Walk your heart to health: Predictors of participation in a community-based walking group intervention in low to moderate income urban communities

Health promotion interventions that effectively engage residents of low to moderate income urban communities in physical activity are critical for addressing racial, ethnic and socioeconomic health disparities. Walk Your Heart to Health (WYHH), an intervention designed to promote heart health through physical activity and social support, has been demonstrated to reduce cardiovascular risk (CVR). Benefits increase with greater participation. We present findings examining predictors of participation in WYHH in Detroit, Michigan. Participants were assigned randomly into intervention or lagged intervention walking groups. Walkers met three times each week at a community site. Walks were led by Community Health Workers. Participation was tracked throughout the 32 week study period, along with psychosocial, anthropometric and pedometer data. We present findings assessing predictors of program adherence for 557 walking group participants. Participants who joined WYHH groups with friends and family members were more likely to maintain participation (p=0.043) compared to those who joined alone. Participants who indicated that there were higher levels of traffic in the areas where they walked (p=0.018) and those reporting a greater number of symptoms of depression at baseline (p=0.000) were less likely to maintain participation over time. Walking group interventions that encourage participants to join with friends and family, and that promote social support, are more likely to maintain participant engagement and reduce CVR. Aspects of the built environment, such as traffic volume, and individual characteristics such as symptoms of depression, should be addressed in health promotion activities in communities that experience high CVR.