Exercise adherence and cognitive decline: Engaging with the Black community to develop and test a goal-setting and exercise intensity intervention

Project Summary The average age of the U.S. population is rapidly increasing and with it the prevalence of age-associated cognitive decline. Furthermore, the risk for age-associated cognitive decline may disproportionately affect many historically underrepresented groups. Regular physical activity (PA) is associated with lower risk for cognitive decline, but many people struggle to maintain PA over the long term. Goal setting presents one promising avenue to facilitate PA maintenance and has strong public health significance. Likewise, exercise intensity may further this aim as challenging goals for higher intensity PA may provide the most robust PA maintenance. Importantly, however, most existing research on goal setting, exercise intensity, and theory- based exercise interventions overall has been generated among high SES, low diversity samples, and the field has largely neglected this disparity, with recent reviews and meta-analyses failing to even report racial, ethnic, or socioeconomic demographic factors. While systems of oppression and structural racism undoubtedly influence disparities in health behavior and outcomes, it is also possible that existing individual-level theory- based interventions are not culturally appropriate for many communities, such as African Americans and Black immigrants (i.e., the Black community). In this application, we will take a community engaged research approach to tailor and test a theory-based intervention promoting adherence to recommended levels of PA in the Black community using the technique of person-centered goal setting. We will determine whether prescriptions of different PA intensities moderate the effectiveness of these goal-setting approaches and test the theoretical mediators associated with the effectiveness of these interventions on behavioral adherence and healthy changes in biomarkers associated with cognitive decline. Therefore, the overarching goals of this project are to take a community engaged research approach to 1) tailor a theory-based goal-setting exercise intervention in the Denver metropolitan area Black community (R61) and 2) utilize the Operating Conditions Framework to test the efficacy of the intervention for PA adherence, weekly volume of exercise, and changes in biomarkers associated with cognitive decline (R33). These objectives will be met through collaboration with our community partner The Gyedi Project to focus on and fully engage the Black community in the Denver metropolitan area in the research process.