Association of Social Support with Physical Activity: The Strong Heart Family Study

Abstract

Background: Perceived social support may shape engagement in physical activity, yet evidenceis mixed and limited in American Indian populations. Objective: To examine the association between perceived social support and ambulatory physical activity in the Strong Heart Family Study (SHFS). Methods: This secondary data analysis included data collected as part of the SHFS, a longitudinal study of risk factors for cardiovascular disease among American Indians from 12 tribes. In total, there were 1,564 SHFS participants included in both cross-sectional and longitudinal analyses. Social support was assessed using a questionnaire adapted from the National Comorbidity Survey, and daily ambulatory physical activity was assessed using Accusplit AE120 pedometers. Generalized estimating equations were used to examine the association of social support at baseline with: (1) physical activity at baseline; (2) change in physical activity during a 4-8 year follow up. Results are presented per 10-point increase in social support score. Results: Participants had a mean age of 39.0 ± 15.7 years, and 61% were female. Social support was associated with higher levels of physical activity in both cross- sectional and longitudinal analyses. After adjustment for potential confounders, in cross-sectional analyses, a 10-point higher perceived social support score was associated with taking 329 more steps per day (95% CI: 52, 606; p=0.02). In the longitudinal analyses, a 10-point higher baseline social support score was associated with taking 414 additional steps per day at follow-up (95% CI: 123, 705; p=0.005). Estimates were similar in exploratory models that were additionally adjusted for BMI and prevalent diabetes. Conclusions: These findings indicate that perceived social support was positively associated with pedometer-measured ambulatory physical activity in both cross-sectional and longitudinal analyses. Further studies are needed to clarify which aspects of support, specifically culturally grounded forms of support and activity-specific encouragement, are most relevant for supporting physical activity within American Indian communities.