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Keywords:

  • Obesity;
  • weight management;
  • African Americans;
  • exercise;
  • diet;
  • self-efficacy;
  • social support

Abstract

Purpose: This report explores the extent to which sociodemographic and psychosocial factors could explain differences in obesity or dietary and exercise behaviors between middle-aged African American (AA) and European American (EA) women seen in primary care. We focus on “race × predictor” interactions that could explain how AA and EA women differ in ways that affect the prevalence of obesity.

Design: This comparative exploratory study uses data from the baseline examination of the Reasonable Eating and Activity to Change Health (REACH) trial, which included 173 AA women and 278 EA women. Inclusion criteria were membership in one of the study family medicine practices, an elevated body mass index (greater than 27 kg/m2), age 40 to 69 years, and no contraindications to increased activity and dietary change.

Methods: Secondary data analyses were employed.

Findings: There was evidence of race differences in the level of multiple variables related to weight management but there were only three significant “race × predictor” interactions out of 48 comparisons: (a) race × physical health, with BMI as the dependent variable; (b) race × the percentage of dietary fat, with total dietary kilocalories as the dependent variable; and (c) race × median income, with exercise minutes per week as the dependent variable.

Conclusions: The results support the proposition that the weight management experience of AA and EA primary care women is similar after different exposure levels are taken into account. The results contribute to the body of literature that addresses obesity management for AA and EA women in primary care settings.

Clinical Relevance: Findings illustrate the need for obesity prevention and management efforts from both multidisciplinary primary care providers and community-wide public health interventions. AA and EA women have different resources, but the same factors generally influence weight management, whether one is AA or EA. This suggests that clinical interventions and public health interventions for AA and EA women can be designed around the same principles while paying attention to relevant cultural issues.