Kumanyika S K, Morssink C, Agurs T
Nutrition Department, Pennsylvania State University, University Park.
Ethn Dis. 1992 Spring;2(2):166-75.
This paper explores cultural factors that potentially influence the effectiveness of weight-control programs for African-American women and attempts to challenge the perception that such programs operate in a culture-free context. The prevalence of obesity and related chronic conditions is notably higher among African-American than among white women. A larger net weight gain during adulthood among African-American women is associated at least in part with a lesser likelihood of losing weight. Evidence from clinical trials also suggests that African-American women have difficulty in losing weight. Cultural variables are thought to limit the intensity of weight-loss motivations among African-American women, but it is also possible that unrecognized cultural variables within behavioral weight-control programs limit their applicability to persons who do not fit a typical middle-class white American prototype. Many perspectives that differ between African-American and American cultures are directly relevant to the tasks and expectations involved in conventional behavioral therapy. Thus, efforts to make programs culturally appropriate for African-American women may need to go beyond superficial adaptations (eg, logistical accommodations) toward a behavioral analysis of weight control as it is likely to be approached by African-American women within their cultural context.
本文探讨了可能影响非裔美国女性体重控制项目效果的文化因素，并试图挑战那种认为此类项目在无文化背景下运作的观念。肥胖及相关慢性病在非裔美国女性中的患病率显著高于白人女性。非裔美国女性成年后净体重增加更多，这至少部分与减肥可能性较低有关。临床试验的证据也表明，非裔美国女性减肥困难。文化变量被认为会限制非裔美国女性减肥动机的强度，但行为体重控制项目中未被认识到的文化变量也有可能限制其对不符合典型美国中产阶级白人原型的人群的适用性。非裔美国文化和美国文化之间存在差异的许多观点与传统行为疗法所涉及的任务和期望直接相关。因此，使项目在文化上适合非裔美国女性的努力可能需要超越表面的调整（如后勤保障），转向对体重控制进行行为分析，因为这可能是在其文化背景下非裔美国女性会采用的方式。
