Literacy, Knowledge, Health Belief, and Self-efficacy among Urban Obese Low-income African American Women

The purpose of the study was to examine the relationships among the psycho-social factors of literacy, knowledge about obesity, health beliefs about obesity, and self-efficacy among urban low-income obese African American women. Five instruments were used in the study: Rapid Estimate of Adult Literacy in Medicine, Knowledge about Obesity and Exercise scale, Health Beliefs about Obesity questionnaire, a Self-efficacy scale for coping with difficulties in life, and a demographic profile questionnaire. The sample consisted of a total of 89 urban low-income African American women between the ages of 21 and 60 years with a BMI of 41 (SD=5.3). The women in this sample had literacy skills equivalent to high school grade level. Literacy was significantly correlated with knowledge about exercise (r=.28, p=.01), however, health beliefs and knowledge about obesity were unrelated to literacy. Women with higher self-efficacy had greater knowledge about obesity and stronger health beliefs than women with lower self-efficacy. Results from multivariate regression showed that combined knowledge about obesity and exercise was associated with higher total score on the health belief questionnaire (p<.0001) and increased education (p<.0001). When the Health Belief about Obesity Questionnaire subscales were simultaneously analyzed in relation to knowledge about obesity and exercise (adjusted for age and education), higher belief scores about benefits and susceptibility were each significantly associated with knowledge (both p<.0001), as was education (p=.0002). In conclusion, we suggest further investigations focusing on psycho-social variables that affect patient literacy, exercise, and obesity among urban low-income women.