Exercise Testing & Training Facility utilization only. Coronary heart disease (CHD) continues to be the leading cause of death in African-American women. They have a high prevalence of CHD risk factors such as obesity, hypertension, and diabetes mellitus. Typically, African- American women have sedentary lifetsyles; thus, they can achieve the greatest health benefits from regular, moderate-intensity physical activity. Most exercise training and other therapeutic interventions have not targeted these women, and few studies have been culturally-specific, sustainable, or efficacious in altering CHD risk factors. This study is a randomized trial using churches in East Baltimore and will compare a 6- month intensive and culturally sensitive behavioral intervention, focused on increasing moderate-intensity physical activity with a minimal, self- help behavioral intervention that encourages the same level of physical activity. Subjects will be sedentary African-American women who are between the ages of 50 and 70 years.
The specific aim of the intervention is to increase total daily energy expenditure by 150 kilocalories per day and time spent in moderate- intensity physical activity by 30 minutes per day. We shall assess effects of increased physical activity on selected cardiovascular risk factors, e.g. peak oxygen uptake, BP, HDL cholesterol, serum insulin and plasma glucose. Six churches will be randomized into intensive or minimal intervention status, and 33-34 women per church will be recruited, for a total of 100 women in each group. The intensive behavioral intervention will consist of twice-weekly aerobic classes conducted at the churches and additional group and home-based programs. Volunteer lay leaders wil be trained as neighborhood exercise specialists to supplement certified aerobics instructors in conducting the intervention. The proposed study fills an existing gap. It examines a culturally-sensitive physical activity intervention conducted in a community setting and its asociation with increased daily energy expenditure in African-American women - a group of high health risk women who are sedentary for whom regular physical activity can provide benefits.
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