Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Medical Towers 615, Birmingham, AL, 35205, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
J Racial Ethn Health Disparities. 2022 Apr;9(2):546-565. doi: 10.1007/s40615-021-00985-x. Epub 2021 Feb 5.
Providing ongoing treatment through extended care programs can improve weight loss maintenance (WLM), but the effectiveness of these programs for African Americans (AA) are mixed and may be due to unique cultural factors.
To identify, prioritize, and organize factors associated with WLM as experienced by AA and White adults initially successful with weight loss.
Adults identified their greatest amount of lifetime weight loss, and those achieving ≥5% weight loss were classified as maintainers (continued >5% weight reduction for ≥1 year) or regainers (≤5% weight reduction) based on current weight. The nominal group technique was conducted to identify and rank WLM facilitators and barriers. Online card sorting tasks and hierarchical clustering were performed to illustrate conceptual relationships between facilitators (maintainers only) and barriers (regainers only).
Participants (maintainers, n = 46; regainers, n = 58; 81.7% women, 48.1% AA) identified known factors associated with successful weight management (daily weighing, self-monitoring, regular physical activity, mindful eating). However, the perceived importance of these factors differed between groups (maintainer vs. regainers; AA vs. Whites). Unique factors affecting WLM were also identified (refresher groups recommended by White maintainers and regainers; self-accountability identified by AA maintainers). Salient facilitators and barriers were best represented in 2-3 clusters; each group had ≥1 unique cluster(s) revealing group-specific higher-order domains associated with successful WLM.
As lifestyle interventions for WLM (particularly for AA) are developed, attention to the preferences, and lived experiences of these groups is recommended. Strategies targeting physical activity maintenance and autonomy-supportive approaches may improve WLM among AA.
通过扩展护理计划提供持续治疗可以改善减肥维持（WLM），但这些计划对非裔美国人（AA）的有效性存在差异，这可能是由于独特的文化因素。
确定、优先考虑和组织与非裔美国人和白人成年人最初成功减肥相关的因素，以维持体重。
成年人确定了他们一生中最大的减肥量，那些体重减轻≥5%的人根据当前体重被归类为维持者（持续 >5%的体重减轻持续≥1 年）或恢复者（≤5%的体重减轻）。采用名义群体技术确定和排名 WLM 的促进因素和障碍。在线卡片分类任务和层次聚类用于说明促进因素（仅维持者）和障碍（仅恢复者）之间的概念关系。
参与者（维持者，n=46；恢复者，n=58；81.7%为女性，48.1%为 AA）确定了与成功体重管理相关的已知因素（每日称重、自我监测、定期体育锻炼、正念饮食）。然而，这些因素的重要性在组间（维持者与恢复者；AA 与白人）有所不同。还确定了影响 WLM 的独特因素（白人维持者和恢复者推荐的复习小组；AA 维持者确定的自我问责制）。影响 WLM 的显著促进因素和障碍最好用 2-3 个聚类来表示；每个组都有≥1 个独特的聚类，揭示了与成功 WLM 相关的特定于组的更高阶领域。
在制定 WLM 的生活方式干预措施（特别是针对 AA）时，建议关注这些群体的偏好和生活体验。针对身体活动维持和支持自主性的策略可能会提高 AA 的 WLM。
