Exploring the Obesity-Related Lifestyle Attitudes and Behaviors of African-American Women and Afro-Caribbean Immigrant Women in Metro Atlanta, Georgia

Background. Obesity has been associated with a number of negative health consequences (e.g., hypertension/heart disease, type-2 diabetes, osteoarthritis, and respiratory illnesses). Despite health communication campaigns to reduce overweight/obesity by encouraging lifestyle changes (e.g., eating healthier foods and exercising), the rates of overweight and obesity levels have continued to rise. Studies indicate that the rate of overweight and obesity in the U.S. is highest among Blacks. Messages targeted toward “Blacks” (African-Americans) in the United States treat this segment of the population as a homogenous group and fail to account for within-group cultural differences. Cultural values and beliefs related to food, physical activity, and ideal body size may contribute to overweight and obesity. Objective. This study was designed to gain a deeper understanding of the similarities and differences between African-American and Afro-Caribbean immigrant women living in the Metro Atlanta, Georgia, in terms of the role that culture and social environments play in forming obesity-related—food, physical activity, and body image—attitudes, values, and behaviors. Method. A social cognitive theory (SCT) framework informed the design of semi-structured interview guides. Study participants were comprised of 13 African-American women and 12 Afro-Caribbean women who recently immigrated to the United States from English-speaking countries. All participants were living in Atlanta, Georgia at the time of the study. They were recruited through convenience and snowball sampling and interviewed between October 5 and December 26, 2014. Data from audio-recorded in-depth interviews were transcribed and analyzed using textual analysis software package NVivo9. Results. African-American and Afro-Caribbean participants were similar in terms of some food-, physical activityand body-image related attitudes and behaviors. Health-related concerns and matrilineal influence affected the food-related behaviors of both groups of participants. Physical activity and body image-related attitudes and behaviors of women in both groups were affected by the norms of their childhood and current social environments. Although a healthy physical activity lifestyle was important to women in both groups, not all women were consistently physically active. The study also revealed some differences between African-American and Afro-Caribbean participants. In general, the African-American women described the food-related norms of their childhood environments in negative terms and were more likely to have changed their foodrelated behaviors for health reasons. The Afro-Caribbean women described their childhood foodrelated norms in positive terms, and thus, strove to maintain healthy behaviors from their childhood. The norms of the current social environments of African-Americans, but the childhood social environments of Afro-Caribbean participants, influenced them more toward healthier food-, physical activityand body image-related attitudes and behaviors. In terms of body ideals, Afro-Caribbean women typically identified a smaller “ideal body size” than African-American women. African-Americans from the South, or those with parents from the South tended to choose larger figures than women from the North. Conclusion. Consistent with other SCT studies, this study found attitudes and behaviors that were consistent with those modeled within the participants’ social environments. There are more cultural differences than similarities between African-American and Afro-Caribbean women. The similarities and differences revealed in this study have implications for the design of culturally relevant obesity-related messages. INDEX WORDS: African-American women, Afro-Caribbean immigrants, Culture, Cultural competence, Culturally-relevant message design, Obesity, Social cognitive theory EXPLORING THE OBESITY-RELATED LIFESTYLE ATTITUDES AND BEHAVIORS OF AFRICAN-AMERICAN WOMEN AND AFRO-CARIBBEAN IMMIGRANT WOMEN IN METRO ATLANTA, GEORGIA