Abstract
Background
Gaining insight into African American women’s health behavior desires and weight management is pivotal since they have the highest prevalence of obesity in the U.S. Exploring an association between psychological factors (e.g. acculturation status and readiness to change) and anthropometric characteristics, including body mass index (BMI) is critical for developing effective health promotion programs that improve lifestyle behaviors among this group. The purpose of this study was to ascertain nutrition and physical activity behaviors based on the stages of change (SOC) theory and its association with BMI and acculturation status among adult African American Women (AAW).
Methods
SOC, acculturation status, and BMI were analyzed using a population-based sample of 294 AAW living in Florida. Logistic regression analysis was conducted by modeling BMI as the outcome variable to assess the influence of acculturation and SOC while controlling for sociodemographic characteristics. The significance level was set at 5% and all tests were two-sided.
Results
Our findings indicated that 59.4% of AAW were overweight or obese. Among those who reported SOC for physical activity, 229 (81.5%) were in the preparation, active, or maintenance SOC for physical activity. Of 279 participants, 214 (77%) reported being in the preparation, active, or maintenance SOC for practices in good eating habits. SOC for nutrition scores, acculturation scores, and age were significantly different among categories of BMI. AAW who were overweight or obese were significantly more likely to be in the preparation or action SOC for physical activity rather than the maintenance stages of change, compared to normal weight AAW.
Conclusion
Findings suggest that while AAW are ready to change, they still struggle to engage in behaviors that reduce their BMI. SOC, along with cultural factors should be considered when developing health interventions to assist AAW improve health behaviors that subsequently reduce BMI and prevent the onset of chronic diseases.
Keywords:
obesity, acculturation, African American women, African American, nutrition, physical activityReferences
Office of Minority Health. Obesity and African Americans. Available from: https://minorityhealth.hhs.gov/obesity-and-african-americans; 2024. Accessed May 20, 2024.
Warren M, Beck S, Delgado D. The state of obesity: Better policies for a healthier America 2019. Trust for American’s Health; 2024. Available from: https://www.tfah.org/wp-content/uploads/2019/09/2019ObesityReportFINAL-1.pdf; 2024. Accessed May 20, 2024.
Cockerham WC, Bauldry S, Sims M. Obesity-related health lifestyles of late-middle age Black Americans: The Jackson Heart Study. Am J Prev Med. 2022;63(1):S47-S55.
Ogden CL, Fryar CD, Martin CB, Freedman DS, Carroll MD, Gu Q, et al. Trends in obesity prevalence by race and Hispanic origin—1999-2000 to 2017-2018. JAMA. 2020;324(12):1208-10.
Lofton H, Ard JD, Hunt RR, Knight MG. Obesity among African American people in the United States: a review. Obesity. 2023;31(2):306-15.
Belgrave FZ, Abrams JA. Reducing disparities and achieving equity in AAW’s health. Am Psychol. 2016;71(8):723.
Chinn JJ, Martin IK, Redmond N. Health equity among Black women in the United States. J Womens Health. 2021;30(2):212-9.
Webb FJ, Khubchandani J, Hannah L, Doldren M, Stanford J. The perceived and actual physical activity behaviors of AAW. J Community Health. 2016;41:368-75.
Ralston PA, Wickrama KK, Coccia CC, Lemacks JL, Young-Clark IM, Ilich JZ. Health for Hearts United longitudinal trial: improving dietary behaviors in older African Americans. Am J Prev Med. 2020;58(3):361-9.
Hepburn M, Bautista C, Feinn R. Health promotion behaviors among urban black women. West J Nurs Res. 2021;43(11):1001-9.
Webb FJ, Khubchandani J, Doldren M, Balls-Berry J, et al. African-American womens’ eating habits and intention to change: A Pilot Study. J Racial Ethn Health Dispar. 2014;1:199-206.
Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical model of health behavioral change: A systematic review. Iran J Nurs Midwifery Res. 2019;24(2):83-90.
Toth S, Jenkins I, Highfill C. Investigating exercise readiness and life stress among undergraduate students at an Historically Black University. Am J Health Educ. 2021;52(5):288-95.
Sbrocco T, Osborn R, Clark RD, Hsiao CW, Carter MM. Assessing the stages of change among AAW in a weight management program. J Black Psychol. 2012;38(1):81-103.
Mills SD, Fox RS, Gholizadeh S, Klonoff EA, Malcarne VL. Acculturation and health behaviors among African Americans: A systematic review. J Cross Cult Psychol. 2017;48(7):1073-97.
Guevarra JS, Kwate NOA, Tang TS, Valdimarsdottir HB, et al. Acculturation and its relationship to smoking and breast self-examination frequency in AAW. J Behav Med. 2005;28:191-9.
Awad GH, Kashubeck-West S, Bledman RA, Coker AD, et al. The role of enculturation, racial identity, and body mass index in the prediction of body dissatisfaction in AAW. J Black Psychol. 2020;46(1):3-28.
Ard JD, Skinner CS, Chen C, et al. Informing cancer prevention strategies for African Americans: The relationship of African American acculturation to fruit, vegetable, and fat intake. J Behav Med. 2005;28:239-47.
Landrine H, Corral I. Sociocultural correlates of cigarette smoking among African-American men versus women: Implications for culturally specific cessation interventions. J Health Psychol. 2016;21(6):954-61.
Landrine H, Klonoff EA. Conclusions: The future of research on Black women's health. Black Women's Health. 2014:367-82.
Salihu HM, Adegoke KK, Das R, Wilson RE, Mazza J, Okoh JO, et al. Community-based fortified dietary intervention improved health outcomes among low-income African-American women. Nutr Res. 2016;36(8):771-9.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Green SB. How many subjects does it take to do a regression analysis. Multivar Behav Res. 1991;26:499-510.
Singh GK, Daus GP, Allender M, Ramey CT, Martin EK, Perry C, et al. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016. Int J MCH AIDS. 2017;6(2):139-64.
Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:12.
Banerjee S, Radak T, Khubchandani J, Dunn P. Food insecurity and mortality in American adults: results from the NHANES-linked mortality study. Health Promot Pract. 2021;22(2):204-14.
Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:1-20.
Scarinci IC, Moore A, Wynn-Wallace T, Cherrington A, Fouad M, Li Y. A community-based, culturally relevant intervention to promote healthy eating and physical activity among middle-aged AAW in rural Alabama: findings from a group randomized controlled trial. Prev Med. 2014;69:13-20.
Lofton H, Ard JD, Hunt RR, Knight MG. Obesity among African American people in the United States: A review. Obesity. 2023;31(2):306-15.
Pickett S, Burchenal CA, Haber L, Batten K, Phillips E. Understanding and effectively addressing disparities in obesity: A systematic review of the psychological determinants of emotional eating behaviours among Black women. Obes Rev. 2020;21(6):e13010.
Nelson DS, Gerras JM, McGlumphy KC, Shaver ER, Gill AK, Kanneganti K, et al. Racial discrimination and low household education predict higher body mass index in African American youth. Child Obes. 2018;14(2):114-21.
Halbert CH, Bellamy S, Briggs V, Bowman M, Delmoor E, Johnson JC, et al. Intervention completion rates among African Americans in a randomized effectiveness trial for diet and physical activity changes. Cancer Epidemiol Biomarkers Prev. 2014;23(7):1306-13.
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Copyright (c) 2024 Fern J. Webb, Kavita Batra, Jagdish Khubchandani, Srikanta Banerjee, Joyce Balls-Berry
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