Author ORCID Identifier


Date of Award

Spring 5-10-2024

Degree Type


Degree Name

Doctor of Public Health (DrPH)


Public Health

First Advisor

Claire Spears

Second Advisor

Matt Hayat

Third Advisor

Vonetta Dotson


Introduction: Arthritis affects 53.2 million United States adults, is a leading cause of disability, and costs the United States over $600 billion per year. Black/African American women bear a disproportionate burden of arthritis-attributable pain and activity limitations, and although moderate-to-vigorous physical activity reduces pain and improves physical function among adults with arthritis, Black/African American women with arthritis are less likely to meet physical activity guidelines, compared to men, non-Hispanic White/Caucasian adults, and adults without arthritis. Mindfulness, defined as “purposeful, non-judgmental awareness of the self and the present moment” is a low-cost nonpharmaceutical method for managing pain and positively influencing health behaviors. Little research has examined the mechanisms by which mindfulness might positively benefit physical activity and no research has examined these mechanisms among Black/African American women with arthritis. This study aimed to understand the association among mindfulness, meditation behavior, pain, pain catastrophizing, kinesiophobia, self-efficacy and physical activity (total and moderate-to-vigorous physical activity).

Methods: A convenience sample of Black/African American adult (³18 years) women with self-reported diagnosed arthritis (n = 281) participated in an online, cross-sectional survey. Based on a conceptual model describing three mechanistic pathways, gamma regressions were conducted to assess associations among mindfulness, meditation behavior, pain, pain catastrophizing, kinesiophobia, self-efficacy, and physical activity (moderate-to-vigorous and total), while controlling for the following covariates: age, body mass index, education level, number of chronic diseases, depression, and mobility limitations.

Results: Over half (55.9%) of Black/African American women reported engaging in meditation behavior. A significant positive association was found between meditation behavior and moderate-to-vigorous and total physical activity. Additionally, a significant interaction between meditation behavior and self-efficacy for moderate-to-vigorous physical activity suggests that meditation behavior may strengthen the positive relationship between self-efficacy and physical activity.

Conclusion: Meditation behavior (including, but not limited to mindfulness) may positively influence physical activity among Black/African American women with arthritis through multiple mechanistic pathways. Future research using longitudinal, experimental, and mixed methods designs is needed to determine the exact nature of these pathways (direct, mediated, moderated), and the acceptability, feasibility, efficacy and effectiveness of mindfulness and meditation interventions for improving physical activity among Black/African American women with arthritis.


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