diseases such as type 2 diabetes and cardiovascular disease. AA women are under-studied and under-treated for MetS and they often explore complementary therapies because the allopathic pharmacological care they receive may be too expensive or may have unappealing side effects. There is scant research demonstrating acceptability of yoga and dance by AA women. If efficacious, Yogic Dance (YD) specifically developed for AA women may be an important additional approach to managing MetS and the related complications in this population. Because physical activity has been a public health priority since the inception of Healthy People initiatives, effective interventions emphasizing prevention of chronic diseases that contribute greatly to the nation's financial health care burden will be of great value. YD offers a response to the calls of many federal health care agencies for public health programming to support physical activity in community-based settings.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Predoctoral Individual National Research Service Award (F31)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Banks, David
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University of Virginia
Schools of Nursing
United States
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