Physical inactivity is associated with worse asthma outcomes, and Black girls are disproportionately impacted by both physical inactivity and asthma morbidity. Family-based approaches to increasing physical activity are more effective and sustainable, yet no study to date addresses the unique asthma-related, culture-specific, and multi-level barriers to physical activity. This project aims to apply a theory-based approach to develop the first evidence for a dyad lifestyle physical activity intervention that is culturally tailored for urban Black girls with asthma, with the goal of improving outcomes and reducing disparities for Black girls with asthma.

The goal of this study is to adapt the intervention for Black girls with asthma using a dyad approach. In Aim 1, we will engage urban Black girls (8-12 years) with asthma and their mothers in interviews to understand how the ACTION intervention should be modified to fit the needs of urban Black girls with asthma. In Aim 2, we will modify and then pilot test the intervention (Mothers and Daughters in ACTION).

This project applies mixed methods based on the aims:

Aim 1: Identify the key components of a dyad physical activity intervention for urban Black girls (ages 8-12) with asthma and their mothers, using qualitative methods.

Methods: We will conduct semi-structured interviews with up to 25 urban Black mother/daughter dyads using a theory-based approach (behavior change wheel and adaption theories). These findings will inform the modified intervention (Mothers and Daughters in ACTION).

Aim 2: Determine feasibility (recruitment, adherence, retention) and acceptability of modified physical activity intervention (Mothers and Daughters in ACTION) in 30 dyads of urban Black girls with asthma and their mothers, based on an observational study.

Methods: We will conduct a pre/post observational study over 6 months using mixed-methods. A priori feasibility benchmarks are: >50% of eligible dyads will agree to participate; >80% of dyads will attend all sessions; >80% of participants will provide valid ActiGraph wear data 4 out of 7 days [device worn >10 hours per day]; >80% of participants will complete follow-up assessments at 3- and 6-months. Acceptability of the intervention will be determined using qualitative (interviews) and quantitative (survey) tools.

Exploratory aim: Describe changes in physical activity (# steps, time spent/day in light, moderate, vigorous, sedentary; for mothers and daughters), asthma control (girls only), and exhaled nitric oxide (girls only) from baseline to follow-up (3 and 6-months).

Software will be provided by the mentors.

Opportunities exist to present the work at conferences with the pediatric and asthma focused professional organizations, such as Pediatric Academic Societies, American Thoracic Society, and American Academy of Allergy, Asthma & Immunology.