A qualitative exploration of the factors influencing physical activity engagement among Black individuals with heart failure in South Florida

BMC Public Health. 2025 Nov 3;25(1):3746. doi: 10.1186/s12889-025-24945-w.

ABSTRACT

BACKGROUND: Black people in the United States have the highest rates of heart failure, and the worst outcomes of any racial/ethnic group which has been linked to both sociostructural (e.g. racism, poverty, food deserts) and behavioral factors. Physical activity is vital in managing heart failure, yet little is known about the perceptions of the Black community with heart failure. The purpose of this study was to understand and interpret physical activity engagement and the factors that may influence it in Black individuals with heart failure.

METHODS: This study used a thematic analysis approach. One-on-one semi-structured interviews of eight Black individuals with heart failure addressed physical activity habits, health beliefs, health literacy, medical mistrust, depression, self-efficacy, health disparities, social support, barriers and facilitators. Line-by-line coding was conducted, and themes were developed.

RESULTS: The four key themes identified were 1. I don’t understand what heart failure is; 2. I was told that physical activity would not hurt; 3. I struggled when treated by providers from different cultures; 4. Having heart failure means I don’t have long to live. All eight participants acknowledged that physical activity was important but reported being underactive. Most could not describe what heart failure was and thus could not explain the importance of physical activity in managing heart failure. Physical activity instruction was not emphasized by healthcare providers, which likely contributed to an undervaluation of physical activity and to underactivity. Cultural differences between patients and clinicians had potential to result in non-adherence to recommendations.

CONCLUSIONS: Healthcare providers should strive for adequate patient literacy about heart failure, and educate on the importance of physical activity, ensuring the appropriate level of instruction is provided so that Black individuals with heart failure are informed to best address their health.

PMID:41184767 | DOI:10.1186/s12889-025-24945-w