scholarly journals Determinants of Successful Weight Loss in Low-Income African American Women: A Positive Deviance Analysis

2018 ◽  
Vol 9 ◽  
pp. 215013271879213 ◽  
Author(s):  
Elaine Seaton Banerjee ◽  
Sharon J. Herring ◽  
Katelyn Hurley ◽  
Katherine Puskarz ◽  
Kyle Yebernetsky ◽  
...  
Keyword(s):  
Weight Loss ◽  
African American ◽  
African American Women ◽  
Low Income ◽  
Primary Care Providers ◽  
Positive Deviance ◽  
Care Providers ◽  
Chi Square ◽  
American Women ◽  
Successful Weight Loss

Objective: We set out to investigate the behaviors of low-income African American women who successfully lost weight. Methods: From an urban, academic, family medicine practice, we used a mixed methods positive deviance approach to evaluate 35 low-income African American women who were obese and lost at least 10% of their maximum weight, and maintained this loss for 6 months, comparing them with 36 demographically similar control participants who had not lost weight. Survey outcomes included demographics and behaviors that were hypothesized to be related to successful weight loss. Interviews focused on motivations, barriers, and what made weight loss successful. Survey data were analyzed using t tests and linear regression for continuous outcomes and chi-square tests and logistic regression for categorical outcomes. Interviews were analyzed using a modified approach to grounded theory. Results: In adjusted analyses, women in the positive deviant group were more likely to be making diet changes compared with those women who did not lose at least 10% of their initial body weight. Major themes from qualitative analyses included ( a) motivations (of health, appearance, quality of life, family, and epiphanies), ( b) opportunity (including time and support), ( c) adaptability. Conclusions: The findings of this study may be useful in developing motivational interviewing strategies for primary care providers working with similar high-risk populations.

Overcoming Obesity: A Mixed Methods Study of the Impact of Primary Care Physician Counseling on Low-Income African American Women Who Successfully Lost Weight

2017 ◽  
Vol 32 (2) ◽  
pp. 374-380 ◽  
Author(s):  
Elaine Seaton Banerjee ◽  
Sharon J. Herring ◽  
Katelyn E. Hurley ◽  
Katherine Puskarz ◽  
Kyle Yebernetsky ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
African American ◽  
Mixed Methods ◽  
African American Women ◽  
Low Income ◽  
Positive Deviance ◽  
American Women ◽  
Patient Reported ◽  
The Impact

Purpose: Low-income, African American women are disproportionately impacted by obesity. Little is known about the interactions between low-income, African American women who successfully lost weight and their primary care physicians (PCPs). Design: Mixed methods, positive deviance study. Setting: Urban university-based family medicine practice. Participants: The positive deviance group comprised low-income, African American women who were obese, lost 10% body weight, and maintained this loss for 6 months. Measures: The PCP- and patient-reported weight-related variables collected through the electronic medical record (EMR), surveys, and interviews. Analysis: Logistic regression of quantitative variables. Qualitative analysis using modified grounded theory. Results: The EMR documentation by PCPs of dietary counseling and a weight-related medical problem were significant predictors of positive deviant group membership. Qualitative analyses of interviews revealed 5 major themes: framing obesity in the context of other health problems provided motivation; having a full discussion around weight management was important; an ongoing relationship with the physician was valuable; celebrating small successes was beneficial; and advice was helpful but self-motivation was necessary. Conclusion: The PCP counseling may be an important factor in promoting weight loss in low-income, African American women. Patients may benefit from their PCPs drawing connections between obesity and weight-related medical conditions and enhancing intrinsic motivation for weight loss.

Long-Term Breastfeeding in African American Mothers

2017 ◽  
Vol 33 (1) ◽  
pp. 128-139 ◽  
Author(s):  
Tyra Toston Gross ◽  
Marsha Davis ◽  
Alex K. Anderson ◽  
Jori Hall ◽  
Karen Hilyard
Keyword(s):  
African American ◽  
African American Women ◽  
Digital Media ◽  
Health Care Providers ◽  
Low Income ◽  
Lessons Learned ◽  
Care Providers ◽  
Breastfeeding Support ◽  
American Women

Background: According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach. Methods: African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software. Results: Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media. Conclusion: Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.

African American Women and Weight Loss

2011 ◽  
Vol 23 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Teresa Mastin ◽  
Shelly Campo ◽  
Natoshia M. Askelson
Keyword(s):  
Weight Loss ◽  
African American ◽  
Social Cognitive Theory ◽  
African American Women ◽  
Low Income ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
The United States ◽  
Structured Interviews ◽  
American Women

In the United States, almost 80% of African American women are either overweight or obese. In this study, 46 low-income African American women struggling with weight issues participated in structured interviews using a social cognitive theory framework. Participants shared their social cognitive theory related weight loss thoughts and their perceived weight loss obstacles. Results suggest that although participants’ primary weight-related obstacles were environment-based, for example, unsafe environments in which to engage in regular exercise, they more often offered individual-based solutions. The study concludes with a discussion of media advocacy as a tool that can be used to promote environmental solutions.

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