Dr. Betty Leslie

Purpose of the Study
To determine whether certain cultural factors and barriers contribute to attitudes and behaviors of African-American women toward overweight and obesity.

Methodology
The methodology consisted of in-depth case studies involving 10 African-American women of lower middle-class income status who were attending an urban undergraduate college along the Gulf Coast region of the United States. The researcher collected data using three primary instruments: (a) face-to-face, semi-structured interviews; (b) a self-administered survey; and (c) a food and physical fitness diary.

Findings

• Study factors identified as contributing to the attitudes of the sample included (a) preparation and cooking of food; (b) dietary habits; (c) influence of family, friends, and community; (d) tolerance for being overweight and obese; (e) health-related conditions associated with obesity; and (f) lack of nutritional and physical fitness knowledge.
• Study weight-loss barriers included (a) lack of time, (b) stress, (c) lack of self-control, (d) lack of social support, (e) lack of economic support, (f) consumption of food at social activities, and (g) structural issues, such as unsafe neighborhoods due to high crime rates and unleashed vicious dogs.
• Respondent identified influencing factors as (a) drinking excessive amounts of alcohol, (b) the availability of fast-food restaurants in black urban communities, (c) having a large number of children without losing weight between pregnancies, (d) an unwillingness to break with traditions regarding the eating of certain foods, and (e) the need for better health information and communication in the black community.
• Respondent identified these weight-loss barriers as contributing factors to overweight and obesity: (a) lack of positive personal relationships, (b) negative communication and treatment from others due to being overweight, (c) providing care to ill family members, and (d) lack of community awareness and support.
• The findings from this study supported findings from other research studies, indicating that certain cultural and personal factors play a significant role in contributing to the general attitudes and behaviors of African-American women toward overweight and obesity.
• The conceptual framework used to evaluate the findings based on the participants’ responses was the Lifestyle Modification Assessment Model. The participants’ attitudes and behaviors toward improving their overall health were assessed by whether they believed changing their attitudes and behaviors would either improve their overall health or reduce certain risk factors.

In evaluating the overall changes in attitudes and behaviors, all participants reported the following:

1. They would be willing to change their attitudes and behaviors to improve their overall health and quality of life.
   
   
2. They believed that making necessary changes in attitudes and behaviors would improve their overall health and quality of life. 
   
   These changes included (a) avoiding “junk foods” and “fast foods,” (b) avoiding cooking with high-fat ingredients, (c) drinking more water, (d) taking more responsibility for one’s own health, (e) developing a new outlook on life, (f) demanding more respect from others, (g) believing in oneself, (h) having a more positive attitude, (i) exercising more, (j) reducing food portions, (k) refraining from improper dieting and taking diet pills, (l) developing better eating habits, (m) spending more time relaxing, (n) taking nutrition classes to learn more about proper diet, (o) using food as a source of energy rather than a source of pleasure and overindulgence, and (p) involving the entire family in making healthy lifestyle changes.
   
   
3. In evaluating the findings based on a 14-day food and physical diary, the majority of the respondents showed improvement in eating behaviors and physical activities.

These improvements included (a) having more nutritious breakfasts; (b) eating more sensible lunches; (c) eating more balanced dinner meals, including more green vegetables; (d) consuming more fruits, nuts, and other nutritious “low carb” snacks; (e) drinking more water; and (f) engaging in some form of regular exercise and physical activity.

Conclusions

• African-American women can accrue significant benefits by participating in non-threatening intervention strategies, such as self-reports, interviews, diaries, and other one-on-one communication interventions.
• These types of intervention strategies allow these women the opportunity to express their personal concerns regarding being overweight or obese and to identify ways to replace risk factors with positive outcomes.
• Also, African-American women can change their attitudes and behaviors toward cultural factors, such as cooking techniques and eating habits, exercising regimens, body image, and tolerance for being overweight and obese.

Implications for Social Change

• Since obesity is a modern American epidemic, this study has implications for social change in obesity research by identifying specific cultural factors and barriers associated with obesity and other health problems.
• Overweight and obesity are influenced largely by cultural and lifestyle factors associated with personal attitudes and behaviors. Therefore, it is necessary for society to help improve the overall quality of life by promoting wellness and good health.
• On a broader scale, this study revealed the need for greater social action in the area of obesity research by encouraging local governmental agencies and community leaders to become more involved in implementing policies and programs that promote and support initiatives, such as Healthy People 2010. Such initiatives provide platforms for African-American women and other Americans to become more proactive with health-related issues in an effort to reduce the proportion of people who are overweight and obese in this country.