University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC, 29208, USA.
University of South Carolina, Department of Psychology, Barnwell College 224, 1512 Pendleton Street, Columbia, SC, 29208, USA.
Soc Sci Med. 2023 Jun;326:115898. doi: 10.1016/j.socscimed.2023.115898. Epub 2023 Apr 15.
Black men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South.
We conducted individual telephone interviews with 23 Black men (mean age 50 ± 14 years) with overweight or obesity living in rural South Carolina communities in 2020 and 2021. Interviews were audio recorded, professionally transcribed, and coded by two men's health researchers who achieved an intercoder reliability of 70%. Content analysis using QSR NVivo 12 was used to generate themes using deductive and inductive approaches.
Physical health and health behaviors were perceived as key determinants of overall health. Family, friends, and other social contacts often provided positive social support that increased motivation but also hindered motivation by engaging in behaviors men were trying to avoid. Younger participants had stronger views of rural environments not supporting healthy lifestyles, which compounded personal challenges such as time constraints and lack of motivation. Comfort was discussed as a critical program consideration, and gender concordance among program participants and facilitators was perceived as promoting comfort. Participants noted preferences and benefits of in-person, group programs emphasizing physical activity, and younger participants more strongly endorsed programs that incorporated sports and competition.
Findings from this study provide important evidence to inform the development of weight management interventions for Black men in the rural US South. Based on these findings, an innovative, competitive "football-themed" weight management program promoting peer support and integrating competitive physical activities is being evaluated for younger Black men in the rural South.
美国南部农村地区的黑人男性在体重管理行为试验中代表性不足。需要进行定性研究，为这一人群提供可以减少肥胖和健康差距的干预措施。我们探讨了内在、社会和环境因素如何影响动机和与体重相关的行为，以及如何为美国南部农村地区的黑人男性调整行为干预措施。
我们于 2020 年至 2021 年在南卡罗来纳州农村社区对 23 名超重或肥胖的黑人男性进行了个人电话访谈（平均年龄 50 ± 14 岁）。访谈进行了录音，并由两名男性健康研究人员进行专业转录和编码，他们的编码者间信度达到 70%。使用 QSR NVivo 12 进行内容分析，采用演绎和归纳方法生成主题。
身体健康和健康行为被视为整体健康的关键决定因素。家人、朋友和其他社会联系人经常提供积极的社会支持，这增加了动力，但也通过参与男性试图避免的行为来阻碍动力。年轻的参与者对不支持健康生活方式的农村环境有更强的看法，这加剧了个人面临的挑战，如时间限制和缺乏动力。舒适度被讨论为一个关键的项目考虑因素，项目参与者和促进者之间的性别一致性被认为可以促进舒适度。参与者注意到对强调身体活动的面对面、小组项目的偏好和益处，年轻的参与者更强烈地支持纳入运动和竞争的项目。
本研究的结果为在美国南部农村地区为黑人男性开发体重管理干预措施提供了重要证据。基于这些发现，正在评估一项创新的、有竞争力的“足球主题”体重管理计划，该计划旨在促进同伴支持并整合有竞争力的身体活动，针对的是南部农村地区的年轻黑人男性。
