By Heather O’Donnell
Moderate-to-vigorous physical activity (MVPA) aids in the prevention of premature mortality and chronic diseases, such as coronary and heart disease, type 2 diabetes, and breast and colon cancers (Garber et al., 2011; Lee et al., 2012). However, most people living in upper-middle and high-income countries do not engage in an adequate amount of MVPA, leading to increased morbidity and premature mortality rates (Lee et al., 2012). Underserved populations, including individuals with low socioeconomic status, individuals belonging to racial and ethnic minority groups, and individuals with physical disabilities are more likely than other groups to not engage in an adequate amount of MVPA (Conn et al., 2016; Cooper et al., 2015; Heath et al., 2012; Taylor et al., 1998). These populations should be targeted in MVPA health promotion interventions to reduce health disparities and promote health equity.
Individuals with low socioeconomic status face several barriers to MVPA, including financial constraints, time constraints stemming from work commitments, high levels of stress, low educational attainment, low motivation, and perceptions of lack of safety (Pedersen et al., 2021). They also experience low literacy rates and lack access to transportation and facilities where they would be able to participate in MVPA (Mendoza-Vasconez et al., 2016).
Recruitment strategies to promote MVPA and reduce barriers to access have included advertising messaging through mass media, social marketing, traditional marketing, and simple mobile features, such as text messaging and mobile phones (Mendoza-Vasconez et al., 2016). Successful interventions for individuals with low socioeconomic status should emphasize making MVPA a part of everyday life and communicating knowledge about health and health behaviors (Cleland et al., 2012; Heath et al., 2006; Sallis et al., 1998; Yancey et al., 2006).
Individuals with physical disabilities, such as Parkinson’s disease, cerebral palsy, spinal cord injury, cancer, multiple sclerosis, and stroke, also struggle to engage in MVPA. They commonly experience fatigue, pain, and weakness, as well as difficulty finding disability-friendly MVPA opportunities (Rimmer et al. 2004; Wilhite et al., 2016). Recruitment strategies for these individuals should include more flexible inclusion criteria, multiple marketing platforms, the maintenance of regular contact, and the involvement of community gatekeepers (Mendoza-Vasconez et al., 2016). MVPA promotion programs should include fall prevention education, incorporate technology for personalized, interactive, at-home interventions, and address psychosocial barriers and social support (Mendoza-Vasconez et al., 2016).
Compared to non-Hispanic White individuals, individuals from racial and ethnic minority backgrounds engage in a lower amount of MVPA (West, 2023). African Americans and Latinos experience some of the lowest levels of physical activity and highest levels of chronic diseases of all races (Larsen et al., 2015). Women from these backgrounds are especially likely to engage in an inadequate amount of MVPA (Sternfeld et al., 1999). Suggested recruitment strategies to target these individuals should include advertising messaging on multiple marketing platforms, providing free transportation to improve attendance, partnering with community health centers, and hiring research staff members that reflect the participants’ cultural backgrounds (Mendoza-Vasconez et al., 2016). Physical activity promotion interventions should include the use of linguistically appropriate materials for non-English speakers and cultural adaptations through the inclusion of values that pertain to specific cultures (Mendoza-Vasconez et al., 2016).
Addressing MVPA among underserved populations is one part of the comprehensive effort to address the social determinants of health (SDOHs), the conditions in which people are born, grow, live, work, and play that influence health (WHO, 2018). The SDOHs encompass a variety of social, economic, and environmental factors, such as socioeconomic status, education, employment, social support networks, and neighborhood and physical environments (Artiga and Hinton, 2018). Intervening on these social determinants of health will improve health outcomes and decrease longstanding disparities in health and healthcare for underserved populations.
Heather O’Donnell is a recent graduate of the Bloustein School of Planning and Public Policy, having earned a bachelor of science degree in Public Health.
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