Designing a Culturally Responsive Resistance Training Intervention to Support Cognitive Health in Older Black Men: Findings from a Mixed-Methods Study.

BACKGROUND AND OBJECTIVES: Black men face elevated risks for chronic disease and cognitive decline yet remain underrepresented in exercise and brain-health research. Although resistance training (RT) improves cognition in older adults, little is known about how older Black men perceive RT as a brain-health strategy. This study examined beliefs, motivations, and barriers related to RT (Aim 1) and used these findings to inform the design of a culturally-grounded RT intervention (Aim 2). RESEARCH DESIGN AND METHODS: A mixed-methods exploratory design included surveys (N = 37) and semi-structured interviews with Black men ≥55 years old. Quantitative measures assessed RT behavior, stage of change, cognitive-health beliefs, and perceived barriers and motivators. Qualitative data were analyzed thematically using phenomenology and theory-informed frameworks. Integrated findings informed a design thinking-based, community-centered 12-week intervention framework. RESULTS: Only 21.6% engaged in RT two or more times weekly, though most expressed concern about cognitive aging and interest in maintaining mental clarity. Cognitive-health beliefs were strongly associated with RT participation (Pseudo R2 = .71). Practical barriers-time, pain, limited knowledge, and access-were more influential than attitudinal barriers. Qualitative themes highlighted cultural influences and a strong desire to maintain independence with aging. DISCUSSION AND IMPLICATIONS: Findings indicate high motivation to protect cognitive health but limited culturally responsive pathways for RT adoption. Results support the use of mixed-methods, community-engaged approaches to develop feasible strategies promoting cognitive vitality and independence among aging Black men.