Formative research in a multi-cultural public health environment to engage African American women and Latinas in achieving a healthy weight

Design: Qualitative, exploratory approach; data were collected in eleven focus group sessions using a semi-structured questionnaire.

Subjects/Setting: Focus groups were conducted during the summer of 2007 at various Women, Infants and Children sites in a greater Los Angeles area. A total of 47 low-income women participated - 33 Spanish-speaking and 14 African American, aged 18 to 44.

Analysis: Recurring themes within group discussion were identified by three independent investigators, one who was ethnicity concordant

Results: Information from this qualitative study demonstrates that cultural beliefs, environmental, psychological and social factors can be barriers to successful prevention and treatment of overweight. When body image and cultural norms were discussed, African American women reported preferring to be overweight. Many dismissed the BMI chart as well as advice to lose weight when delivered by Caucasian/Asian providers as not relevant for Black women. Both groups want to receive care from the same ethnic background providers. Both groups expressed similar barriers to healthy eating and regular physical activity. Barriers included: convenience of fast food, a taste for fast foods, advertising, lack of access and affordability of quality foods, lack of childcare and cooking skills, lack of recreational opportunities and community safety.

Conclusions: Health education efforts must be based on direct knowledge of the belief systems and cultural frameworks of the targeted populations. Health care providers must be prepared to adjust educational approaches to the cultural background of the clients. Environmental barriers to healthy behaviors must be addressed for long-term success.