• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of herLink to Publisher's site
Health Educ Res. Aug 2011; 26(4): 732–738.
Published online May 19, 2011. doi:  10.1093/her/cyr034
PMCID: PMC3139490

Exploring the feasibility of a physical activity intervention for midlife African American men


Background. This study tested the initial efficacy of implementing a physical activity (PA) behavior change intervention for midlife African American (AA) men. Methods. Intervention components were based on information gathered during formative research preceding the intervention. Eligible participants were underactive AA men ages 45–66 years. In a quasi-experimental pre–post design, participants attended 90-min program sessions twice weekly for 8 weeks. Session topics specific to PA included overcoming barriers, gaining social support, setting goals, tracking progress and integrating into one’s lifestyle. Participants were assigned to teams to facilitate group discussion, problem solving, accountability and camaraderie. Results. 25 AA men (mean age = 54.7 ± 4.8 years) completed the intervention. After 8 weeks, significant (P < 0.05) positive changes were observed for moderate to vigorous-intensity PA (+7.3 hour week−1) and overall PA (+9.4 hour week−1), self-efficacy for PA (+12%), social support for PA from family (+28%) and friends (+53%), self-regulation for planning (+33%) and goal setting (+48%) and each fitness component (+9 to +144%). Based on a post-intervention satisfaction survey, participants rated the program very positively. Conclusion. These positive results attest to the feasibility of successfully engaging midlife AA men in a tailored PA behavior change program.


The need to promote physical activity (PA) in midlife (45–64 years) and older (≥65 years) African American (AA) men is paramount because they suffer much higher rates of acute and chronic physical and mental conditions that can be ameliorated by regular PA [1, 2]. Quite alarming, though, is the lack of focus on AA men of all ages in several obesity, health disparities, PA and prevention reviews and essays published in recent years [38]. Albeit AA women are also at high risk for many health disparities, the dismal inclusion of AA men in PA intervention research is perplexing. A recent systematic review of interventions to increase PA and physical fitness in AA adults included 29 qualified studies, only one of which included solely AA men [9]. However, that study used a clinic-based exercise training protocol to enhance aerobic fitness and was not an intervention focused on promoting change in PA via behavior modification [10]. Thus, there remains a large gap in our ability to translate evidence-based programs into practice for this vulnerable population.

To help fill this notable gap in knowledge, our research team initiated a process to develop and evaluate a PA intervention designed to be sensitive to the needs and preferences of midlife AA men. A rigorous formative research phase identified recruitment strategies [11], PA attitudes, beliefs, barriers and enablers and acceptable PA program components for midlife AA men [12, 13]. This paper describes the outcomes of the pilot project founded on results of the formative research phase and implemented to test the feasibility of delivering a gender and culturally tailored PA intervention for AA men ages 45–66 years.


A quasi-experimental pre–post design was used with assessments at baseline and 8 weeks. The study was approved by the University of South Carolina Institutional Review Board and written informed consent was provided by all participants. The intervention was implemented from May through July 2008.


Inclusion criteria were inactive or irregularly active (i.e. not meeting current PA guidelines for American adults [14]) AA men 45–66 years of age without any contraindications to mild- to moderate-intensity PA. Participants were recruited May to June, 2008, through local media, a university AA faculty listserv, flyers and announcements in community settings (e.g. barbershops, churches), mailings to senior residential facilities, a wellness center’s membership roster and word of mouth. The recruitment goal was 30–35 participants based on the sample size from a previously published first-generation PA behavior change study [15] and available physical space. Sixty-three persons responded to recruitment efforts with 53 being deemed eligible. Thirty-eight eligible men agreed to participate in the program and 31 of those appeared in person to complete pre-intervention assessments and formally consented to participate in the study. Due mostly to time conflicts, four men who completed pre-intervention assessments never attended any of the group sessions resulting in 27 study participants.


The primary theoretical foundation of the intervention was social cognitive theory [16], which has been successfully applied to PA behavior change [17]. Intervention components were derived from prior formative research involving interviews with 49 older AA men [12, 13]. Group-sessions mediated by two trained facilitators were conducted twice per week for 90 min per session for 8 weeks with session format and content adapted from previously conducted research [18, 19].

Standard intervention elements

Session content included benefits of PA, overcoming barriers to being active (e.g. time constraints, lack of social support, low motivation, poor access to PA resources, factors related to chronic conditions and aging), utilizing social support for PA, goal setting, self-monitoring, fitting PA into a daily routine, remaining active during high-risk times and PA maintenance.

Tailored cultural and gender intervention elements

Components integrated into the program based on formative research included


The intervention was tailored to participants based on the traditional views of masculine identity and gender role perspectives revealed during prior interviews with midlife AA men. As such, the concepts of responsibility, stress management and relapse prevention were integrated into group sessions. A community service project was also instituted to help fulfill the aspect of ‘giving back’ that emerged during the formative research phase.

Accessibility/integration with existing services:

The intervention was conducted in partnership with a city-managed wellness center located in a redeveloped area adjacent to a neighborhood with a 100% AA population.

Incorporate social time.

Small and large group-based processes were used to promote camaraderie and social interaction among the men.

Healthy/Friendly competition.

Teams with 4–5 participants each were randomly organized. Team members reported to one another on weekly progress toward previously identified goals. Based on this information, a weekly ‘Most Valuable Person’ for each team was selected and publicly recognized, thereby providing social models for participants. Each week, research staff shared information among the teams regarding team member attendance and goal achievement to spur friendly competition.

Create program identity/ownership.

This was accomplished with program t-shirts, team affiliations and several organized group activities.

Research staff helped each participant establish an initial overall PA goal (e.g. accumulating 150 min week−1 of moderate- intensity PA) and weekly goals established to foster gradual progress. These individualized goals were recorded on a PA log that was completed daily by the participants, reviewed each week and modified as needed. Only brief PA demonstrations on stretching, resistance training, and brisk walking were provided during the program. Thus, the men completed the vast majority of their desired PA outside of the group sessions.


At baseline and posttest (8 weeks), participants completed a series of assessments in the community wellness center. Standing height and body weight were assessed with a portable stadiometer and calibrated digital scale, respectively. Lower-body leg strength (chair stand test) and flexibility (chair sit-and-reach test) were assessed [2022]. The Rockport Fitness (1 mile) Walking test conducted on an indoor track was used to measure aerobic fitness [23]. Participants completed the CHAMPS PA Questionnaire for Older Adults to measure PA in terms of hours per week of total and moderate-vigorous PA (MVPA) [24, 25], Social support [26], self-efficacy [27] and self-regulation [28] for PA were assessed. At posttest, a 14-item survey adapted from a previous study [29] was used to gauge participant satisfaction with the program.

Data analysis

Unadjusted paired t-tests were conducted to explore pre- to post-intervention differences for all outcomes with statistical comparisons limited to participants who had complete pre- and post-intervention data for any given outcome. Level of significance was P ≤ 0.05.


Table I presents demographic characteristics and baseline values for 31 men who consented to participate. By mid-intervention, 2 of the 27 participants withdrew from the study due to scheduling conflicts leaving 25 men who completed the full program. Attendance ranged from 63 to 93% (mean = 86 ± 7%) across the 16 sessions. The completion and submission of weekly activity logs ranged from 70 to 93% (mean = 82 ± 8%). After 8 weeks, significant (P ≤ 0.05) positive changes were observed for MVPA and overall PA (hour week−1), self-efficacy for PA, social support from family and friends, self-regulation for planning and goal setting, both functional fitness components and aerobic fitness (Table II). Satisfaction with the program was very high (Table III). One participant reported a minor leg muscle strain as a result of walking with no other adverse events reported by the remaining participants.

Table I.
Participant baseline characteristics
Table II.
Changes in behavioral, psychosocial and functional fitness components
Table III.
Satisfaction survey results (N = 25a)


Previous PA intervention studies have not focused solely on midlife and older AA men, and in studies where they have been included, they comprised only a very meager proportion of the overall sample [9, 30]. The positive findings of this study attest to the feasibility of engaging midlife AA men in a tailored PA behavior change intervention. Over 8 weeks, significant positive changes in PA level, self-efficacy, perceived social support, self-regulation, aerobic fitness and more objective indicators of functional fitness were observed. In addition, attendance was very good, compliance for weekly submission of PA logs was high and ratings of satisfaction with various program components were very favorable. However, recruitment, retention and post-intervention assessment data indicate the need to account for a 20–35% loss to follow-up when determining adequate sample size for future studies.

One of the unique aspects of this intervention was the incorporation of healthy/friendly competition. Based solely on observations by research staff, the strategy of using teams to integrate this feature seemed to suit the men extremely well and may have contributed to the marked increase in the social support from friends (Table II). One previous qualitative study with older AA men and women mentioned the potential use of external competition as 1 of 16 potential strategies for exercise program retention [31]. However, there has not been any explicit description of this strategy in any published intervention studies to promote PA among community-dwelling AA adults. The inclusion of a community service project that involved PA (i.e. performing 2 hours of yard and household work for an elderly couple with physical limitations) has also not been described by other investigators. Finally, the consideration of masculine identity and gender role embodied by midlife AA men and its potential influence on PA behavior is novel [32] and intervention processes designed to account for these proved effective in meeting the men’s needs and interests.

As this was a pilot study with a small self-selected sample and without a comparison group, and pre- to post-intervention assessments were conducted without blind conditions, the results must be viewed with caution. It is also unknown if the PA intervention would maintain its effectiveness beyond the 8 weeks used in this study. The use of self-reported PA may have resulted in inaccurate depictions of PA level. However, the CHAMPS instrument has proven validity [24], reliability [24] and sensitivity to change [24, 25, 29, 33]. Although the relative changes in total PA and MVPA (107–155%) in the current study were similar to those reported in diverse groups of older adults in previous PA intervention research using CHAMPS [25, 29, 33], future studies may wish to incorporate objective measures of PA to avoid biases associated with self-report. The treatment satisfaction survey did not include issues related to the tailoring of the intervention, and therefore, it is difficult to know which elements may have been more important to the men than others. Nevertheless, the general intervention format and content used in the current study have been previously demonstrated to result in similar significant changes in PA behavior under rigorously controlled conditions with larger sample sizes over longer periods of time [18, 34, 35], as well as during community-based translation projects [33] involving other populations.

In summary, this pilot program resulted in positive behavior, psychosocial and functional fitness outcomes in midlife AA men. The significant findings and lessons learned from this small pre–post community-based pilot study set the stage for a larger clinical trial that will control for threats to internal validity to fully test the efficacy of the intervention to increase PA and improve health- and fitness-related outcomes in this at-risk population.


National Institute on Aging at the National Institutes of Health (1R21AG028674).

Conflict of interest statement

None declared.


We acknowledge the support of the City of Columbia and Charles R. Drew Wellness Center. We are grateful to all of the students, guest speakers and community partners who assisted the program and Jorge Banda for manuscript preparation.


1. Hoyert D, Arias E, Smith BJ, et al. Deaths: final data for 1999. Natl Vital Stat Rep. 2001;49:1–113. [PubMed]
2. US Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.
3. Kumanyika S. Obesity, health disparities, and prevention paradigms: hard questions and hard choices. Prev Chronic Dis. 2005;2:A02. [PMC free article] [PubMed]
4. Kumanyika SK, Whitt-Glover MC, Gary TL, et al. Expanding the obesity research paradigm to reach African American communities. Prev Chronic Dis. 2007;4:A112. [PMC free article] [PubMed]
5. Kirchhoff A, Elliott L, Schlichting J, et al. Strategies for physical activity maintenance in African American women. Am J Health Behav. 2008;32:517–24. [PMC free article] [PubMed]
6. Fleury J, Lee SM. The social ecological model and physical activity in African American women. Am J Community Psychol. 2006;37:129–40. [PubMed]
7. Jilcott SB, Laraia BA, Evenson KR, et al. A guide for developing intervention tools addressing environmental factors to improve diet and physical activity. Health Promot Pract. 2007;8:192–204. [PubMed]
8. Vrazel J, Saunders RP, Wilcox S. An overview and proposed framework of social-environmental influences on the physical-activity behavior of women. Am J Health Promot. 2008;23:2–12. [PubMed]
9. Whitt-Glover MC, Kumanyika SK. Systematic review of interventions to increase physical activity and physical fitness in African-Americans. Am J Health Promot. 2009;23:S33–56. [PubMed]
10. Kokkinos PF, Narayan P, Colleran J, et al. Effects of moderate intensity exercise on serum lipids in African-American men with severe systemic hypertension. Am J Cardiol. 1998;81:732–5. [PubMed]
11. Friedman D, Hooker SP, Wilcox S, et al. J Health Comm. African American men's perspectives on promoting physical activity: “we're not that difficult to figure out! (accepted for publication) [PMC free article] [PubMed]
12. Burroughs E, Rheaume C, Feeney S, et al. Recruiting African American Men: What Works. Hilton Head island, SC: American Academy of Health Behavior, Annual Meeting; 2009.
13. Burroughs E, Hooker SP, Wilcox S, et al. Development of a tailored physical activity intervention for middle-aged and older African American Men. Philadelphia, PA: American Public Health Association, Annual Meeting; 2009.
14. US Department of Health and Human Services (USHHS) 2008 Physical Activity Guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion; 2008.
15. King AC, Ahn DK, Oliveira BM, et al. Promoting physical activity through hand-held computer technology. Am J Prev Med. 2008;34:138–42. [PMC free article] [PubMed]
16. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.
17. Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med. 2002;22(4 Suppl):73–107. [PubMed]
18. Dunn AL, Marcus BH, Kampert JB, et al. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA. 1999;281:327–34. [PubMed]
19. Blair SN, Dunn AL, Marcus BH, et al. Active Living Every Day: Get Active with a Proven 20-Step Program. Champaign, IL: Human Kinetics; 2001.
20. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999;70:113–9. [PubMed]
21. Miotto JM, Chodzko-Zajko WJ, Reich JL, et al. Reliability and validityof the Fullerton Functional Fitness Test: an indpendent replication study. J Aging Phys Act. 1999;7:339–53.
22. Rikli RE, Jones CJ. Development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act. 1999;7:127–59.
23. Kline GM, Porcari JP, Hintermeister R, et al. Estimation of VO2max from a one-mile track walk, gender, age, and body weight. Med Sci Sports Exerc. 1987;19:253–9. [PubMed]
24. Harada ND, Chiu V, King AC, et al. An evaluation of three self-report physical activity instruments for older adults. Med Sci Sports Exerc. 2001;33:962–70. [PubMed]
25. Stewart AL, Verboncoeur CJ, McLellan BY, et al. Physical activity outcomes of CHAMPS II: a physical activity promotion program for older adults. J Gerontol A Biol Sci Med Sci. 2001;56:M465–70. [PMC free article] [PubMed]
26. Sallis JF, Grossman RM, Pinski RB, et al. The development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987;16:825–36. [PubMed]
27. Wilcox S, Sharpe PA, Hutto B, et al. Psychometric properties of the self-efficacy for exercise questionnaire in a diverse sample of men and women. J Phys Act Health. 2005;2:285–97.
28. Rovniak LS, Anderson ES, Winett RA, et al. Social cognitive determinants of physical activity in young adults: a prospective structural equation analysis. Ann Behav Med. 2002;24:149–56. [PubMed]
29. Hooker S, Seavey W, Weidmer C, et al. The active aging community grant program: translating science into practice to promote physical activity to older adults. Ann Behav Med. 2005;29:155–65. [PubMed]
30. Brawley LR, Rejeski WJ, King AC. Promoting physical activity for older adults: the challenges for changing behavior. Am J Prev Med. 2003;25(3 Suppl. 2):172–83. [PubMed]
31. Walcott-McQuigg JA, Prohaska TR. Factors influencing participation of African American elders in exercise behavior. Public Health Nurs. 2001;18:194–203. [PubMed]
32. Griffith D, Gunter K, Allen J. Male gender role strain as a barrier to African American men's physical activity. Health Educ Behav. DOI: 10.1177/1090198110383660. [PubMed]
33. Wilcox S, Dowda M, Leviton LC, et al. Active for life: final results from the translation of two physical activity programs. Am J Prev Med. 2008;35:340–51. [PubMed]
34. Rejeski WJ, Brawley LR, Ambrosius WT, et al. Older adults with chronic disease: benefits of group-mediated counseling in the promotion of physically active lifestyles. Health Psychol. 2003;22:414–23. [PubMed]
35. Brawley LR, Rejeski WJ, Lutes J. A group-mediated cognitive-behavioral intervention for increasing adherence to physical activity in older adults. J Appl Biobehav Res. 2000;5:47–65.

Articles from Health Education Research are provided here courtesy of Oxford University Press
PubReader format: click here to try


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...