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Smart Walk, a culturally tailored smartphone-delivered physical activity intervention for obese Black women, demonstrates high feasibility and promising results regarding cardiometabolic risk reduction.

Regular aerobic physical activity (PA) reduces the risk of cardiovascular disease and type-2 diabetes. Research shows culturally tailored interventions for African American (AA) women increase PA. A pilot study in the International Journal of Environmental Research and Public Health has assessed the feasibility and preliminary effectiveness of Smart Walk, a culturally tailored smartphone-delivered intervention designed to increase PA and reduce cardiometabolic risk in obese AA women.

Participant Characteristics

Participants (n = 60) had a mean age of 38.4 years. Half were married (36.7%) or in a committed relationship (13.3%). Nearly half had a bachelor’s degree (20%) or higher (26.7%). Income levels were diverse, with the majority having an annual income between $25,000 and $75,000.

High Retention and Engagement Rates in Physical Activity Intervention

The intervention demonstrated good feasibility and acceptability. The recruitment rate was 7.5 women per month. Moreover, 85% of the randomized participants were retained at the 4-month assessment and 78% at 8 months. All 30 intervention participants wore Fitbit on 67% of intervention days, while 24 of these were retained at 4 months and wore Fitbit on 73% of intervention days. All PA promotion text messages were delivered to 77% of participants.

Participant Engagement and Feedback in a Physical Activity Promotion Intervention

On average, participants viewed 7.4 out of 14 multimedia PA promotion modules. App discussion board use was limited, with 71% of participants using it only once a week or less. Ninety-six percent of participants completing the intervention reported that activity tracking and text messages were helpful and motivating, while all of them found PA promotion modules helpful and motivating for increasing PA.  

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Intervention Group Showed Significant Increases in Self-Reported Physical Activity

Intervention participants showed substantially greater increases in self-reported MVPA (moderate-to-vigorous physical activity) than the comparison group participants at 4 and 8 months. Similar results were observed with self-reported weekly energy expenditure. However, statistically significant differences between the groups were only observed for baseline to 8-month changes in light and moderate intensity PA and total PA. The comparison group showed unexpected increases in accelerometer-measured MVPA at 4 and 8 months, while the intervention group showed decreases; however, these changes were minor.

Negligible Changes in Cardiometabolic Risk Markers

Meaningful but statistically non-significant improvements in cardiorespiratory fitness and blood pressure were documented among intervention participants compared to the control group. Differences in baseline to 4-month change for body mass index and lipid, serum, and inflammatory cardiometabolic risk markers were negligible in both arms, with no significant between-group differences.

Intervention Participants Showed Improved Physical Activity Behavior

Intervention participants showed a significantly greater improvement in behavioral capability for PA than the control group at both 4 and 8 months. The intervention group also demonstrated greater (but not statistically significant) improvements in PA self-efficacy, social support, and PA self-regulation.


Joseph, R. P., Todd, M. M., Ainsworth, B. E., Vega-López, S., Adams, M. A., Hollingshead, K., Hooker, S. P., Gaesser, G. A., & Keller, C. (2023). Smart Walk: A Culturally Tailored Smartphone-Delivered Physical Activity Intervention for Cardiometabolic Risk Reduction among African American Women. International Journal of Environmental Research and Public Health, 20(2), 1000. https://doi.org/10.3390/ijerph20021000