Dimensions of Racial Identity as Predictors of Physical Activity in Midlife African American Women
thesisposted on 02.02.2012 by Elaine C. Hardy
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Physical inactivity leads to serious health consequences, particularly for midlife African American (AA) women. Midlife African American (AA) women are less physically active and have higher obesity-related morbidity and mortality than midlife White women. Studies to examine these disparities typically view AAs as a homogeneous group, despite evidence of important within-group variance. Using a culturally-adapted identity-based motivational model, the purpose of this study was to determine whether dimensions of racial identity have differential influence on physical activity in midlife AA women. A convenience sample of 252 AA women aged 40-65 was recruited from a predominantly Black community in Northwest Indiana. Using a cross-sectional design, participants completed the Jackson Heart Study physical activity measure (JPAC), and the Behavioral Risk Factor Surveillance Systems (BRFSS) physical activity measure along with a measure of dimensions of racial identity (Black American, Multicultural, Bicultural, Afrocentric, and Racial Salience), self-labeled race, and psychometrically valid and reliable self-report measures of known predictors of physical activity (self-efficacy, social support, neighborhood factors, BMI, and self-rated health). Using level of physical activity (JPAC) as the outcome variable, a multiple regression model was fit to the data. The mean age was 52+7 yrs, and 59% were obese (BMI>30). Multiple regression revealed the only dimension of racial identity that was predictive of level of physical activity was Black American (=-.15) controlling for the other variables in the model. Black American racial identity was shown to negatively predict level of physical activity along with BMI (=-.15), while, self-efficacy (=.27), social support for physical activity (=.17), and good/excellent health (=.19) positively predicted level of physical activity, accounting for 24% of the variance in the level of physical activity. Using the BRFSS physical activity measure as the outcome variable, based on the distribution of the data, we collapsed these groups into two categories reflecting sufficient vs. insufficient activity .A logistic regression model was fit to the data. Logistic regression revealed the odds of engaging in sufficient levels of physical activity were 2.5 times higher for women who reported good or excellent health compared to those who reported poor or fair health. In addition, an increase of one point on the physical activity self-efficacy scale increased the odds of engaging in sufficient levels of physical activity by 20% while an increase in BMI one unit reduced the odds of engaging in sufficient levels of physical activity by 40%, controlling for other factors in the model. These variables significantly predicted sufficient physical activity. The disparities of race and sociocultural factors on health behavior have long been a focus of nursing. The findings from this cross-sectional study suggest that this sample of midlife African American women, having a strong dimension of racial identity in Black American, are more likely to engage in a lower level of physical activity. These findings provide foundational data necessary for future longitudinal work to examine the multidimensional role of racial identity on physical activity in midlife African American women over time. Longitudinal studies need to be developed with culturally, individually tailored interventions taking into account dimensions of racial identity to examine its effect on physical activity over time.