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Effectiveness of an online, dyadic, culturally adapted physical activity intervention for south Asian mothers and
Namratha R Kandula1,2, David X Marquez3, Mudita Rastogi4
1Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Background:
South Asian females in the United States experience elevated cardiometabolic risk and have lower levels of moderate-to-vigorous intensity physical activity (MVPA) than other race and ethnic groups. This study evaluated the effectiveness of a dyadic, culturally adapted behavioral intervention to increase MVPA among US South Asian mothers and adolescent daughters.
Methods:
Type-1 hybrid, phase II randomized controlled trial with data collection from August 1, 2020 to March 26, 2024. Participants were 126 South Asian mother-daughter dyads from the Chicago, Illinois, metropolitan area. South Asian women not meeting MVPA recommendations at baseline and who had a daughter aged 11-16 years were eligible. Mother-daughter dyads were randomized to either an education control of written health education materials (n=63 dyads) or a dyadic, culturally adapted behavioral intervention delivered online (n=63 dyads). The 18-week behavioral intervention included exercises classes, discussion groups, and activity tracking tools. The primary outcome was the between-group difference in accelerometer-measured MVPA change from baseline to 4 months using intent-to-treat analyses. Secondary outcomes included light physical activity (LPA), step count, sedentary time, self-efficacy, blood pressure, and mother-daughter communication. Analyses were conducted from May 2024-January 2025.
Findings:
Among 126 randomized dyads, mean (SD) age was 42.8 (5.6) years for mothers and 13.5 (1.7) years for daughters. Among mothers, 94% were born outside the US. Mean difference in MVPA change in the intervention vs control group were -1.9 minutes/day (95% CI, -6.4 to 2.5 min/day) for mothers and -0.9 minutes/day for MVPA (95% CI, -7.3 to 5.5) for daughters. Intervention participation was not associated with greater improvements in secondary outcomes.
Interpretation:
A dyadic, culturally adapted PA intervention was not more effective than written health education materials for improving MVPA among South Asian mothers and adolescent daughters. Effective PA promotion across the lifecourse for this elevated-risk population requires further investigation.
Trial Registration:
ClinicalTrials.gov Identifier: NCT04400253.