1
|
Briggs R, Rowden H, Lagojda L, Robbins T, Randeva HS. The lived experience of food insecurity among adults with obesity: a quantitative and qualitative systematic review. J Public Health (Oxf) 2024; 46:230-249. [PMID: 38409966 PMCID: PMC11141780 DOI: 10.1093/pubmed/fdae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 11/16/2023] [Accepted: 12/01/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Food insecurity and obesity are increasing both globally and in the UK. In this review we systematically assess the lived experiences of people with obesity who are food insecure and often turn to food banks. METHODS We systematically searched electronic databases from January 2007 until October 2022. Data from eligible studies were extracted and the studies assessed for quality. Thematic analysis and narrative synthesis approach was used to analyse the extracted data. RESULTS Six themes were identified among 25 included studies, including: the financial cost of food; psychological aspects related to food insecurity; geographical access and the food environment; food practices in the home; experience of food assistance; and parental-child relationships. The cost of healthy food and psychological factors were identified as key driving factors of the relationship between food insecurity and obesity. Psychological factors such as depression, low self-esteem and stress played an important part in the lived experience of people with obesity and food insecurity. CONCLUSION The food environment provides context in which food decisions are made, therefore, systems change is necessary to ensure families can afford the food that enables a healthy diet. For clinicians, identification, and attention to the impact of food insecurity on people with obesity are important.
Collapse
Affiliation(s)
- Rebecca Briggs
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Hope Rowden
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Lukasz Lagojda
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Clinical Evidence-Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Timothy Robbins
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Harpal S Randeva
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
- Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| |
Collapse
|
2
|
Mackelprang JL, Graves JM, Schulz HM. Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:195. [PMID: 38397685 PMCID: PMC10887878 DOI: 10.3390/ijerph21020195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
The lived experiences of homeless and unstably housed women, including their health-related priorities, are understudied in smaller metropolitan and rural communities. In this study, we partnered with a day center for women who experience homelessness in Spokane, Washington. We used Photovoice, a community-based participatory action research method, to explore the health-related concerns, needs, and behavior of women who are homeless or unstably housed. Participant-generated photographs and group interview data were analyzed using thematic analysis. Three themes were generated: "These are my supports", "I'm trying to make my health better", and "[My] choices are very limited". The themes illustrated individual, interpersonal, community, and societal strengths and vulnerabilities aligned with the social ecological model. Participants demonstrated resourcefulness, creativity, and hope as they strived toward health improvement. Trauma-informed, strengths-based approaches that respect the autonomy of homeless and unstably housed women and that amplify their voices are needed to minimize power imbalances in research, policy, and practice. This includes an imperative for healthcare and social work programs to ready graduates to deliver effective, empathic services by increasing their knowledge of social determinants of health and of the stigma faced by marginalized communities. Moreover, collaborating with these communities when designing, implementing, and evaluating services is critical.
Collapse
Affiliation(s)
- Jessica L. Mackelprang
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne 3122, Australia
| | - Janessa M. Graves
- Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA 98195, USA
- College of Nursing-Spokane, Washington State University, Spokane, WA 99201, USA;
| | - Halle M. Schulz
- College of Nursing-Spokane, Washington State University, Spokane, WA 99201, USA;
- Honors College, Washington State University, Pullman, WA 99164, USA
| |
Collapse
|
3
|
Exum AC, Templin J, Fazzino TL. Bridging gaps by including culture: Development and empirical test of the culturally informed theory for disordered eating among Black women. Eat Behav 2022; 44:101600. [PMID: 35152181 DOI: 10.1016/j.eatbeh.2022.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Leading eating disorder (ED) theories were informed primarily by samples of White females. Therefore, ED theories lack consideration of sociocultural factors that may impact ED symptom development among Black women. The current study proposed the first culturally informed theory for disordered eating among Black women, positing that ethnic discrimination, strong black woman (SBW) ideology (cultural and societal expectations of strength), and culturally informed appearance satisfaction may significantly impact stress. Stress may be associated with coping-motivated eating behaviors, which may lead to maladaptive weight control behaviors. METHODS Black women (N = 208) completed surveys assessing socio-cultural factors, stress, commensal and binge eating, and maladaptive weight control behaviors. Path analysis was used to test the proposed theory. RESULTS The final model had a good fit for the data. Findings overall supported the hypothesized model. Specifically, higher ethnic discrimination (β = 0.044, p = .003), greater endorsement of SBW ideology (β = 0.074, p =< .001), and lower culturally informed appearance satisfaction (β = -0.032, p = .025) were associated with greater stress. Stress was positively associated with binge eating (β = 0.457, p = .046), and binge eating was significantly associated with excessive exercise (=0.152, p = .008) and purging (β = 0.273, p = <.001). In contrast, commensal eating was not associated with stress or weight control behaviors (p values = .697 to .749). CONCLUSIONS The current study found that stress, as influenced by sociocultural factors, may play a role in binge eating, and subsequently, weight control behaviors among Black women. This theory is a starting point for future research on the specialized conceptualization of eating and maladaptive weight control behaviors among Black women.
Collapse
Affiliation(s)
- Alexis C Exum
- Department of Psychology, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA.
| | - Jonathan Templin
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, USA; Center for Advanced Studies in Measurement and Assessment, University of Iowa, Iowa City, IA, USA
| | - Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA.
| |
Collapse
|
4
|
Nho JH, Kim EJ. Health promoting behaviors in low-income overweight and obese women in Korea: an exploratory qualitative study. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2021; 27:348-357. [PMID: 36311453 PMCID: PMC9328637 DOI: 10.4069/kjwhn.2021.11.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 07/29/2023] Open
Abstract
Purpose This study aimed to explore and understand the health promoting behaviors of low-income overweight and obese women in Korea. Methods Data were collected from 10 low-income overweight and obese women working at a community self-sufficiency center through semi-structured in-depth interviews. Individual interviews were conducted and transcribed. Deductive content analysis was done, using the MAXQDA program. Results The health promoting behaviors practiced by low-income overweight and obese women were affected by intrapersonal, interpersonal, and organizational/community factors. Six categories were identified and two category clusters were derived that could best describe their health promoting experiences. As main category clusters, despite "feeling that the body and mind are not healthy" participants noted "difficulty maintaining a healthy lifestyle." Overall, the participants had poor nutritional status, lacked physical activity, experienced much stress in intrapersonal level, and faced intrapersonal-level barriers to health promoting behaviors. Moreover, participants had a lack of personal will, and lack of specific information to practice health promoting behaviors, a lack of time, and too many overall burdens to earn a living for their family while trying to maintain health promotion behaviors. Conclusion Lifestyle interventions for nutrition management, encouragement of physical activity, and stress management are needed for overweight and obese low-income women. In addition, social support and policies are needed to improve their living environment.
Collapse
Affiliation(s)
- Ju-Hee Nho
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
| | - Eun Jin Kim
- College of Nursing, Jeonbuk National University, Jeonju, Korea
| |
Collapse
|
5
|
Sanchez R, Ranjit N, Kelder SH, Gill M, Hoelscher DM. Intention to lose weight and use of electronic cigarettes among adolescents. Prev Med Rep 2021; 23:101406. [PMID: 34136339 PMCID: PMC8181191 DOI: 10.1016/j.pmedr.2021.101406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 11/17/2022] Open
Abstract
Electronic cigarette use among American adolescents is a major public health concern given the negative health consequences of nicotine in youth. Recent literature has shown that weight control may be one motivation for use in this population. This study examined associations between intention to lose weight and e-cigarette use among adolescents having overweight or obesity from an ethnically diverse sample of Texas youth by gender. We performed a cross-sectional analysis of a state representative sample of 9056 eighth and eleventh grade students from the 2015-2016 Texas School Physical Activity and Nutrition (Texas SPAN) study. Validated survey items assessed weight intentions and e-cigarette use. Staff collected anthropometric measures. Logistic regression analysis was conducted to assess the relationship between e-cigarette use and weight intentions with gender interaction, adjusting for grade, race/ethnicity, economic status, weight-behaviors and stratified by BMI class. More than half (50.9%) of the weighted sample were Hispanic and 12.5% were Non-Hispanic Black; 8.5% used e-cigarettes; and 50.0% intended to lose weight. Of the 40.2% of the sample having overweight or obesity, 82.9% intended to lose weight. Among respondents with obesity, use of e-cigarettes was significantly higher among males intending to lose weight than among females intending to lose weight (12% versus 6%, p = 0.007). These findings contrast with previous research suggesting that e-cigarette use in females is more likely to be motivated by an intent to lose weight. The ethnic diversity of the Texas SPAN population may explain this discrepancy.
Collapse
Affiliation(s)
- Ruth Sanchez
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| | - Nalini Ranjit
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| | - Steven H. Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| | - Montana Gill
- Texas Department of State Health Services, Division of Community Health Improvement, 110 West 49 St., Austin, TX 78756, USA
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| |
Collapse
|
6
|
Healthy eating beliefs and the meaning of food in populations with a low socioeconomic position: A scoping review. Appetite 2021; 161:105135. [PMID: 33493606 DOI: 10.1016/j.appet.2021.105135] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 11/22/2022]
Abstract
Profound understanding of healthy eating beliefs in populations with a low socioeconomic position (SEP) can benefit attempts to improve diet quality in this population, but literature on this subject is fragmented. The purpose of this scoping review was to systematically map healthy eating beliefs and the meaning of food and eating in populations with a low SEP. Systematic search of electronic databases yielded 35 relevant publications that were included in a qualitative synthesis. Populations with a low SEP perceived healthy eating as important, although they expressed various meanings of 'healthy' and 'good' eating. Lack of time and money posed perceived barriers to healthy eating, as well as social influences, and desired identities that can be expressed by specific foods. Traditions were important influences on food and eating practices. Eating behavior was perceived as one's own responsibility and desirably within one's own control. Parents expressed the role of food to regulate children's (eating) behavior. In conclusion, perceived limited control over what is eaten due to various barriers as described by populations with a low SEP, may also be viewed as competing values. Deeper understanding of reasons and thoughts underlying healthy eating beliefs and what it means to eat 'well' is largely lacking in this domain. The findings call for an in-depth exploration of the origin and construction of beliefs regarding 'healthy' and 'good' eating in populations with a low SEP.
Collapse
|
7
|
Arlinghaus KR, Laska MN. Parent Feeding Practices in the Context of Food Insecurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020366. [PMID: 33418887 PMCID: PMC7825020 DOI: 10.3390/ijerph18020366] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 02/06/2023]
Abstract
The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents’ perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.
Collapse
|
8
|
Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
Collapse
Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
| |
Collapse
|
9
|
López-Cepero A, Frisard C, Lemon SC, Rosal MC. Emotional Eating Mediates the Relationship Between Food Insecurity and Obesity in Latina Women. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:995-1000. [PMID: 33168208 PMCID: PMC7656045 DOI: 10.1016/j.jneb.2020.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To examine the mediating role of emotional eating (EE) in the association between food insecurity (FI) and obesity in Latina women. DESIGN A secondary analysis of a cross-sectional study. PARTICIPANTS Women (n = 297) were recruited from a community health center in Lawrence, MA. VARIABLES MEASURED The 6-item US Department of Agriculture Household Food Security Scale was used to measure FI. The Three-Factor Eating Questionnaire Revised 18-item, version 2 was used to measure EE. Measured height and weight were used to calculate body mass index. Covariates included: age, education, marital status, number of children in the house, physical activity, and country of birth. ANALYSIS Multivariable logistic and linear regressions. Mediation was tested and the mediated proportion was calculated. RESULTS Overall, 36.7% of women experienced FI. In adjusted regression models, FI was positively associated with obesity (odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.08-2.97; P = 0.02) and EE (β = 0.22; 95% CI, 0.001-0.44; P = 0.05), and EE was positively associated with obesity (OR = 1.82; 95% CI, 1.37-2.42; P < 0.01). When EE was included in the main effects model, FI was not significantly associated with obesity (OR = 1.64; 95% CI, 0.97-2.76; P = 0.06) and EE explained 21% of the association. CONCLUSIONS AND IMPLICATIONS Longitudinal studies are needed to confirm the findings. If the findings are confirmed, future studies can explore interventions to ameliorate EE among Latina women experiencing FI, and providers can screen for EE in Latinas experiencing FI.
Collapse
Affiliation(s)
- Andrea López-Cepero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, University of Massachusetts, Worcester, MA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, University of Massachusetts, Worcester, MA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, University of Massachusetts, Worcester, MA.
| |
Collapse
|
10
|
Pickett S, Burchenal CA, Haber L, Batten K, Phillips E. Understanding and effectively addressing disparities in obesity: A systematic review of the psychological determinants of emotional eating behaviours among Black women. Obes Rev 2020; 21:e13010. [PMID: 32067355 DOI: 10.1111/obr.13010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/21/2019] [Accepted: 01/17/2020] [Indexed: 11/28/2022]
Abstract
Emotional eating may be a particularly important contributor to differences in body weight and weight loss response to behavioural interventions among non-Hispanic Black women. We performed a systematic review on the impact of psychological factors (stress, anxiety, depression, and discrimination) upon emotional eating and weight among non-Hispanic Black women, applying the Preferred Reporting Items for Systematic Reviews and Meta-analysis for relevant studies. The initial search yielded 4593 articles with 15 accepted for review. Based on this review, there is a suggestion that negative emotions, in particular, perceived stress, may be predictive of emotional eating among non-Hispanic Black women. Results from the only two longitudinal studies identified by the review indicate that stress influences emotional eating, and emotional eating predicts weight gain over time. Findings from this review highlight the need for more studies that examine various negative emotions that may lead to emotional eating and weight gain among non-Hispanic Black women. Findings from this review also highlight the need for more rigorous studies to differentiate the effects of emotional eating from that of the physiologic (ie, activation of the hypothalamic-pituitary axis) responses to stress and its impact on high-risk groups.
Collapse
Affiliation(s)
- Stephanie Pickett
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Clare A Burchenal
- School of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Leora Haber
- School of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Kendra Batten
- School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY, USA
| |
Collapse
|
11
|
Goode RW, Kalarchian MA, Craighead L, Conroy MB, Gary-Webb T, Bennett E, Cowell MM, Burke LE. Perceptions and experiences of appetite awareness training among African-American women who binge eat. Eat Weight Disord 2020; 25:275-281. [PMID: 30221323 PMCID: PMC6420865 DOI: 10.1007/s40519-018-0577-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 09/05/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women. METHODS African-American women, aged 18-70 years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention. RESULTS Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns. CONCLUSION AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population. LEVEL OF EVIDENCE Level V, qualitative descriptive study.
Collapse
Affiliation(s)
- Rachel W Goode
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Campus Box #3550, Chapel Hill, NC, 27599-3550, USA.
| | | | - Linda Craighead
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Molly B Conroy
- Division of General Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Tiffany Gary-Webb
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Mariah M Cowell
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Campus Box #3550, Chapel Hill, NC, 27599-3550, USA
| | - Lora E Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
12
|
Sung B, Etemadifar A. Multilevel Analysis of Socio-Demographic Disparities in Adulthood Obesity Across the United States Geographic Regions. Osong Public Health Res Perspect 2019; 10:137-144. [PMID: 31263662 PMCID: PMC6590879 DOI: 10.24171/j.phrp.2019.10.3.04] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives The objective of this study was to examine the socio-demographic disparities in obesity among US adults across 130 metropolitan and micropolitan statistical areas. Methods This study used data from the 2015 Behavioral Risk Factor Surveillance System and Selected Metropolitan/Micropolitan Area Risk Trend of 159,827 US adults aged 18 years and older. Data were analyzed using the multilevel linear regression models. Results According to individual level analyses, socio-demographic disparities in obesity exist in the United States. Individuals with low socioeconomic status were associated with a higher body mass index. The participants from the Midwest United States tend to have higher body mass index than those who from the South. According to metropolitan and micropolitan statistical area level analyses, secondly, there were significant differences in obesity status between different areas and the relation of obesity with 5 socio-demographic factors varied across different areas. According to geospatial mapping analyses, even though obesity status by metropolitan and micropolitan statistical area level has improved overtime, differences in body mass index between United States regions are increasing from 2007 to 2015. Conclusion Socio-demographic and regional disparities in obesity status persist among US adults. Hence, these findings underscore the need to take socio-environmental factors into account when planning obesity prevention on vulnerable populations and areas.
Collapse
Affiliation(s)
- Baksun Sung
- Department of Sociology, Social Work, and Anthropology, Utah State University, United States
| | - Amin Etemadifar
- Department of Sociology, Social Work, and Anthropology, Utah State University, United States
| |
Collapse
|
13
|
Opichka K, Smith C, Levine AS. Problematic Eating Behaviors Are More Prevalent in African American Women Who Are Overweight or Obese Than African American Women Who Are Lean or Normal Weight. FAMILY & COMMUNITY HEALTH 2019; 42:81-89. [PMID: 30768472 DOI: 10.1097/fch.0000000000000222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Problematic eating behaviors such as overeating and loss of control over consumption can lead to obesity. Problematic eating behaviors among women of differing body mass indexes were explored through focus group methodology, the Palatable Eating Motives Scale (PEMS), and a taste test in a sample of low-income African American women (n = 45). Women who were overweight or obese (W-O/O) reported more problematic eating behaviors including eating in the absence of hunger, frequent overeating, and increased food thoughts than women who were lean or normal weight (W-L/N). The W-O/O appear to possess more problematic eating behaviors than W-L/N.
Collapse
Affiliation(s)
- Katelyn Opichka
- Department of Food Science and Nutrition, University of Minnesota, St Paul
| | | | | |
Collapse
|
14
|
Rossi A, Friel C, Carter L, Garber CE. Effects of Theory-Based Behavioral Interventions on Physical Activity Among Overweight and Obese Female Cancer Survivors: A Systematic Review of Randomized Controlled Trials. Integr Cancer Ther 2018; 17:226-236. [PMID: 29076388 PMCID: PMC6041897 DOI: 10.1177/1534735417734911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/23/2017] [Accepted: 09/07/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To determine whether theory-based physical activity (PA) interventions for overweight and obese female cancer survivors lead to increased PA and improved health. METHODS This systematic review examined randomized controlled trials analyzing the impact of theory-based PA interventions on overweight and obese female cancer survivors through December 2016. Searches of 5 electronic databases revealed 10 articles that included 1351 participants who met the inclusion criteria. RESULTS Participants were primarily non-Hispanic white (74%-100%) breast or endometrial cancer survivors. Intervention characteristics and PA assessment tools varied greatly. Adherence (68%-99%) and retention (79%-100%) were relatively high. Social cognitive theory was utilized as the theoretical construct in 9 of the 10 studies. Home-based interventions led to small improvements in PA (Cohen's d range = 0.25-0.31), whereas home-based plus center-based interventions led to moderate to large improvements (Cohen's d range = 0.45-1.02). Only three of the studies assessed psychosocial behavioral processes associated with PA, and the results were mixed. Health-related outcomes included improvements in aerobic fitness (Cohen's d = 0.32-1.1 in 5 studies), large absolute decreases in waist circumferences (>6 cm in 3 of 5 studies; Cohen's d = -0.31 to -1.02), and no change in inflammatory biomarkers (in 2 studies). Only one serious adverse event (pelvic stress fracture) was attributed to the interventions. CONCLUSIONS Theory-based PA interventions are safe and feasible for overweight and obese female cancer survivors. Interventions that include a center-based component showed moderate to large effect sizes for PA. Future studies should evaluate behavioral variables and more health-related clinical outcomes.
Collapse
Affiliation(s)
- Amerigo Rossi
- Long Island University Brooklyn, NY,
USA
- Columbia University, New York, NY,
USA
| | | | | | | |
Collapse
|
15
|
Smart Homes and Sensors for Surveillance and Preventive Education at Home: Example of Obesity. INFORMATION 2016. [DOI: 10.3390/info7030050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
16
|
Tester JM, Lang TC, Laraia BA. Disordered eating behaviours and food insecurity: A qualitative study about children with obesity in low-income households. Obes Res Clin Pract 2015; 10:544-552. [PMID: 26689335 DOI: 10.1016/j.orcp.2015.11.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/05/2015] [Accepted: 11/20/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND While there is information in the literature describing the poor nutritional intake of food-insecure youth, eating behaviours among food-insecure children - particularly, obese children are less well-described. We conducted focus groups with family members of low-income children who were initiating care in a paediatric obesity clinic. Food hiding emerged as a theme, and generated the motivation for this analysis. METHODS Between April 2012 and December 2013, a total of 7 focus groups were conducted (4 food-insecure groups and 3 food-secure). Based on recruitment from 37 index patients, the focus groups were attended by a total of 47 participants. Participant responses about eating behaviours were evaluated using a combination of inductive codes derived from the data and deductive codes informed by criteria for diagnosis of disordered eating. RESULTS While participants from food-secure and food-insecure households all had anecdotes about their children overeating, respondents in two of the food-insecure groups described episodes that resemble binge eating. The topic of hiding food emerged in the food-insecure groups, though was not endorsed in the food-secure groups despite probing. Night-time eating arose spontaneously in two of the food-insecure groups, but not in the food-secure groups. CONCLUSION This study highlights the presence of food hiding, binge eating, and night-time eating in food-insecure children with obesity. These factors would further compound their health burden, and the relationship between disordered eating and food insecurity in children with obesity warrants further study.
Collapse
Affiliation(s)
- June M Tester
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA(1).
| | - Tess C Lang
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA(1)
| | - Barbara A Laraia
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| |
Collapse
|
17
|
Dressler H, Smith C. Depression Affects Emotional Eating and Dietary Intake and Is Related to Food Insecurity in a Group of Multiethnic, Low-income Women. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2015. [DOI: 10.1080/19320248.2015.1045666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
18
|
|
19
|
Friedman DB, Foster C, Bergeron CD, Tanner A, Kim SH. A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations. Am J Health Promot 2014; 29:332-8. [PMID: 24670073 DOI: 10.4278/ajhp.130514-qual-247] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. APPROACH Qualitative focus groups/interviews. SETTING Rural and urban counties in one southeastern state. PARTICIPANTS Two hundred twelve African-American and white men and women ages 21+. METHOD Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. RESULTS Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. CONCLUSION Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.
Collapse
Key Words
- Clinical Trials
- Focus Groups
- Health focus: prevention, treatment, participation in clinical trials
- Interviews
- Manuscript format: research
- Motivators
- Outcome measure: perceptions, knowledge
- Prevention Research
- Qualitative
- Recruitment Barriers
- Research Participation
- Research purpose: descriptive
- Setting: statewide, community
- Strategy: education, recruitment
- Study design: qualitative
- Target population age: adults, seniors
- Target population circumstances: all education levels, all income levels, South Carolinians, rural and urban, African-American and white
Collapse
|
20
|
Dressler H, Smith C. Environmental, personal, and behavioral factors are related to body mass index in a group of multi-ethnic, low-income women. J Acad Nutr Diet 2013; 113:1662-8. [PMID: 24119531 DOI: 10.1016/j.jand.2013.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
Abstract
Environmental, personal, and behavioral determinants of body mass index (BMI) are not well understood in the low-income demographic. To investigate these factors, a cross-sectional survey was developed using Social Cognitive Theory (SCT), utilizing formative data from focus groups and measured environmental, personal, and behavioral constructs, in addition to food-related self-identity, food security, and heights and weights. Participants were urban women (n=330) who qualified for a food and nutrition assistance program. Data collection occurred at sites within the community, including homeless shelters, food pantries, libraries, and community centers. The outcome of interest was BMI and the relationship to environmental, personal, and behavioral constructs, and food-related self-identity. All three SCT construct models were significant, but the personal construct regression model predicted the greatest variance in BMI among the women (31%). Decreased BMI was associated with SCT and self-identity variables indicating preventative behaviors, while increased BMI was associated with SCT and self-identity emotional eating variables. Overall results suggest that personal, behavioral, and self-identity factors can help to explain some weight variation observed among women living in similar obesogenic, low-income environments. Although additional research is needed, results suggest interventions with this population should address eating healthy to prevent disease, exercising for health, and shaping health-promoting self-identities.
Collapse
|