EXAMINING THE EFFECTIVENESS OF BEHAVIORAL WEIGHT LOSS INTERVENTIONS AMONG AFRICAN AMERICAN WOMEN Public Deposited

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Last Modified
  • March 21, 2019
Creator
  • Blackman Carr, Loneke
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
Abstract
  • African American women are disproportionately burdened with a high prevalence of unhealthy weight. Behavioral weight loss interventions are less effective for African American women, producing less weight loss, compared to non- Hispanic white women. The purpose of this dissertation was to determine why African American women lose less weight, and find strategies to increase weight loss in behavioral weight loss interventions. Aim 1 was a secondary data analysis of 170 African American and non-Hispanic white women who completed a primarily Internet- delivered behavioral weight loss intervention to determine if racial weight loss differences existed, and identify contributing factors. African American women lost significantly less weight than non-Hispanic white women (p=0.0002), a difference mediated by total website log-ins and change in self-regulatory weight control behaviors. Aim 2 compared the effects of a standard vs a culturally-based, physical activity-enhanced behavioral weight loss intervention among 85 African American women over 6 months. Contrary to our hypothesis, women lost more weight in the standard vs the enhanced group, though not significantly more (p=0.43). Objectively measured physical activity was also not different between groups (p=0.45). All participants’ weight decreased, and physical activity increased, significantly from baseline. Aim 3 determined if participants in aim 2 differed in physical activity- related psychosocial variables change. Employing a multiple linear regression model, we observed no between group differences in the 6-month change in self-efficacy, social support or autonomous motivation for physical activity, or perceived physical activity benefits and barriers. However, a significant change from baseline was observed in both groups for several variables. Results of this dissertation indicate that standard behavioral weight loss treatment was effective for overweight or obese African American women, but their study engagement and adoption of weight control strategies can be improved. However, treatment effectiveness remains suboptimal for this population. The continued identification of behavioral strategies that African American women partially or do not adopt may inform how weight loss can be maximized. Moreover, cultural adaptation of behavioral weight loss interventions above the individual level (e.g. policy, neighborhood, economic) may be necessary to improve weight loss in African American women.
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  • In Copyright
Advisor
  • Evenson, Kelly
  • Tate, Deborah
  • Ward, Dianne
  • Samuel-Hodge, Carmen
  • Bangdiwala, Shrikant
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
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