Using Formative Research to Adapt an Evidence-Based Weight Loss Intervention for Low-Income African American Women

Introduction

Despite the high prevalence of obesity in low-income African American women, community-based weight loss approaches for this population have been limited. Guided by a community-based participatory research approach, this study used formative research to adapt an evidence-based intervention (Obesity Reduction Black Intervention Trial (ORBIT) for implementation in a predominately low-income African American community on the Southside of Chicago.

 Methods

The Obesity Reduction Black Intervention Trial (ORBIT) was a university-based randomized controlled weight loss and weight-loss maintenance (WLM) intervention study targeting African American women ages 30-65 years.  As a follow-up to ORBIT, 40 participants completed a semi -structured ethnographic interview to better understand the barriers/facilitators associated with weight loss in black women. Interviews lasted approximately 45-60 minutes, were transcribed verbatim, and coded using Atlas.ti and constant comparative analysis. 

Results

Data analysis showed that weight status in African American women is the result of a complex interaction between multiple social, cultural, environmental, economic, and psychosocial contexts. Women discussed several issues including definitions of an ideal body image, traditional and western food preferences, limited food access, economic inequality, stress, socio-cultural history, and social and family context.

Conclusion

Study findings were used to inform the development of “Doing Me: Sisters Standing Together for a Healthy Mind and Body”, a community-based, culturally tailored weight loss intervention adapted from ORBIT. Additions to the program sessions included mindful eating, coping with historical and current trauma, sleep, and caring for black hair, as well as several measures such as the superwoman Schema and John Henryism scale.