Improving Cardiometabolic Health with Meditative Movement in Mobility Impaired Women - More than 1 in 10 mid-life (age 35-64) Americans have mobility impairing disabilities, this is especially so for women who have higher prevalence than men. Mid-life is a critical window for women to enhance healthy aging, by improving health and reducing cardiometabolic (CM) risk. The higher prevalence of daily stress encountered by mid-life women with mobility impairment has been linked to emotional health and CM disease risk factors, such as excess abdominal fat that can lead to premature mortality. This is especially so for women with mobility impairment (WMI) who have higher prevalence of mobility impairment, excess body fat, higher risk for cardiometabolic risk than men, and are typically not eligible for most interventions that involve vigorous PA. Our work combines two forms of low intensity PA meditative movement, Tai Chi and Qigong (TCQ), in a mind-body practice described in our model, Biobehavioral Model of Effects of TCQ on Body Composition. TCQ can be completed in a seated position and has been tested in non-impaired populations, consistently showing improvements in body composition, as well as stress related factors and associated dynamics (neurophysiological and hormonal) associated with abdominal fat in women. Our own preliminary study using TCQ with WMI provides evidence of reduced abdominal fat. Reduced stress in response to TCQ is directly observed as changes in heart rate variability and cortisol, reductions in reported emotional distress, and behavioral indicators of emotional eating and sleep quality. These all contribute to excess abdominal fat (measured as waist circumference WC) and strongly associated with cardiometabolic risk. Our team brings singular expertise in the proposed TCQ intervention to be implemented, measures, and engaging with WMI. Building on our extensive experience working with our partners, we propose to recruit a nationally representative, diverse sample (final N=196) of WMI (age 35-64) who have a waist circumference >83 cm (benchmark of cardiometabolic risk). We will randomize women to a 12-week, online, on-demand TQG intervention or health education video (HEV) control, with assessments at baseline (T1), immediately post- intervention (12 weeks; T2), and at a 24-week follow-up (T3) to determine the efficacy and sustained effects of the TCQ intervention. We hypothesize that TCQ participants will experience (T2) and sustain (T3) significant improvements in WC, heart rate variability (increased high frequency power) and salivary diurnal cortisol (decreased area under the curve) (primary outcomes). We also expect that TCQ participants will experience (T2) and sustain (T3) improvements in self-reported perceived stress and emotion regulation, depressive symptoms and anxiety, emotional eating and sleep quality (secondary). Last we will explore a model of biobehavioral mechanisms by which TCQ may reduce abdominal fat via physiological and behavioral pathways. If efficacious, TCQ could have high impact improving accessible strategies to reduce stress responses and abdominal fat as well as reducing CM risk and improving healthy aging among WMI.
