Social Interaction Key to Making African-American Walking Programs Work

Newswise — Four years ago residents in south Sumter, S.C., didn’t know their neighbors or take walks in their neighborhood for fear of violence amid gangs and drug dealers. That changed, in part, as a result of a University of South Carolina trial study called PATH or Positive Action for Today’s Health.

South Sumter, like many underserved communities, is largely African-American with a higher prevalence of hypertension, obesity, poor nutrition and inactivity than the general population. Using community-led grassroots social marketing, such as personalized door hangers and calendars featuring photos of residents, the PATH trial increased walking and improved the connectedness and health of the community.

Findings from the health psychology study, which was funded by the National Institutes of Health, appear in the latest issue of American Journal of Public Health.

The study, conducted by Dawn Wilson, a College of Arts and Sciences psychology professor, provides encouraging news for underserved African-American communities wanting to increase physical activity among residents. Wilson’s findings showed that a social marketing approach to implementing a walking program is feasible and effective.

“This is the first study to provide evidence that grassroots social marketing can work in impoverished areas. Not knowing your neighbor is more common today. This is especially true in high crime areas where a neighbor could be a gang member. You don’t know, and it is the unknown that terrifies people,” Wilson said. “Getting out and walking increases awareness of your community.”

Sumter was one of three South Carolina communities involved in the study. The other two included Florence and Orangeburg. Each community was given a slightly different intervention. Florence and Sumter had police-patrolled walking programs, with Sumter receiving an additional social marketing component. Orangeburg received a comprehensive health promotion program. All were aimed at improving the health of the community.

To help ensure success, Sumter residents were given input into the design of the health intervention program.

“We asked them what they would do if they had all the money in the world to make their neighborhood the way they wanted it. They said, ‘We’d have a block party and get to know our neighbors,’ ” Wilson said. “They wanted to come together. Our research shows that social life is a big predictor on whether they come out and walk. In fact, if they don’t have a social life, they are less likely to walk.”

The effectiveness of the social component is evident in the comparison of the Florence and Sumter communities. Sidewalk walking trails were cleaned up and patrolled in the evening by police officers whom residents chose and trusted. Scheduled walks took place three to five weekday mornings and evenings as well as Saturday morning. Sumter used social marketing to encourage participation and held Pride Strides, where residents could invite family members and choir and church groups to walk with them. Sumter saw as many as 494 people walking in a month as compared with Florence, which had about 40 people walking each month.

“The Pride Strides encouraged people to be leaders on their own. They’d bring out family and friends and their choirs. We gave them tips on how to share a prayer and personal health tips on walks. They tied that into their health, safety and spirituality themes on their calendar and door hangers. They developed friendships and confidence,” Wilson said.

Wilson said police support was essential for the communities to achieve its social goals.

“Our qualitative data shows that it changed the relationship between the community and the police. When you make a physical presence, the prostitutes and drug dealers will move. Even though our study has concluded, the police are still supporting the community. They are coming through the community on a more regular basis and working with the residents to help them with their vision for their community. They’re helping to keep things moving forward.”

Sandra Coulon, a doctoral student who worked with Wilson on the trial design and implementation, said the study is novel because it is about creating a new environment.

“It wasn’t contained in some sort of institution such as a church, school or YMCA. It was about how people get out and take charge of their neighborhood,” Coulon said. “The peer led walking groups in these communities were successful, and building that police support was novel. We weren’t sure how it would go, but the community guided us. Having them lead the efforts in their own community was the first thing that happened and the most successful strategy in the study.”

Wilson said that the key to replicating the study in other impoverished communities is to build relationships and trust and understand that residents know what is best for their community. Researchers across the country have contacted Wilson about implementing the PATH program in underserved communities.

As a result of their increased activity and neighborly support, adults say that walking is easier, fun and has lessened blood pressure and pain from arthritis.

“It really has changed these people’s lives,” said Wilson, who credits the community for having a vision to overcome barriers of access and safety, for greater connectedness as it PATH to better health.

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