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

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

Subjects/Setting: 14 African American women aged 18 to 44 were recruited at various Women, Infants and Children sites in Los Angeles County.

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 beliefs, economic and environmental factors can be barriers to successful prevention and treatment of overweight. When body image and cultural norms were discussed, overweight participants reported having a positive body image. They stated that being overweight is accepted and desirable among African Americans. Several whose weight reflected a healthy BMI stated that they wanted to gain weight and felt too skinny. Many participants questioned the relevance of the BMI charts for their population. The women prefer health information and education delivered by African American doctors and health professionals. Barriers to healthy eating include convenience of fast food, a taste for fast foods, and lack of access and affordability of quality foods. Many report working long hours, stress and lack of time and skill to prepare healthy food. Regular physical activity barriers include time, safety and childcare.

Conclusions: To improve health promotion for African American populations, cultural and psychological factors distinctive to this underserved population and barriers they articulate should be considered when developing weight loss interventions.