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An exploration of the role of socioeconomic and cultural influences on weight management in Black women
Dissertation

An exploration of the role of socioeconomic and cultural influences on weight management in Black women

Tiffany Eaton
Doctor of Public Health (Dr.P.H.), Drexel University
Jun 2024
DOI:
https://doi.org/10.17918/00010473
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Eaton_Tiffany_20243.25 MB
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Abstract

Behavioral weight loss interventions Weight loss--Social aspects Women, Black--Social conditions Cultural influences Obesity--Social aspects Socioeconomic status
Obesity is a widely studied area in public health, with numerous, varied public health efforts and multiple research areas to study; however, progress in addressing the epidemic is hampered by increasing prevalence nationwide and the presence of racial/ethnic, gender and socioeconomic disparities. This calls for a need to critically examine and evaluate approaches that have been or are currently being used to address this complex public health issue - particularly in Black women. The purpose of this three-part dissertation was to explore how race, socioeconomic status (SES) and culture influence the ways in which socioeconomically diverse Black women in the United States approach weight management. The first study was a scoping review of 72 articles to examine what is known about how race, SES and culture influence weight loss outcomes for Black women enrolled in behavioral weight loss programs. Findings indicate that there are a variety of socioeconomic and cultural factors that influence weight management behaviors, and the ways in which they can positively or negatively influence weight loss outcomes for Black women across SES. The second study, a qualitative inquiry, explored the experience of weight management among 20 Black women of different SES who either lived and/or worked in Philadelphia County, Pennsylvania. Findings from this study identified five emergent themes related to weight management: (1) cultural nuances; (2) "it [COVID] just shifted the norm"; (3) the influence of social media; (4) acknowledgement of privilege; and (5) the role of work culture. Lastly, the third study involved applying constructs of the Getting to Equity in Obesity Prevention (GTE) Framework to a subsample of articles (n=35) from the first study to assess where and how equity-related considerations were applied to behavioral weight loss interventions for socioeconomically diverse Black women. The findings from this study led to an adaptation of the GTE framework that includes equity-related considerations that can be useful for researchers and practitioners in designing and implementing individually-oriented behavioral weight loss interventions. This dissertation research contributes to the body of research a better understanding of the landscape of weight loss literature as it pertains to Black women, socioeconomic status, and cultural influences. In addition, these three studies inform recommendations that can inform future obesity-related research and praxis in an effort to improve reporting of weight loss studies, suggestions for potentially maximizing the effectiveness of weight loss efforts for Black women and ways to address root causes of obesity disparities.

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