A perspective: Overweight and Obesity in African American Women-Intervention: Health Belief Model

Overweight and Obesity in African American Women

Intervention: Health Belief Model

?Introduction

According to Healthy people 2030, two in five adolescents have obesity in the United States and the rate of Obesity in the US is at 42.4% passing the national obesity mark (Healthy People, 2030). Obesity is associated with several health-related chronic diseases such as several types of cancer, type 2 diabetes, cardiovascular diseases: hypertension, and stroke. Individuals who are overweight have a high tendency to suffer from high blood pressure, high levels of blood fats, diabetes, and LDL cholesterol, (US Department of Health and Human Resources, Office of Minority Health, 2020). The stigma and discrimination surrounding obesity also leads to associated health problems, such as low self-esteem, diminished confidence, poor mental health.

A few ethnic populations have more likelihood to have obesity compared to other groups. According to CDC, 2021, there are more groups that suffer from obesity more than other groups. For example, Non-Hispanic Black adults with over 45.6% makes the population the highest age-adjusted prevalence of obesity, this is followed by Hispanic/Latino population adults with 44.8%, while 42.2% of non-Hispanic White adults suffer from obesity leaving non-Hispanic Asian adults with the lowest at 17.4% (CDC, 2021). Data from the Office of Minority Health, states about four out of five African American women are either overweight or obese (OMH, 2020). This data underscores the fact that the current target population has the highest-ranking rate of obesity when compared to other groups in the United States.?

In a bid to address obesity in African American Women, the Health Belief Model (HBM) will be used as an intervention method. My reason for selecting this model is because it speaks to and exposes the cultural belief system and general lifestyle behind overweightness of the target population. The Health Belief Model will be suitable to develop a step-by-step approach and to reduce the modifiable risk factors of obesity as it is the most widely recognized model, whilst creating a culturally suitable weight management program to intervene in overweightness in this focus group-African American Women.

Planning Model Proposed

The Health Belief Model is the personal beliefs that influence health behavior (Hayden, 2019). The most known concepts used in creating healthier behaviors through directly narrowing on the individual’s positive behavioral change. When this model is applied, it predicts the preventative health behavior as it has been designed to assist in describing and altering perceptions behind each action that affects one’s lifestyle. The theory motivates and helps one to weigh the pros and cons on reasons behind such health behaviors and how to view and value the outcome of the lifestyle changes. Abolfotouh et al., revealed from recent studies that many health problems can be practically resolved using the HBM constructs because of the fundamental elements of perception and motivation (Abolfotouh et al.,2015). In other words, if people decide to avoid diseases, they may believe that the existence of the risks factors of the diseases will eventually impact on their lifestyle, hence the significant role of HBM to reduce the severity of the diseases (Abolfotouh et al.,2015).

The different constructs used to evaluate the lifestyle changes include Perceived susceptibility which explains that individuals are perceived to be at risk given the health condition. This category of people can be predisposed to health conditions which makes them more susceptible. This observation could be from the family trait or genetics, or culture. Consequently, the importance to educate and increase the awareness of the risk factors that comes with being overweight and how to reduce the tendency, by eating healthy, maintaining a regular exercise routine, and positioning yourself in a support circle, encourages one’s goal to achieving a healthy living.

Perceived severity describes the seriousness of the health implications being obese: For example, sharing the story of an intimate family member who is currently suffering a form of illness resulting from being obese such as stroke, type 2 diabetes directly affects the mindset, thereby influencing the belief system the individual holds about current lifestyle. Perceived benefit is when an individual believes that the effectiveness of the behavior reduces the perceived threats associated with the disease, also reduces the stigma from the society, while there are greater benefits such as enhanced self-esteem, confidence boost, the ability to travel and explore innate desires, wearing desired size of clothes and more social engagements. Perceived barriers: explains the obstacles individuals had overcome in trying to change their behaviors. Perceived barriers can be physical, emotional, psychological, socio-economic. For example, the lack of support from friends or family, inability to dedicate time to commit, the probable disbandment from social groups who are obese. The perceived benefits should far outweigh the perceived barriers. Cues to action, such as the support system from family and or community group, serving as prompts to continue the regime of weight management. The medium could include offering rewards, words of affirmation to encourage and stimulate a change in behavior. Self- efficacy is one’s belief to perform for a desired expected outcome. While an individual’s personal factors that affect whether the new behavior is adopted is the Modifying variables.

Background

African American women have the greatest incidence of adult obesity in the United States. Existing data reveals that more than 50% African American females aged 30 to 44 years are obese compared with 33% similarly aged White American females (Flegal et al., 2010). Furthermore, over 50% of African American women over 20 years are either overweight or obese (Walcott-McQuigg et al., 2002). Investigations exposes the reasons why more than half of African American Females are overweight. Some factors are influenced by genetics, individual lifestyle, cultural belief systems, environmental, social, and economic determinants (income, access to health services, physical area with walkways and other features that discourages exercises, proximity to affordable healthy groceries). These barriers including time management given the scenario where a black woman is having to work two jobs to build and sustain income, as well as maintain a home front impedes on the ability to achieve a healthy lifestyle in the long run.

The type of environment inhabited by people shapes a discouraging experience from physical walk outs, or exposure to fresh air. Limited access to quality education is both directly and indirectly linked to overweight. Compare to a scenario where men and women with university degrees have lower overweightness incidence thanks to education, health awareness and literacy also access to early screening (CDC, 2021). Household income and access to health care are enlisted to be responsible factors associated to the many health risks that contributes to obesity. The lack of job opportunities to achieve and maintain a quality standard of living falls short when there is no sustainable means of income.

According to American Psychological Association, other studies have researched on the biological factors which correlates with obesity among African- American women. Some of these studied have shown that the metabolic profile of fat storage and lower rates of fat oxidation in the population, tieing the relatedness to insulin resistance and hypertension which contributes to the heightened risks of obesity- related disease (APA, 2021). The additional concern is the psychological dynamic range of stress reactivity towards race-based perceptions. The role corticotrophin-releasing factor plays as well as cortisol which adds to the abdominal obesity, and leading comorbidities (APA, 2021).

This calls for a concern in general, as 48% of African American adults, are clinically obese (men at 37.1%, women at 56.6%, compared to 32.6% of whites (including men at 32.4% and women at 32.8). This alarming data for black American women, presents itself when considering the related health risks associated with overweightness. It is imperative to increase awareness of the health risks of obesity and how lifestyle behaviors impact on our mental, financial, and social well-being.

?Theory Application to the Intervention

The HBM intervention was used on a focus group of fifty (50) African American Women, divided into seven subgroups. This intervention was adopted because it is mainly recognized and has the cultural embed within each concept addresses the target population’s perceptions. The study commenced with analyzing each of the constructs starting with perceived susceptibility. As expressed in the feedback from the group, the terms used in describing their person signals different perceptions between being obese and overweight as two different things; while the latter to them means being thick, which could be defined as either being sexy, or curvy- perceived as a likable weight even as the saying goes “big is beautiful”. However, nursing this notion lends to the idea that if big is beautiful and sexy, one would rather choose being overweight-curvy than obese- means having “between 300 to 600 pounds" (James, et al., 2012). This perception on the other hand, paints the impression that being skinny or bony is sickly within the population’s cultural parlance. Reconnecting the two meanings (obese and overweightness) whilst emphazing and providing clarity on the health implications of being both overweight and obese, using the Body Mass Index chart will be a learning opportunity to alter the belief system of this population. To deepen the susceptibility of being obese, presenting cases of family members (genetics) currently suffering from the implications of being obese, or overweight exposes the probabilities and makes a case for better weight management (James, et al., 2012).

Perceived severity explains the seriousness of the health risks due to overweightness. It is critical to share the possibilities of slumping, or having a heart attack, stroke, or hypertension leading to sudden death. This sudden death or managing a terminal illness, paying for medications hampers on household income, leads to debt, especially the burden of financial recovery. Maintaining financial stability can be a challenge and reiterating the shared realities, gains a higher influence to rather maintain a healthy weight. Discussing the perceived benefits like access to varieties of clothes, engaging in more social activities, such as travels, shopping and fitting into the desired styles of wears, less worry and better management of any underlying genetic conditions served as a game changer when applying the HBM theory with the group. The focus group revealed the lack of family support or motivation to lose weight, lack of time for physical activity, owing to working two jobs, also little or no access to reliable and sincere information (James, et al., 2012). Other barriers discussed were poor habitable locations with walk paths to improve on their fitness, or access to gym facilities or proximity to fresh grocery stores, and availability and affordability of healthy food options as perceived barriers. Cues to action includes meeting with a wellness coach, subscribing to a weight loss application to get walk prompts, feedback from a physician on the tendency of being overweight, the dawning reality of having someone close or a family member’s demise from a heart attack or high blood pressure may trigger the commencement of a weight loss program immediately. Self-efficacy is when you try to do what you think you can do and not attempt doing what you think you cannot. This self-affirmation draws from the knowledge and having the opportunity to access reliable information, as it is commonly said – “knowledge is power”. Thus, adequate resources to achieve the desired change, and the support circle of reassurance provides efficiency and will power. This leads to the modifying variables which buttresses the individual’s personal factors whether the new behavior is adopted. In general, the feedback from the group exposes the social determinants experienced by the African American population.

References

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