Design and Testing of a Behavioral Weight Loss Program for African American Women Who Are Severely Obese
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Braxton, Danielle. Design and Testing of a Behavioral Weight Loss Program for African American Women Who Are Severely Obese. 2016. https://doi.org/10.17615/7tt3-2980APA
Braxton, D. (2016). Design and Testing of a Behavioral Weight Loss Program for African American Women Who Are Severely Obese. https://doi.org/10.17615/7tt3-2980Chicago
Braxton, Danielle. 2016. Design and Testing of a Behavioral Weight Loss Program for African American Women Who Are Severely Obese. https://doi.org/10.17615/7tt3-2980- Last Modified
- March 20, 2019
- Creator
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Braxton, Danielle
- Affiliation: Gillings School of Global Public Health, Department of Nutrition
- Abstract
- The prevalence of severe obesity (BMI > 40 kg/m2) in African American women doubled between 1990 (3%) and the year 2000 (6%) and tripled between 2000 and 2010 (18%). Despite this trend, there are no published studies that specifically seek to investigate the weight loss needs of African American women who are severely obese. Behavioral weight loss (BWL) programs offer many benefits, yet we know very little about how to design effective treatments for this population. Thus, the overarching goal of this research is to understand the weight loss barriers of African American women who are severely obese and then design and pilot test a BWL program tailored to meet these specific needs. To meet this goal we conducted two formative research projects and one experimental research project. First, we coordinated 5 focus groups with African American women who are severely obese (n = 20). The purpose of the focus groups was to better understand cultural adaptations to traditional BWL approaches with a specific focus on understanding the relevance and importance two culturally defined forms of stress known as Role Overload (RO) and the Superwoman Role (SR). Second, we used baseline data from a 5-year community-wide research project (n = 664) in Lenoir County, NC—a rural southeastern US city—to compare diet and physical activity behaviors as well as the physical and mental well-being status of African American women who are severely obese (BMI > 40 kg/m2, n = 112, 36.5%) with overweight/obese African American women (BMI 25.0 - 39.9 kg/m2, n = 185, 60.3%). Using the literature and findings from our two formative research projects, we developed a BWL program that incorporated additional content in the curriculum that focused on stress reduction. Using a 2-arm RCT we compared the modified BWL program that included the additional stress-reduction content to a standard BWL program. Our primary outcome was difference in body weight between the two groups at 6-months follow-up compared using a 2-sample t-test and intent-to-treat (ITT). Forty-six (n= 46) women were recruited for the BWL intervention and randomly assigned to treatments. Findings indicated that the pre-post weight changes were not significantly different between groups; -0.31%. vs. – 2.1% for intervention and control groups respectively (p = 0.17). Despite significant efforts to obtain follow-up data, the attrition rate was high (n = 19, 41%). More research needs to be devoted to understanding how to improve BWL program retention and program adherence among African American women who are severely obese. The most critical questions that future research studies should address are: (1) Which cultural and psychosocial variables are most relevant to consider when designing a BWL program for this specific population?; and (2) How and to what degree does the BWL program need to be modified to successfully incorporate these adaptations?
- Date of publication
- May 2016
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- DOI
- Resource type
- Rights statement
- In Copyright
- Advisor
- Giscombe, Cheryl
- Keyserling, Thomas
- Samuel-Hodge, Carmen
- Ammerman, Alice
- Paez, Sadye
- Tate, Deborah
- Degree
- Doctor of Philosophy
- Degree granting institution
- University of North Carolina at Chapel Hill Graduate School
- Graduation year
- 2016
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