Abstract P219: Moderated-Mediated Effects of Environmental Barriers and Income Level on Exercise Determinants Among Black Americans With Hypertension
Bibliographic record
Abstract
Introduction: Black individuals are disproportionately affected by hypertension and due to racial disparities have fewer opportunities to engage in preventive measures such as exercise compared to their White counterparts. There is a dearth of research employing a theory-driven approach to comprehensively investigate the factors contributing to disparities in exercise participation among racial groups, both at the individual and environmental levels. The I-Change Model is a contemporary health behavior model comprising three primary pillars hypothesized to influence health behavior: Awareness, Motivation, and Action/Planning. What sets this model apart is its unique emphasis on the proximity of the barrier construct to predicting behavior execution, a feature that may contribute to disparities in exercise participation, including racial disparities. Hence, this observational study aimed to apply the ‘I-Change model’ to identify factors that contribute to exercise behaviors among Black and White individuals with Hypertension. Methods: We used the I-Change model, which includes mediating behavioral determinants, along with moderators that include environmental barriers (e.g., access and transportation to a supportive exercise environment), and income (low vs. moderate and above) to gain a better understanding of racial disparities in exercise participation. Individuals with hypertension (n= 370) that comprised of Black (n= 142) and White (n= 228) adults who were recruited via an online recruitment platform and completed a survey that included validated theoretical constructs. Hayes PROCESS 4.0 Macro (model #16) for SPSS was used to construct the theoretical model and analyze the data. The model included race (x), exercise time (y), behavioral determinants (mediators), environmental behaviors, and income (moderators between mediators and exercise time). Results: I-Change determinants (risk of heart disease, planning, exercise knowledge, exercise partner/social support) mediated the relationship between race and exercise time (β= .24, 95% CI .098, .394) in favor of White participants. Moderated-mediation effects were found on barriers that interacted between planning and exercise time (β= .03, 95% CI .0018, .0674), and income which interacted between social support and exercise time, (β= .05, 95% CI .0004, .1056). Conclusion: Intervention work at the community level for low-income Black individuals with hypertension supported by a theoretical framework is needed. Specifically, an exercise promotion program that supports the development of I-Change determinants, which provides an accessible and supportive environment, would be helpful in providing equitable exercise opportunities for Black individuals with hypertension.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.017 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".