Advertisement
Research Article| Volume 54, ISSUE 7, P647-659, July 2022

Download started.

Ok

Key Focus Group Themes to Inform Weight Management Interventions in Deep South African Americans

      Abstract

      Objective

      To understand African Americans’ perceptions, barriers, and facilitators to recruitment, enrollment, adoption, maintenance, and retention in a nutrition and physical activity promotion program.

      Design

      Four focus groups were conducted.

      Setting

      Two community settings located in Jackson and Hattiesburg, Mississippi.

      Participants

      Participants (n = 28) were aged 18–50 years.

      Main Outcome Measure(s)

      Barriers and facilitators associated with healthy eating, physical activity, achieving a healthy weight, and participation in a health behavior change program.

      Analysis

      A conventional thematic content analysis approach includes data familiarization, initial code generation, initial theme generation, themes review, and team review for finalization of themes.

      Results

      Major themes related to health behaviors and participation in a behavior change program were identified by participants, including time constraints, costs, social support, consistency and self-efficacy, motivation for longevity and disease prevention, physical appearance, fear of injury/pain, social norms/stigma associated with outdoor physical activity, body criticism from family members, and having empathic and validating program staff support.

      Conclusions and Implications

      Several social determinants of health were identified as essential considerations for promoting healthy nutrition and physical activity behaviors among African American adult Mississippians. Cultural and spiritual implications were also identified. Study insights inform policy approaches for designing culturally appropriate health behavior change programs in the Deep South.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.

      Subscribe:

      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Wang Y
        • Beydoun MA
        • Min J
        • Xue H
        • Kaminsky LA
        • Cheskin LJ
        Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic.
        Int J Epidemiol. 2020; 49: 810-823
      1. The Office of Minority Health. Obesity and African Americans.https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=25. Accessed February 26, 2021.

      2. Centers for Disease Control and Prevention. Adult obesity prevalence maps. https://www.cdc.gov/obesity/data/prevalence-maps.html. Accessed February 26, 2021.

        • Kasen S
        • Cohen P
        • Chen H
        • Must A.
        Obesity and psychopathology in women: a three decade prospective study.
        Int J Obes (Lond). 2008; 32: 558-566
        • Bhaskaran K
        • Douglas I
        • Forbes H
        • dos-Santos-Silva I
        • Leon DA
        • Smeeth L.
        Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5•24 million UK adults.
        Lancet. 2014; 384: 755-765
        • Clayton J
        • Blome J.
        National Institutes of Health policy on the inclusion of women and minorities as subjects in clinical research.
        in: Gallin JI Ognibene FP Johnson LL Principles and Practice of Clinical Research. 4th ed. Academic Press, 2018: 177-188
        • Shavers-Hornaday VL
        • Lynch CF
        • Burmeister LF
        • Torner JC.
        Why are African Americans under-represented in medical research studies? Impediments to participation.
        Ethn Health. 1997; 2: 31-45
        • Lavie CJ
        • Milani RV.
        Effects of cardiac rehabilitation, exercise training, and weight reduction on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in obese coronary patients.
        Am J Cardiol. 1997; 79: 397-401
        • McNaughton SA
        • Crawford D
        • Ball K
        • Salmon J.
        Understanding determinants of nutrition, physical activity and quality of life among older adults: the Wellbeing, Eating and Exercise for a Long Life (WELL) study.
        Health Qual Life Outcomes. 2012; 10: 109
      3. Office of Disease Prevention and Health Promotion. Healthy People 2030. https://health.gov/healthypeople. Accessed October 3, 2021.

        • Ball K
        • Timperio AF
        • Crawford DA.
        Understanding environmental influences on nutrition and physical activity behaviors: where should we look and what should we count?.
        Int J Behav Nutr Phys Act. 2006; 3: 33
        • Brown SD
        • Lee K
        • Schoffman DE
        • King AC
        • Crawley LM
        • Kiernan M.
        Minority recruitment into clinical trials: experimental findings and practical implications.
        Contemp Clin Trials. 2012; 33: 620-623
        • Bopp M
        • Wilcox S
        • Laken M
        • et al.
        Factors associated with physical activity among African-American men and women.
        Am J Prev Med. 2006; 30: 340-346
        • Becker G
        • Newsom E.
        Socioeconomic status and dissatisfaction with health care among chronically ill African Americans.
        Am J Public Health. 2003; 93: 742-748
        • Coughlin SS
        • Smith SA.
        Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: a literature review.
        J Racial Ethn Health Disparities. 2017; 4: 259-268
        • Pekmezi D
        • Marcus B
        • Meneses K
        • et al.
        Developing an intervention to address physical activity barriers for African-American women in the deep south (USA).
        Womens Health (Lond). 2013; 9: 301-312
        • Lancaster KJ
        • Carter-Edwards L
        • Grilo S
        • Shen C
        • Schoenthaler AM.
        Obesity interventions in African American faith-based organizations: a systematic review.
        Obes Rev. 2014; 15: 159-176
        • Lemacks JL
        • James RE
        • Abbott L
        • et al.
        The Church Bridge Project: an academic–community perspective of a church-based weight management pilot intervention among young adult African Americans.
        Progr Community Health Partnersh. 2018; 12: 23-34
        • Lemacks J
        • Abbott LL
        • Bryant AN
        • Choi H
        • Ralston PA.
        The church bridge project: lessons learned from comparing the outcomes of an adapted church-based weight management intervention targeting African American adults.
        J Epidemiol Res. 2020; 5: 37
        • Lemacks JL
        • Abbott LS
        • Greer T
        • et al.
        The church bridge project focus group results: African American perspectives of weight management programs to improve nutrition and physical activity behaviors.
        BMC Nutr. 2021; 7: 39
        • Baum F.
        Researching public health: behind the qualitative-quantitative methodological debate.
        Soc Sci Med. 1995; 40: 459-468
        • Guest G
        • Namey E
        • Taylor J
        • Eley N
        • McKenna K.
        Comparing focus groups and individual interviews: findings from a randomized study.
        Int J Soc Res Methodol. 2017; 20: 693-708
        • Ansari Z
        • Carson NJ
        • Ackland MJ
        • Vaughan L
        • Serraglio A.
        A public health model of the social determinants of health.
        Soz Praventivmed. 2003; 48: 242-251
        • Fielding-Singh P
        • Patel ML
        • King AC
        • Gardner CD.
        Baseline psychosocial and demographic factors associated with studyattrition and 12-month weight gain in the DIETFITS trial.
        Obesity (Silver Spring). 2019; 27: 1997-2004
        • Sherwood NE
        • Jeffery RW.
        The behavioral determinants of exercise: implications for physical activity interventions.
        Annu Rev Nutr. 2000; 20: 21-44
        • Tong A
        • Sainsbury P
        • Craig J.
        Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.
        Int J Qual Health Care. 2007; 19: 349-357
        • Coyne IT.
        Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries?.
        J Adv Nurs. 1997; 26: 623-630
        • Guba EG
        • Lincoln YS.
        Fourth Generation Evaluation.
        Sage Publications, 1989
        • Hsieh HF
        • Shannon SE.
        Three approaches to qualitative content analysis.
        Qual Health Res. 2005; 15: 1277-1288
        • Braun V
        • Clarke V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Urquhart C.
        Grounded Theory for Qualitative Research: A Practical Guide.
        Sage Publications, 2012
        • Birks M
        • Mills J.
        Grounded Theory: A Practical Guide.
        Sage Publications, 2015
        • Lin PY
        • Wood W
        • Monterosso J.
        Healthy eating habits protect against temptations.
        Appetite. 2016; 103: 432-440
        • Sobal J
        • Maurer D.
        Interpreting Weight: the Social Management of Fatness and Thinness.
        1st ed. Routledge, 1999
        • Fletcher GF
        • Balady G
        • Blair SN
        • et al.
        Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association.
        Circulation. 1996; 94: 857-862
        • Johnson AE
        • Boulware LE
        • Anderson CA
        • et al.
        Perceived barriers and facilitators of using dietary modification for CKD prevention among African Americans of low socioeconomic status: a qualitative study.
        BMC Nephrol. 2014; 15: 194
        • Richards Adams IK
        • Figueroa W
        • Hatsu I
        • et al.
        An examination of demographic and psychosocial factors, barriers to healthy eating, and diet quality among African American adults.
        Nutrients. 2019; 11: 519
      4. US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. US Department of Health and Human Services; 2008.https://health.gov/sites/default/files/2019-09/paguide.pdf. Accessed February 26, 2021.

        • Piercy KL
        • Troiano RP
        • Ballard RM
        • et al.
        The physical activity guidelines for Americans.
        JAMA. 2018; 320: 2020-2028
        • Vlaeyen JW
        • Kole-Snijders AM
        • Rotteveel AM
        • Ruesink R
        • Heuts PH.
        The role of fear of movement/(re)injury in pain disability.
        J Occup Rehabil. 1995; 5: 235-252
        • Im EO
        • Lee B
        • Chee W
        • Stuifbergen A
        • Team eMAPA Research
        Attitudes toward physical activity of White midlife women.
        J Obstet Gynecol Neonatal Nurs. 2011; 40: 312-321
        • Roman CG
        • Knight CR
        • Chalfin A
        • Popkin SJ.
        The relation of the perceived environment to fear, physical activity, and health in public housing developments: evidence from Chicago.
        J Public Health Policy. 2009; 30: S286-S308
        • McNeill LH
        • Kreuter MW
        • Subramanian SV.
        Social environment and physical activity: a review of concepts and evidence.
        Soc Sci Med. 2006; 63: 1011-1022
        • Lynch EB
        • Kane J.
        Body size perception among African American women.
        J Nutr Educ Behav. 2014; 46: 412-417
        • Dorsey RR
        • Eberhardt MS
        • Ogden CL.
        Racial/ethnic differences in weight perception.
        Obes (Silver Spring). 2009; 17: 790-795
        • Malekinejad M
        • Horvath H
        • Snyder H
        • Brindis CD.
        The discordance between evidence and health policy in the United States: the science of translational research and the critical role of diverse stakeholders.
        Health Res Policy Syst. 2018; 16: 81
        • Nuttall FQ.
        Body mass index: obesity, BMI, and health: a critical review.
        Nutr Today. 2015; 50: 117-128
        • Norman GJ
        • Zabinski MF
        • Adams MA
        • Rosenberg DE
        • Yaroch AL
        • Atienza AA.
        A review of eHealth interventions for physical activity and dietary behavior change.
        Am J Prev Med. 2007; 33: 336-345
        • Santarossa S
        • Kane D
        • Senn CY
        • Woodruff SJ.
        Exploring the role of in-person components for online health behavior change interventions: can a digital person-to-person component suffice?.
        J Med Internet Res. 2018; 20: e144
        • McGloin AF
        • Eslami S.
        Digital and social media opportunities for dietary behaviour change.
        Proc Nutr Soc. 2015; 74: 139-148
        • Sheets V
        • Ajmere K.
        Are romantic partners a source of college students’ weight concern?.
        Eat Behav. 2005; 6: 1-9
        • Leahey TM
        • Gokee LaRose J
        • Fava JL
        • Wing RR
        Social influences are associated with BMI and weight loss intentions in young adults.
        Obesity (Silver Spring). 2011; 19: 1157-1162
        • Hindle L
        • Carpenter C.
        An exploration of the experiences and perceptions of people who have maintained weight loss.
        J Hum Nutr Diet Off J Br Diet Assoc. 2011; 24: 342-350
        • Bronner Y
        • Boyington JE.
        Developing weight loss interventions for African-American women: elements of successful models.
        J Natl Med Assoc. 2002; 94: 224-235
        • Bennett EV
        • Hurd Clarke L
        • Wolf SA
        • et al.
        Older adults’ experiences of group-based physical activity: a qualitative study from the ‘GOAL’ randomized controlled trial.
        Psychol Sport Exerc. 2018; 39: 184-192
        • James DCS.
        Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model.
        Ethn Health. 2004; 9: 349-367
        • Namin A
        • Ratchford BT
        • Saint Clair JK
        • Bui MM
        • Hamilton ML
        Dine-in or take-out: modeling millennials’ cooking motivation and choice.
        J Retail Consum Serv. 2020; 53101981
        • Davis EM
        • Clark JM
        • Carrese JA
        • Gary TL
        • Cooper LA.
        Racial and socioeconomic differences in the weight-loss experiences of obese women.
        Am J Public Health. 2005; 95: 1539-1543
        • Poe TN.
        The origins of soul food in Black urban identity: Chicago, 1915–1947.
        Am Stud Int. 1999; 37: 4-33
      5. US Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two Volumes). https://www.cdc.gov/nchs/data/hpdata2010/hp2010_final_review.pdf. Accessed February 26, 2021.

        • Pattillo-McCoy M.
        Church culture as a strategy of action in the Black community.
        Am Sociol Rev. 1998; 63: 767-784
        • Holt CL
        • McClure SM.
        Perceptions of the religion-health connection among African American church members.
        Qual Health Res. 2006; 16: 268-281
        • Gutierrez J
        • Devia C
        • Weiss L
        • et al.
        Health, community, and spirituality: evaluation of a multicultural faith-based diabetes prevention program.
        Diabetes Educ. 2014; 40: 214-222
        • Adams SA
        • Matthews CE
        • Ebbeling CB
        • et al.
        The effect of social desirability and social approval on self-reports of physical activity.
        Am J Epidemiol. 2005; 161: 389-398
        • Spence JC
        • Lee RE.
        Toward a comprehensive model of physical activity.
        Psychol Sport Exerc. 2003; 4: 7-24

      Linked Article

      • In the Beginning
        Journal of Nutrition Education and BehaviorVol. 54Issue 7
        • Preview
          I was struggling to find a topic that I could be enthused about for this issue's editorial. With so many issues facing us, this should be easy: baby formula shortages, increasing food insecurity, food pantry shortages, environmental impacts, and political challenges. I went back and read some of my editorials from 10 years ago. Still no creative spark.
        • Full-Text
        • PDF