Breland Jessica Y, Petrova Valentina V, Hicks Olivia, Tanksley Lamont, Borowitz Michelle A, Houseknecht Dakota, Muhammad Na''imah, Nevedal Andrea L, Hoerster Katherine D
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, United States of America.
VA Puget Sound Healthcare System, Seattle Division, Research and Development, Seattle, WA, United States of America.
Prev Med Rep. 2025 Aug 23;58:103224. doi: 10.1016/j.pmedr.2025.103224. eCollection 2025 Oct.
Veterans who self-identify as Black (hereafter Black veterans) and use the Veterans Health Administration (VHA)'s MOVE!® Weight Management Program lose less weight than other veterans. Understanding factors affecting this difference could identify solutions.
We interviewed 18 MOVE! employees and 26 Black veterans who engaged in MOVE! in the United States of America (2022/2023). Separate semi-structured interview guides focused on three research questions: 1) What are Black veterans' experiences in MOVE!?; 2) What factors impact weight management?; 3) How can care be improved? Transcripts were analyzed using deductive/inductive coding and rapid analysis.
Employees and veterans were satisfied with MOVE! experiences. Participants described social determinants of health that could affect weight management or weight loss disparities, including stress, negative interpersonal or institutional experiences, bias, cultural differences, and health care experiences. Employees and veterans noted care could be improved by adjusting materials to address culturally-relevant foods and several suggested more diverse MOVE! staff. Participants expressed interest in training for MOVE! staff and care tailored to preferences/needs.
To ensure veteran-centered care, MOVE! could increase its focus on general health and functioning, managing mental health and stress, culturally-relevant foods, and training. Ongoing engagement with veterans could support these efforts.
自我认定为黑人的退伍军人(以下简称黑人退伍军人)在使用退伍军人健康管理局(VHA)的“行动起来!”体重管理计划时,体重减轻幅度低于其他退伍军人。了解影响这种差异的因素有助于找到解决办法。
我们采访了18名“行动起来!”项目的工作人员以及26名参与该项目的美国黑人退伍军人(时间为2022年/2023年)。分别针对三个研究问题设计了半结构化访谈指南:1)黑人退伍军人参与“行动起来!”项目的体验如何?2)哪些因素影响体重管理?3)如何改善护理?访谈记录采用演绎/归纳编码和快速分析的方法进行分析。
工作人员和退伍军人对“行动起来!”项目的体验感到满意。参与者描述了可能影响体重管理或减肥差异的健康社会决定因素,包括压力、负面的人际或机构体验、偏见、文化差异和医疗保健体验。工作人员和退伍军人指出,通过调整材料以涉及与文化相关的食物,以及一些人建议增加“行动起来!”项目工作人员的多样性,可以改善护理。参与者对为“行动起来!”项目工作人员提供培训以及根据个人偏好/需求提供个性化护理表示感兴趣。
为确保以退伍军人为中心的护理,“行动起来!”项目可以更加关注整体健康和功能、管理心理健康和压力、与文化相关的食物以及培训。与退伍军人持续互动可以支持这些努力。