Multi-site feasibility and acceptability of a faith-based mind-body intervention in Black adults

PROJECT SUMMARY / ABSTRACT Regular physical activity plays an important role in disease prevention and helps people live longer, feel better, and perform daily tasks more easily. Yet, less than 25% of American adults meet physical activity recommendations, and Americans spend an average of 9.5 hours per day sedentary, putting them at increased risk of cardiovascular disease, cancer, and mortality. Black and rural adults are less likely to be physically active and more likely to be sedentary than non-Hispanic White adults and those in urban areas, contributing to racial and ethnic and rural health disparities. Interventions focused on increasing moderate-to-vigorous physical activity have had limited success among Black adults residing in urban and rural areas. Reducing sedentary behavior as a means to increase physical activity may be a more effective approach. Yoga is a practice that combines the mind, body, and spirit through light-intensity movement, breath awareness, and relaxation techniques, and can be a valuable tool to reduce sedentary behavior and promote movement in adults who are insufficiently active and need to build up to regular physical activity. Furthermore, as a mindfulness practice, yoga’s effects on stress may be particularly relevant to Black adults who experience unique stressors, including racism and discrimination. Based on this, we partnered with churches to develop and test the feasibility of Harmony & Health (HH), a theoretically based intervention that integrates yoga practices with Christian spirituality to promote psychosocial wellbeing and movement among insufficiently active Black adults. We first tested the feasibility of HH among Black adults residing in an urban city, and then tested the feasibility of HH among a diverse sample of rural adults. This study is the next logical step and expands on our pilot studies that confirmed the feasibility of HH in Black adults. Feasibility and acceptability were high as measured by study completion (≥80% across studies), attendance (M urban=10.5±3.7; M rural=10.6±4.2), and participant satisfaction (≥97.2% overall across sites). HH also improved psychosocial wellbeing and reduced sitting time. The proposed study builds on these efforts by randomizing 100 Black adults who are not meeting physical activity recommendations from two geographically distinct sites, one urban and one more rural, to participate in HH or an attention control condition. HH sessions will take place twice a week for 8 weeks and focus on sitting less and moving more using stretching, breathing, and guided relaxation with Christian scripture. Assessments occur at baseline (week 0), post-intervention (week 9), and follow up (week 24). Results of this study will determine our ability to deliver these interventions with strong rigor and fidelity across multiple sites and will establish the feasibility and acceptability of this intervention among urban and rural Black adults. Findings from this study will be used to modify training and implementation procedures in preparation for a future fully powered multi-site randomized controlled efficacy trial. If supported, HH could be an innovative strategy to improve psychosocial wellbeing and physical activity in low active Black adults.