Perceived Benefits and Barriers in the Mediation of Exercise Differences in Older Black Women with and Without Obesity



Weight control is an exercise benefit, important for older Black women, a group experiencing obesity disparities. We compared perceived exercise benefits and barriers between Black women with and without obesity and determined which mediated the weight group-exercise relationship.


A survey (n = 234) was administered to determine attitudinal agreement between weight groups (obese or non-obese). Multiple mediation analysis was used to investigate if attitudes mediated the weight group-exercise relationship.


High agreement with all exercise benefits was observed between women with and without obesity. Compared with women without obesity, women with obesity were more likely to report the barriers of only exercising to lose weight (OR = 2.52, 95% CI 1.40–4.55), lack of will power (OR = 1.82, 95% CI 1.05–3.19), weight (OR = 3.04, 95% CI 1.34–6.83), and cost (OR = 2.14, 95% CI 1.02–4.47). Exercising to lose weight and lack of will power mediated the weight group-exercise relationship.


Women largely agreed on the exercise benefits. Lack of will power and engaging in exercise only for weight loss were barriers that were more common among older Black women with obesity. The barriers partially explained the lower exercise engagement in women with obesity. Future work may address these barriers to increase exercise in older Black women.

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  1. 1.

    Bassuk SS, Manson JE. Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol. 2005;99(3):1193–204.

    Article  Google Scholar 

  2. 2.

    Friedenreich CM, Neilson HK, Lynch BM. State of the epidemiological evidence on physical activity and cancer prevention. Eur J Cancer. 2010;46(14):2593–604.

    Article  Google Scholar 

  3. 3.

    Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67–e492.

    Article  Google Scholar 

  4. 4.

    Williams WM, Yore MM, Whitt-Glover MC. Estimating physical activity trends among blacks in the United States through examination of four national surveys. AIMS Public Health. 2018;5(2):144–57.

    Article  Google Scholar 

  5. 5.

    U.S. Department of Health and Human Services. Physical activity guidelines for Americans. In: Services DoHaH, ed. 2nd ed. Washington, D.C.: U.S.2018.

  6. 6.

    Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91.

    CAS  Article  Google Scholar 

  7. 7.

    Newton RA, Cromwell RL, Rogers HL. The relationship between physical performance and obesity in elderly African-American women. Phys Occup Ther Geriatr. 2009;27(6):423–40.

    Article  Google Scholar 

  8. 8.

    Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK. American College of Sports Medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459–71.

    Article  Google Scholar 

  9. 9.

    Leone LA, Ward DS. A mixed methods comparison of perceived benefits and barriers to exercise between obese and nonobese women. J Phys Act Health. 2013;10(4):461–9.

    Article  Google Scholar 

  10. 10.

    Huebschmann AG, Campbell LJ, Brown CS, Dunn AL. “My hair or my health:” overcoming barriers to physical activity in African American women with a focus on hairstyle-related factors. Women Health. 2016;56(4):428–47.

    Article  Google Scholar 

  11. 11.

    Hall RR, Francis S, Whitt-Glover M, Loftin-Bell K, Swett K, McMichael AJ. Hair care practices as a barrier to physical activity in African American women. JAMA Dermatol. 2013;149(3):310–4.

    Article  Google Scholar 

  12. 12.

    Joseph RP, Ainsworth BE, Keller C, Dodgson JE. Barriers to physical activity among African American women: an integrative review of the literature. Women Health. 2015;55(6):679–99.

    Article  Google Scholar 

  13. 13.

    Im E-O, Ko Y, Hwang H, Yoo KH, Chee W, Stuifbergen A, et al. “Physical activity as a luxury” African American Women’s attitudes toward physical activity. West J Nurs Res. 2012;34(3):317–39.

    Article  Google Scholar 

  14. 14.

    Guess N. A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals. BMC Res Notes. 2012;5(1):191.

    Article  Google Scholar 

  15. 15.

    Pekmezi D, Marcus B, Meneses K, et al. Developing an intervention to address physical activity barriers for African–American women in the deep south (USA). Women Health. 2013;9(3):301–12.

    CAS  Article  Google Scholar 

  16. 16.

    Gothe NP, Kendall BJ. Barriers, motivations, and preferences for physical activity among female African American older adults. Gerontol Geriatr Med. 2016;2:2333721416677399.

    PubMed  PubMed Central  Google Scholar 

  17. 17.

    Mathews AE, Laditka SB, Laditka JN, Wilcox S, Corwin SJ, Liu R, et al. Older adults’ perceived physical activity enablers and barriers: a multicultural perspective. J Aging Phys Act. 2010;18(2):119–40.

    Article  Google Scholar 

  18. 18.

    Ray R. An intersectional analysis to explaining a lack of physical activity among middle class black women. Sociol Compass. 2014;8(6):780–91.

    Article  Google Scholar 

  19. 19.

    Eyler AE, Wilcox S, Matson-Koffman D, Evenson KR, Sanderson B, Thompson J, et al. Correlates of physical activity among women from diverse racial/ethnic groups. J Women’s Health Gend Based Med. 2002;11(3):239–53.

    Article  Google Scholar 

  20. 20.

    Leone LA, Allicock M, Pignone MP, Walsh JF, Johnson LS, Armstrong-Brown J, et al. Cluster randomized trial of a church-based peer counselor and tailored newsletter intervention to promote colorectal cancer screening and physical activity among older African Americans. Health Educ Behav. 2016;43(5):568–76.

    Article  Google Scholar 

  21. 21.

    Allicock M, Johnson L-S, Leone L, Carr C, Walsh J, Ni A, et al. Peer reviewed: promoting fruit and vegetable consumption among members of Black churches, Michigan and North Carolina, 2008–2010. Prev Chronic Dis. 2013;10:E33.

    PubMed  PubMed Central  Google Scholar 

  22. 22.

    Leone LA, Campbell MK, Allicock M, Pignone M. Colorectal cancer screening and physical activity promotion among obese women: an online evaluation of targeted messages. J Health Commun. 2012;17(10):1187–203.

    Article  Google Scholar 

  23. 23.

    Kramish Campbell M, James A, Hudson MA, Carr C, Jackson E, Oakes V, et al. Improving multiple behaviors for colorectal cancer prevention among African American church members. Health Psychol. 2004;23(5):492–502.

    Article  Google Scholar 

  24. 24.

    Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9; SUPP/1):S498–504.

    CAS  Article  Google Scholar 

  25. 25.

    Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91.

    Article  Google Scholar 

  26. 26.

    Bopp M, Wilcox S, Laken M, Butler K, Carter RE, McClorin L, et al. Factors associated with physical activity among African-American men and women. Am J Prev Med. 2006;30(4):340–6.

    Article  Google Scholar 

  27. 27.

    Jakicic JM, Davis KK. Obesity and physical activity. Psychiatr Clin. 2011;34(4):829–40.

    Google Scholar 

  28. 28.

    Whitt-Glover M, Keith N, Ceaser T, Virgil K, Ledford L, Hasson R. A systematic review of physical activity interventions among African American adults: evidence from 2009 to 2013. Obes Rev. 2014;15(S4):125–45.

    Article  Google Scholar 

  29. 29.

    Genkinger JM, Jehn ML, Sapun M, Mabry I, Young DR. Does weight status influence perceptions of physical activity barriers among African-American women? Ethn Dis. 2006;16(1):78–84.

    PubMed  Google Scholar 

  30. 30.

    Samuel-Hodge CD, Headen SW, Skelly AH, Ingram AF, Keyserling TC, Jackson EJ, et al. Influences on day-to-day self-management of type 2 diabetes among African-American women: spirituality, the multi-caregiver role, and other social context factors. Diabetes Care. 2000;23(7):928–33.

    CAS  Article  Google Scholar 

  31. 31.

    Woods-Giscombé CL. Superwoman schema: African American women’s views on stress, strength, and health. Qual Health Res. 2010;20(5):668–83.

    Article  Google Scholar 

  32. 32.

    Murakami JM, Latner JD. Weight acceptance versus body dissatisfaction: effects on stigma, perceived self-esteem, and perceived psychopathology. Eat Behav. 2015;19:163–7.

    Article  Google Scholar 

  33. 33.

    Woods-Giscombe CL, Allen AM, Black AR, Steed TC, Li Y, Lackey C. The Giscombe superwoman Schema questionnaire: psychometric properties and associations with mental health and health behaviors in African American women. Issues Ment Health Nurs. 2019;40(8):672–81.

    Article  Google Scholar 

  34. 34.

    James SA, Fowler-Brown A, Raghunathan TE, Van Hoewyk J. Life-course socioeconomic position and obesity in African American women: the Pitt County study. Am J Public Health. 2006;96(3):554–60.

    Article  Google Scholar 

  35. 35.

    Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and socioeconomic status in adults: United States 1988–1994 and 2005–2008. NCHS data brief no 50. Hyattsville: National Center for Health Statistics; 2010.

    Google Scholar 

  36. 36.

    Joseph RP, Coe K, Ainsworth BE, Hooker SP, Mathis L, Keller C. Hair as a barrier to physical activity among African American women: a qualitative exploration. Front Public Health. 2018;5:367.

    Article  Google Scholar 

  37. 37.

    Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care. 2010;13(1):46–51.

    CAS  Article  Google Scholar 

  38. 38.

    Creswell JW, Clark VLP. Designing and conducting mixed methods research. New York: Sage publications; 2017.

    Google Scholar 

  39. 39.

    Petty RE, Barden J, Wheeler SC. The elaboration likelihood model of persuasion. In: RJ DC, Crosby RA, Kegler MC, editors. Emerging theories in health promotoion practice and research: Strategies for Improving Health. San Francisco: Jossey-Bass; 2002. p. 71–99.

    Google Scholar 

  40. 40.

    Wilson BJ. Designing Media Messages About Health and Nutrition: What Strategies Are Most Effective? J Nutr Educ Behav. 2007;39(2, Supplement):S13–9.

    Article  Google Scholar 

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This study was funded by the Centers for Disease Control and Prevention.

(3-U48-DP000059-02S1) and Lineberger Comprehensive Cancer Center’s Cancer Control and Education Pre-Doctoral Fellowship Program (NCI CA057726–16). Dr. Leone’s effort was also supported by a Cancer Health Disparities Training Grant (1T32CA128582–03).

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Correspondence to Loneke T. Blackman Carr.

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This study was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill.

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Blackman Carr, L.T., Nezami, B.T. & Leone, L.A. Perceived Benefits and Barriers in the Mediation of Exercise Differences in Older Black Women with and Without Obesity. J. Racial and Ethnic Health Disparities 7, 807–815 (2020).

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  • Physical activity
  • Exercise
  • Health disparities
  • Obesity