Weight gain prevention among black women in the rural community health center setting: The Shape Program (original) (raw)
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An assessment of obesity among African-American women in an inner city primary care clinic
Journal of the National Medical Association, 2002
Despite multiple patient assessments and interventions, obesity continues to cause significant morbidity and mortality nationwide. This study assesses the prevalence of obesity and weight control practices among middle-aged African-American women. In 1995, 307 women 30 years of age and older were consecutively selected in a non-random fashion from three clinic sites located within a public university hospital that served largely indigent, inner city African-American populations. Interviewers surveyed the respondents using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). The prevailing demographic profile of patients in the clinic was middle-aged, indigent, ill, and of low educational attainment. Over 35% of individuals were classified as being overweight (BMI 25 to 29.9 kg/m2) and 45% were classified as being obese (BMI > or = 30 kg/m2). Therefore, more than 80% of individuals in this study were either overweight or obese, w...
2020
Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity in a family practice located in an underserved community in Northwest Indiana. Fifteen overweight or obese African American women were identified as they presented for routine medical care. The intervention for this EBP project consisted of a 12-week provider-led weight loss program that included lifestyle changes that targeted nutrition, physical activity, behavioral self-management, and follow-up appointments. A one-way repeated measure ANOVA were calculated comparing means of weight, BMI, waist circumference and secondary measure blood pressures at four different intervals: baseline, 4, 8 and 12 weeks. Significant effect was found at baseline weight to 12 weeks weight (F(3,42)=5.77, p <.05), baseline BMI to 12 weeks BMI (F(3,42)= 5.65, p <.05, baseline WC to week 8 WC and baseline WC to 12 weeks WC (F(3,42) =6.868, p <.05). A pairedsamples t test were calculated to further compare the mean at six different intervals. There were significant difference at baseline weight to week 12 weight (t (14)= 2.54, p<.0083), baseline BMI to 12week BMI (t(14)=3.216, p <.0083), baseline WC to week 8 WC (t(14)=3.076, p <.0083) and baseline WC to 12-weeks WC (t(14)=4.305, p < .0083). Secondary outcomes: no significant difference existed for systolic blood pressure (F(3,42)=.021, p >.05 or for diastolic blood pressure (F(3,42)=.210, p >.05). These findings demonstrated that a provider-led intervention improved weight reduction for African American women.
Obesity and Black Women: Special Considerations Related to Genesis and Therapeutic Approaches
Current Cardiovascular Risk Reports, 2013
Black women in the United States are disproportionately affected by obesity, with almost two-thirds considered obese based on body mass index. Obesity has been directly linked to cardiovascular morbidity and mortality in black women. Therefore, understanding contributors to the genesis of obesity in black women is imperative. While biologic differences likely result in varying obesity prevalence across racial/ethnic groups, behaviors such as post-partum weight retention and limited leisure-time physical activity, may especially contribute to obesity in black women. Black women also appear to be particularly susceptible to cultural, psychosocial, and environmental factors that can promote weight gain. Therapeutic interventions are being tailored to specifically address these social determinants of health and to foster lifestyle modification; however, more work is needed to understand barriers to behavior change for black women. Knowledge gaps also remain in identifying mechanisms by which pharmacologic and surgical treatments for obesity modify cardiovascular risk in black women.
Women & Health, 2019
Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m 2. Standard and enhanced groups' weight change (−2.83 kg and −2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.
2018
The US is experiencing what many in public health are calling an "obesity epidemic". The American Heart Association estimates that about 70% of the population is overweight or obese. This issue is especially concerning for minority populations as being overweight or obese disproportionately affects African Americans more so than any other racial grouping in the country. African American women, in particular, are more likely than any other demographic to be overweight or obese throughout their life course. Intervention programs are proving to be ineffective in curtailing this epidemic because they aren't addressing the root cause of the issue: changing the attitudes and behaviors of those most affected by obesity. This capstone explores the complex nature of obesity prevention in regards to social and lifestyle factors that influence behavior among African American women and prevalence of obesity via a literature review of previous research done in this area, categorized in four major areas: lack of comprehensive interventions, impact of culture and lifestyle, how African American women view themselves and their health, and the effects mental health issues have on behaviors that influence obesity. Recommendations will also be discussed of the role public health professionals can play in combating the high prevalence of obesity in this community from the social/behavioral level.
American journal of public health, 2016
To assess the impact of a large-scale place-based intervention on obesity prevalence in Black communities. The Racial and Ethnic Approaches to Community Health across the United States (REACH US) project was conducted in 14 predominantly Black communities in California, Illinois, Massachusetts, New York, Ohio, Pennsylvania, South Carolina, Virginia, Washington, and West Virginia. We measured trends from 2009 to 2012 in the prevalence of obesity. We used Behavioral Risk Factor Surveillance System data to compare these trends with trends among non-Hispanic Whites and non-Hispanic Blacks in the United States and in the 10 states where REACH communities were located, and with a propensity score-matched national sample of non-Hispanic Blacks. The age-standardized prevalence of obesity decreased in REACH US communities (P = .045), but not in the comparison populations (P = .435 to P = .996). The relative change was -5.3% in REACH US communities versus +2.4% in propensity score-matched con...
Achieving Healthy Weight in African-American Communities: Research Perspectives and Priorities
The longstanding high burden of obesity in African-American women and the more recent, steeper than average rise in obesity prevalence among African-American children constitute a mandate for an increased focus on obesity prevention and treatment research in African-American communities. The African-American Collaborative Obesity Research Network (AACORN) was formed to stimulate and support greater participation in framing and implementing the obesity research agenda by investigators who have both social and cultural grounding in African-American life experiences and obesity-related scientific expertise. AACORN's examination of obesity research agenda issues began in 2003 in conjunction with the Think Tank on Enhancing Obesity Research at the National Heart, Lung, and Blood Institute (NHLBI). The assessment was subsequently expanded to take into account the overall NIH strategic plan for obesity research, literature reviews, and descriptions of ongoing studies. In identifying priorities, AACORN members considered the quality, quantity, focus, and contextual relevance of published research relevant to obesity prevention and treatment in African-American adults or children. Fifteen recommended research priorities are presented in five categories adapted from the NHLBI Think Tank proceedings: health effects, social and environmental context, prevention and treatment , research methods, and research training and funding. These recommendations from an African-American perspective build on and reinforce certain aspects of the NHLBI and overall NIH research agendas by providing more specific rationale and directions on areas for enhancement in the type of research being done or in the conceptualization and implementation of that research."
American Journal of Health Promotion, 2015
To compare the effects of a physical activity (PA) intervention of group meetings versus group meetings supplemented by personal calls or automated calls on the adoption and maintenance of PA and on weight stability among African-American women. Design: Randomized clinical trial with three conditions randomly assigned across six sites. Setting: Health settings in predominately African-American communities. Subjects: There were 288 women, aged 40 to 65, without major signs/symptoms of pulmonary/cardiovascular disease. Intervention: Six group meetings delivered over 48 weeks with either 11 personal motivational calls, 11 automated motivational messages, or no calls between meetings. Measures: Measures included PA (questionnaires, accelerometer, aerobic fitness), weight, and body composition at baseline, 24 weeks, and 48 weeks. Analysis: Analysis of variance and mixed models. Results: Retention was 90% at 48 weeks. Adherence to PA increased significantly (p < .001) for questionnaire (d ¼ .56, 128 min/wk), accelerometer (d ¼ .37, 830 steps/d), and aerobic fitness (d ¼ .41, 7 steps/2 min) at 24 weeks and was maintained at 48 weeks (p < .001), with no differences across conditions. Weight and body composition showed no significant changes over the course of the study. Conclusion: Group meetings are a powerful intervention for increasing PA and preventing weight gain and may not need to be supplemented with telephone calls, which add costs and complexity.