Culturally adapted resistance exercise intervention shows high adherence in young Black women
A 24-week randomized trial tested a culturally adapted resistance exercise program with text message support in 27 young Black women. Supervised sessions with ethnically matched trainers achieved 94% adherence, though unsupervised adherence dropped to around 15%.
Researchers enrolled 27 young Black women (14 in motivational exercise group, 13 in standard exercise group) in a 24-week randomized controlled trial designed to evaluate whether cultural adaptation and mobile support could increase resistance exercise uptake. Both groups received 10–11 weeks of supervised resistance training led by a Black female instructor, followed by unsupervised exercise.
The motivational group also received weekly culturally tailored discussions and text-message support to build competence and self-regulation. Recruitment and consent rates were exceptionally high at 97.2% and 100%, and retention remained strong at 93.3% (motivational) and 80.0% (standard) at 24 weeks. Supervised exercise adherence was excellent—93.9% in the motivational group and 88.8% in the standard group—but dropped sharply to 14.3% and 15.4%, respectively, during unsupervised phases. Qualitative interviews revealed that participants valued the ethnically matched trainers and desired more tailored mobile feedback and accountability strategies to sustain long-term engagement outside supervised settings. The study was small and focused on feasibility rather than cardiometabolic outcomes, limiting conclusions about health impacts.
The dramatic drop in adherence from supervised (>88%) to unsupervised (14–15%) phases suggests that the bottleneck is not motivation or cultural relevance—participants embraced the program—but rather loss of structure and accountability outside the gym. Thematic analysis identified specific requests: participants wanted personalized feedback loops, progress tracking, and text-based check-ins that went beyond generic encouragement. The motivational group's cultural adaptations (discussions on competence, autonomy, and self-regulation) did not statistically separate the two groups in retention, implying that ethnically matched instruction alone may be as powerful as added curricular elements. This is important because it reframes 'cultural adaptation' as partly about the relationship and setting, not just curriculum content. The 24-week design is relatively short; long-term sustainability remains unknown. Cardiometabolic markers (blood pressure, glucose, lipids) were not measured, so health benefits are inferred but not demonstrated in this cohort.
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- Evaluating the Feasibility and Acceptability of a Culturally Adapted Intervention to Promote Resistance Exercise in Young Black Women: A Randomized Controlled Trial. — International journal of environmental research and public health (Read the original)