Annals of Behavioral Medicine

, Volume 30, Issue 3, pp 191–200

Modifying physical activity in a multiethnic sample of low-income women: One-year results from the IMPACT (Increasing Motivation for Physical ACTivity) project

  • Cheryl L. Albright
  • Leslie Pruitt
  • Cynthia Castro
  • Alma Gonzalez
  • Sandi Woo
  • Abby C. King


Background: Ethnic minorities or those with low socioeconomic status (SES) are at increased risk of cardiovascular disease, type 2 diabetes, and all-cause mortality, compared to higher SES Whites. National surveys also indicate that low-income, ethnic minority women have the highest rates of inactivity in the United States.Purpose: This study (the Increasing Motivation for Physical ACTivity or IMPACT study) promoted adoption and maintenance of physical activity (PA) in sedentary, low-income women participating in federally funded job training programs.Methods: The study consisted of 2 months of weekly 1-hr classes, then random assignment to 10 months of either home-based telephone counseling for PA plus information and feedback via mailed newsletters (Phone + Mail Counseling condition) or just the mailed newsletters (Mail Support condition). The IMPACT intervention included behavior change strategies for PA as well as discussions related to motivational readiness for PA change. Participants completed surveys and physiological assessments at baseline after the classes ended (i.e., at 10 weeks) and at 6 and 12 months postbaseline. Seventy-three percent of randomized participants (n = 72) were Latina, with a mean age of 32 ± 10 years. More than half the women had not completed high school, and 73% had an annual income less than $20,000.Results: After 10 months of a homebased intervention, women in the phone + mail counseling condition had significantly greater increases in estimated total energy expenditure compared to women in the mail support condition (p < .05).Conclusions: Regular PA counseling delivered via the telephone and through the mail appears effective for encouraging regular PA among low-income women transitioning from welfare or job training to the workforce.


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  1. (1).
    Vrias E, Smith BL: Deaths: Preliminary data for 2001.National Vital Statistics Report, Vol. 51, No. 5. Hyattsville, MD: National Center for Health Statisitics, 2003.Google Scholar
  2. (2).
    Hu FB, Manson JE, Stampfer MJ, et al.: Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.New England Journal of Medicine. 2001,345:790–797.PubMedCrossRefGoogle Scholar
  3. (3).
    Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC: Primary prevention of coronary heart disease in women through diet and lifestyle.New England Journal of Medicine. 2000,343:16–22.PubMedCrossRefGoogle Scholar
  4. (4).
    Stamler J, Stamler R, Neaton JD, et al.: Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: Findings for 5 large cohorts of young adult and middle-aged men and women.Journal of the American Medical Association. 1999,282:2012–2018.PubMedCrossRefGoogle Scholar
  5. (5).
    Manson JE, Spelsberg A: Primary prevention of non-insulin-dependent diabetes mellitus.American Journal of Preventive Medicine. 1994,10:172–184.PubMedGoogle Scholar
  6. (6).
    U.S. 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.Google Scholar
  7. (7).
    Manson JE, Hu FB, Rich-Edwards JW, et al.: A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women.New England Journal of Medicine. 1999,341:650–658.PubMedCrossRefGoogle Scholar
  8. (8).
    Wareham NJ, Wong M-Y, Day NE: Glucose intolerance and physical inactivity: The relative importance of low habitual energy expenditure and cardiorespiratory fitness.American Journal of Epidemiology. 2000,152:132–139.PubMedCrossRefGoogle Scholar
  9. (9).
    Mayer-Davis EJ, D’Agostino RB, Karter AJ, et al.: Intensity and amount of physical activity in relation to insulin sensitivity: The Insulin Resistance Atherosclerosis Study.Journal of the American Medical Association. 1998,279:669–674.PubMedCrossRefGoogle Scholar
  10. (10).
    Blair SN, Brodney S: Effects of physical inactivity and obesity on morbidity and mortality: Current evidence and research issues.Medicine and Science in Sports and Exercise. 1999,31(Suppl. 11):S46-S62.Google Scholar
  11. (11).
    Villeneuve PJ, Morrison HI, Craig CL, Schaubel DE: Physical activity, physical fitness, and risk of dying.Epidemiology. 1998,9:626–631.PubMedCrossRefGoogle Scholar
  12. (12).
    Farrell SW, Braun L, Barlow CE, Cheng YJ, Blair SN: The relation of body mass index, cardiorespiratory fitness, and all-cause mortality in women.Obesity Research. 2002,10:417–423.PubMedGoogle Scholar
  13. (13).
    Lissner L, Bengtsson C, Bjorkelund C, Wedel H: Physical activity levels and change in relation to longevity: A prospective study of Swedish women.American Journal of Epidemiology. 1996,143:54–62.PubMedGoogle Scholar
  14. (14).
    Lee I-M, Paffenbarger RS: Associations of light, moderate, and vigorous intensity physical activity with longevity: The Harvard Alumni Health Study.American Journal of Epidemiology. 2000,151:293–299.PubMedGoogle Scholar
  15. (15).
    DiLorenzo TM, Bargman EP, Stucky-Ropp R, et al.: Long-term effects of aerobic exercise on psychological outcomes.Preventive Medicine. 1999,28:75–85.PubMedCrossRefGoogle Scholar
  16. (16).
    Centers for Disease Control and Prevention:Health, United States 1996–1997, DHHS Publication No. (PHS) 95–1232. Hyattsville, MD: Department of Health and Human Services, 1995.Google Scholar
  17. (17).
    Centers for Disease Control and Prevention: Socioeconomic status of women with diabetes—United States, 2000.Mortality and Morbidity Weekly. 2002,51:147–148, 159.Google Scholar
  18. (18).
    Lantz PM, House JS, Lepkowski JM, et al.: Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of US adults.Journal of the American Medical Association. 1998,279:1703–1708.PubMedCrossRefGoogle Scholar
  19. (19).
    Barnes PM, Schoenborn CA: Physical activity among adults: United States, 2000.Advance Data From Vital and Health Statistics, No. 333. Hyattsville, MD: National Center for Health Statistics, 2003.Google Scholar
  20. (20).
    Schoenborn CA, Barnes PM: Leisure-time physical activity among adults: United States, 1977–98.Advance Data From Vital and Health Statistics, No. 325. Hyattsville, MD: National Center for Health Statisitics, 2002.Google Scholar
  21. (21).
    Crespo CJ, Smit E, Anderson RE, Carter-Pokras O, Ainsworth BE: Race/ethnicity, social class, and their relation to physical inactivity during leisure time: Results from the Third National Health and Nutrition Examination Survey, 1988–1994.American Journal of Preventive Medicine. 2000,18:46–53.PubMedCrossRefGoogle Scholar
  22. (22).
    Crespo CJ, Smit E, Carter-Pokras O, Andersen R: Acculturation and leisure-time physical inactivity in Mexican-American adults: Results from NHANES III, 1988–1994.American Journal of Public Health. 2001,91:1254–1257.PubMedCrossRefGoogle Scholar
  23. (23).
    U.S. Department of Health and Human Services:National Health Interview Survey: Regular Leisure-Time Physical Activity, Data Table for Figure 7.3. 2002. Retrieved January 13, 2003, from released200212/figures07_1-7_.3htmGoogle Scholar
  24. (24).
    Will JC, Massoudi B, Mokdad A, et al.: Reducing risk for cardiovascular disease in uninsured women: Combined results from two WISEWOMAN projects.Journal of the American Medical Womens Association. 2001,56:161–165.Google Scholar
  25. (25).
    Kumanyika S: Special issues regarding obesity in minority populations.Annals of Internal Medicine. 1993,119:650–654.PubMedGoogle Scholar
  26. (26).
    Higgins PG, Learn CD: Health practices of adult Hispanic women.Journal of Advanced Nursing. 1999,29:1105–1112.PubMedCrossRefGoogle Scholar
  27. (27).
    Myers HF, Kagawa-Singer M, Kumanyika S, et al.: Behavioral risk factors related to chronic diseases in ethnic minorities.Health Psychology. 1995,14:613–621.PubMedCrossRefGoogle Scholar
  28. (28).
    Bandura A:Social Foundations of Tthought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall, 1986.Google Scholar
  29. (29).
    Bandura A:Self-Efficacy: The Exercise of Control. New York: Freeman, 1997.Google Scholar
  30. (30).
    Prochaska JO, DiClemente CC: Stages and processes of self-change in smoking: Toward an integrative model of change.Journal of Counsulting and Clinical Psychology. 1983,51:390–395.CrossRefGoogle Scholar
  31. (31).
    Prochaska JO, DiClemente CC: Stages of change in the modification of problem behaviors.Progress in Behavioral Modification. 1992,28:183–218.Google Scholar
  32. (32).
    Marcus BH, Simkin LR: The stages of exercise behavior.Journal of Sports Medicine and Physical Fitness. 1993,33:83–88.PubMedGoogle Scholar
  33. (33).
    Chen AH, Sallis JF, Castro CM, Hickman SA, Lee RE: A home-based behavioral intervention to promote walking in sedentary ethnic minority women: Project WALK.Women’s Health: Research in Gender, Behavior and Policy. 1998,4:19–39.Google Scholar
  34. (34).
    Kumanyika SK, Van Horn L, Bowen D, et al.: Maintenance of dietary behavior change.Health Psychology. 2000,19(Suppl. 1):42–56.PubMedCrossRefGoogle Scholar
  35. (35).
    Marcus BH, Dubbert PM, Forsyth LH, et al.: Physical activity behavior change: Issues in adoption and maintenance.Health Psychology. 2000,19(Suppl. 1):32–41.PubMedCrossRefGoogle Scholar
  36. (36).
    Marcus BH, Simkin LR: The Transtheoretical Model: Applications to exercise behavior.Medicine and Science in Sports and Exercise. 1994,26:1400–1404.PubMedGoogle Scholar
  37. (37).
    Suris AM, Trapp MDC, DiClemente CC, Cousins J: Application of the Transtheoretical Model of behavior change for obesity in Mexican American women.Addictive Behaviors. 1998,23:655–668.PubMedCrossRefGoogle Scholar
  38. (38).
    Dunn AL, Marcus BH, Kampert JB, et al.: Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness.Journal of the American Medical Association. 1999,281:327–334.PubMedCrossRefGoogle Scholar
  39. (39).
    King AC, Sallis JF, Dunn AL, et al.: Overview of the Activity Counseling Trial (ACT) intervention for promoting physical activity in primary care settings.Medicine and Science in Sports and Exercise. 1998,30:1086–1096.PubMedCrossRefGoogle Scholar
  40. (40).
    King AC, Taylor CB, Haskell WL, DeBusk RF: Strategies for increasing early adherence to and long-term maintenance of home-based exercise training in healthy middle-aged men and women.American Journal of Cardiology. 1988,61:628–632.PubMedCrossRefGoogle Scholar
  41. (41).
    Dunn AL, Garcia ME, Marcus BH, et al.: Six-month physical activity and fitness changes in Project Active, a randomized trial.Medicine and Science in Sports and Exercise. 1998,30:1076–1083.PubMedCrossRefGoogle Scholar
  42. (42).
    Avila P, Hovell MF: Physical activity training for weight loss in Latinas: A controlled trial.International Journal of Obesity. 1994,18:476–482.PubMedGoogle Scholar
  43. (43).
    The Writing Group for the Activity Counseling Research Group: Effects of physical activity counseling in primary care. The Activity Counseling Trial: A randomized controlled trial.Journal of the American Medical Association. 2001,286:677–687.CrossRefGoogle Scholar
  44. (44).
    Nader PR, Baranowski T, Vanderpool NA, et al.: The family health project: Cardiovascular risk reduction education for children and parents.Journal of Developmental Behavior and Pediatrics. 1983,4:3–10.CrossRefGoogle Scholar
  45. (45).
    Nader PR, Sallis JF, Patterson TL, et al.: A family approach to cardiovascular risk reduction: Results from the San Diego Family Health Project.Health Education Quarterly. 1989,16:229–244.PubMedGoogle Scholar
  46. (46).
    Taylor WC, Baranowski T, Young DR: Physical activity interventions in low-income, ethnic minority, and populations with disability.American Journal of Preventive Medicine. 1998,15:334–343.PubMedCrossRefGoogle Scholar
  47. (47).
    Collins R, Lee RE, Albright CL, King AC: Ready to be physically active? The effects of a course preparing low income multiethnic women to be more physically active.Health Education & Behavior. 2004,31:47–64.CrossRefGoogle Scholar
  48. (48).
    Prochaska JO, Velicer WF, Rossi JS, et al.: Stages of change and decisional balance for 12 problem behaviors.Health Psychology. 1994,13:39–46.PubMedCrossRefGoogle Scholar
  49. (49).
    Fletcher GF, Balady G, Blair SN, et al.: Statement on exercise: Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association.Circulation. 1996,94:857–862.PubMedGoogle Scholar
  50. (50).
    Resnicow K, Baranowski T, Ahluwalia JS, Braithwaite RL: Cultural sensitivity in public health: Defined and demystified.Ethnicity and Disease. 1999,9:10–21.PubMedGoogle Scholar
  51. (51).
    Resnicow K, Braithwaite R, Dilorio C, Glanz K: Applying theory to culturally diverse and unique populations. In Glanz K, Rimer BK, Lewis FM (eds),Health Behavior and Health Education. San Francisco: Jossey-Bass, 2002, 485–509.Google Scholar
  52. (52).
    King AC, Frederiksen L: Low-cost strategies for increasing exercise behavior: Relapse preparation training and social support.Behavior Modification. 1984,8:3–21.CrossRefGoogle Scholar
  53. (53).
    Bassett DR Jr,Ainsworth BE,Leggett SR, et al.: Accuracy of five electronic pedometers for measuring distancewalked.Medicine and Science in Sports and Exercise. 1996,28:1071–1077.PubMedGoogle Scholar
  54. (54).
    Dunn AL, Marcus BH, Kampert JB, et al.: Reduction in cardiovascular disease risk factors: 6-month results from Project Active.Preventive Medicine. 1997,26:883–892.PubMedCrossRefGoogle Scholar
  55. (55).
    Sallis JF, Haskell WL, Wood PD, et al.: Physical activity assessment methodology in the Five-City Project.American Journal of Epidemiology. 1985,121:91–106.PubMedGoogle Scholar
  56. (56).
    Blair SN, Haskell WL, Ho P, et al.: Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments.American Journal of Epidemiology. 1985,122:794–804.PubMedGoogle Scholar
  57. (57).
    Welk GJ, Almeida J, Morss G: Laboratory calibration and validation of the BioTrainer and Actitrac activity monitors.Medicine and Science in Sports and Exercise. 2003,35:1057–1064.PubMedCrossRefGoogle Scholar
  58. (58).
    Marin G, Sabogal F, Marin B, Otero-Sabogal R, Perez-Stable E: Development of a short acculturation scale for Hispanics.Hispanic Journal of Behavioral Sciences. 1987,9:183–205.CrossRefGoogle Scholar
  59. (59).
    Landis J, Koch GG: The measurement of observer agreement for categorical data.Biometrics. 1977,33:159–174.PubMedCrossRefGoogle Scholar
  60. (60).
    Lee RE, McGinnis KA, Sallis JF, et al.: Active vs. passive methods of recruiting ethnic minority women to a health promotion program.Annals of Behavioral Medicine. 1998,19:378–384.Google Scholar
  61. (61).
    King AC, Haskell WL, Young DR, Oka RK, Stefanick ML: Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years.Circulation. 1995,91:2596–2604.PubMedGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2005

Authors and Affiliations

  • Cheryl L. Albright
    • 1
  • Leslie Pruitt
    • 2
  • Cynthia Castro
    • 2
  • Alma Gonzalez
    • 2
  • Sandi Woo
    • 2
  • Abby C. King
    • 2
  1. 1.Stanford Prevention Research CenterStanford University School of Medicine Cancer Research Center of Hawaii University of HawaiiUSA
  2. 2.Stanford Prevention Research CenterStanford University School of MedicineUSA
  3. 3.Cancer Research Center of HawaiiUniversity of HawaiiHonolulu

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