Suchergebnisse

Purpose To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention. Design A secondary analysis of data from a behavioral weight loss intervention. Setting The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Subjects Eighty-one Black women with overweight/obesity (age = 48.4 ± 10.9 years [M ± SD], BMI = 36.4 ± 4.5 kg/m2 [M ± SD]). Measures Identification with the multiple caregiver role and barriers was assessed with the Multiple Caregiving Measurement Instrument. Weight was measured with a digital scale and height with a stadiometer. The Block food frequency questionnaire evaluated dietary intake. Moderate-to-vigorous physical activity (MVPA) was measured objectively with an accelerometer. Study adherence was measured by session attendance, self-weighing, and self-monitoring (diet and physical activity) frequency. Analysis Generalized linear models were used to examine the relationship between the multiple caregiver scales and the outcomes of interest, controlling for study arm, cohort, and income. Chi-square tests tested correlations. Results Greater identification with the multiple caregiver role was associated with decreased session attendance (β = −.56 [SE = .27], P < .05) and a trend towards weight gain (β = .36, [SE = .19], P = .07). Greater multiple caregiver barriers score predicted a decrease in fruit/vegetable intake (β = −.17 [SE = .07], P < .05). All regression results are unstandardized. Negative correlations between multiple caregiver barriers and MVPA ( r = −.24, P = .06) and daily self-weighing ( r = −.19, P = .10) approached significance. Conclusions Participants' identification with multiple caregiving role and barriers can reduce adherence, behavior and weight change. Interventions to address Black women's multiple roles and barriers during weight loss are needed to maximize outcomes.

<strong></strong><p class="Pa7"><strong>Objective: </strong>We set out to determine if a primarily Internet-delivered behavioral weight loss intervention produced differ­ential weight loss in African American and non-Hispanic White women, and to identify possible mediators.</p><p class="Pa7"><strong>Design: </strong>Data for this analysis were from a randomized controlled trial, collected at baseline and 4-months.</p><p class="Pa7"><strong>Setting: </strong>The intervention included monthly face-to-face group sessions and an Internet component that participants were recom­mended to use at least once weekly.</p><p class="Pa7"><strong>Participants: </strong>We included overweight or obese African American and non-Hispanic White women (n=170), with at least weekly Internet access, who were able to attend group sessions.</p><p class="Pa7"><strong>Intervention: </strong>Monthly face-to-face group sessions were delivered in large or small groups. The Internet component included automated tailored feedback, self-monitor­ing tools, written lessons, video resources, problem solving, exercise action planning tools, and social support through message boards.</p><p class="Pa7"><strong>Main outcome measure: </strong>Multiple linear regression was used to evaluate race group differences in weight change.</p><p class="Pa7"><strong>Results: </strong>Non-Hispanic White women lost more weight than African American women (-5.03% vs.-2.39%, P=.0002). Greater website log-ins and higher change in Eating Behavior Inventory score in non-Hispanic White women partially mediated the race-weight loss relationship.</p><p class="Default"><strong>Conclusions: </strong>The weight loss disparity may be addressed through improved website engagement and adoption of weight control behaviors. <em></em></p><p class="Default"><em>Ethn Dis. </em>2018;28(1):43-48; doi:10.18865/ed.28.1.43.</p>

Low fruit and vegetable (F&V) consumption is associated with higher rates of obesity and chronic disease among low-income individuals. Understanding attitudes towards F&V consumption and addressing policy and environmental changes could help improve diet and reduce disease risk. A survey of North Carolinians receiving government assistance was used to describe benefits, barriers, and facilitators of eating F&V and shopping at farmers' markets in this population. A total of 341 eligible individuals from 14 counties completed the survey. The most commonly cited barriers to eating F&V were cost (26.4%) and not having time to prepare F&V (7.3%). Facilitators included access to affordable locally grown F&V (13.5%) and knowledge to quickly and easily prepare F&V (13.2%). Among people who did not use farmers' markets, common barriers to shopping there were not being able to use food assistance program benefits (35.3%) and not knowing of a farmers' market in their area (28.8%); common facilitators included transportation (24.8%) and having more information about farmers' market hours (22.9%). In addition to breaking down structural/environmental barriers to farmers' market usage, there is a need to disseminate promotional information about farmers' markets, including hours, location, and accepted forms of payment.