African-American Women: Body Image, Weight, & Depression Open Access

Nelson, Michelle Alyson (2009)

Permanent URL: https://etd.library.emory.edu/concern/etds/g158bh841?locale=en
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Abstract


Abstract
African-American Women: Body Image, Weight, & Depression
By Michelle A. Nelson
Obesity in African-American women (AAW) has become a disease of epidemic
proportions. In addition, disproportionately higher rates of depression have been found in AAW
when compared to other groups of women. Cultural factors, body image and depression have
been purported to separately influence the weight of AAW.
The purpose of this study was to explore the relationship among cultural factors (social
organization, biological factors, time and environmental control), weight class and depression in
AAW with body image as a moderating variable. The adapted Transcultural Assessment Model
was used to guide this study.
A descriptive, correlational design was utilized to obtain data from 103 male-female
African-American dyads. Measures completed by participants included the Partner Perceptions of
a Woman's Weight Scale, Female Perception of Weight and Dress Size Index, Male Perception
of Female Partner's Weight and Dress Size Index. Waist-hip ratio and BMI were used as weight
indicators. AAW were categorized as normal (n=31), overweight (n=34), or obese (n=37).
Findings indicated that obese AAW had the highest motivation for weight loss and lowest
levels of self-efficacy for physical activity and diet control, perceptions of body image and male
significant other's perception of body image. Normal weight AAW had the highest level of
depression. There was an inverse relationship between depression and education, health beliefs
about weight and weight control, self-efficacy for diet and physical activity and future time
perspective. Body image moderated the relationship between the male partner's age and the
AAW's BMI. A positive relationship was found between income and waist-hip ratio.
It was concluded that the highest level of concordance satisfaction regarding preferences
for the woman's dress size and weight was noted between the group of overweight AAW and
their male partners.

Table of Contents



Table of Contents

Chapter

1. Introduction...............................................................................1

Statement of the Problem...............................................................1
Conceptual
Framework..................................................................4

Overview of the Transcultural Assessment Model..............................4

Conceptual Model of the Study....................................................6

Propositions of the Conceptual Framework.......................................9
Assumptions of the Conceptual Framework......................................12
Significance of the Proposed Study...................................................12
Definition of Key Variables............................................................13
Specific Aims.............................................................................17
Summary...................................................................................19

II. Background

The Impact of Overweight and Obesity in the United States......................21

The Impact of Overweight and Obesity in African-American Women...........22

Morbidity and Mortality Related to Obesity..........................................23
Culture.....................................................................................24

Cultural Factors in the Culture of Obesity............................................25

Social Organization Factors.........................................................25

Socioeconomic Status............................................................25

Income..............................................................................26

Education..........................................................................28

Family History of Obesity......................................................30

Environmental Control Variables..................................................31

Partner Perceptions of Weight..................................................31

Health Beliefs about Weight and Weight Control...........................33
Empowerment through Self-Efficacy for Diet and Physical Activity.....36
Biological Variables..................................................................38
Age.................................................................................39
Depression and Overweight and Obesity......................................40
Family History of Depression...................................................42
The African-American Woman's History of Depression...................44
Time as a Variable...................................................................45
Perceptions of Body Image............................................................48
Summary..................................................................................52

III.
Research Design and Methods
Overview.................................................................................54
Research
Design.........................................................................55
Sample Recruitment and Setting......................................................56
Sample Inclusion and Exclusion Criteria.............................................57
Data Collection Procedures............................................................59



Protection of Human Subjects........................................................61
Operationalization of Variables.......................................................63
Anthropometric Measures.........................................................63
Self-Report Measures..............................................................65
Data Analysis.......................................................................71
Methodological Assumptions.....................................................76
Limitations Related to the Conduct of the Study..............................76
Summary.............................................................................78

IV. Results...................................................................................80
Overview................................................................................80

Recruitment and Screening of Participants.........................................80

Data Analysis Procedures.............................................................81

Description of the Sample.............................................................82
Description
of
Female Participants...................................................82
Description of Male Participants......................................................86
Results of Data Analysis...............................................................89
Aim 1..................................................................................89
Aim 2.................................................................................91
Aim 3.................................................................................95
Aim 4..................................................................................111
Additional Analyses.....................................................................119
Qualitative Comments Made by Participants That Amplify Findings...........129
Summary.................................................................................130

V.
Discussion, Conclusions and Recommendations

Summary of the Research..............................................................132

Discussion of the Findings............................................................138

Obesity and Depression............................................................138

Implications of the Findings for the Transcultural Assessment Model.......141

Socioeconomic Status...............................................................142

Family History of Obesity.........................................................143

The Woman's Perceptions of Her Body Image.................................144

The Male Partner's Perception of the Female's Body Image..................145

Health Beliefs about Weight and Weight Control..............................146

Self-efficacy Related to Diet and Physical Activity............................147

Time Perspective.....................................................................148

Age and Weight.....................................................................148

Body Mass Index and Waist-Hip Ratio..........................................149

Discussion of Additional Findings....................................................152
Conclusions................................................................................153

Implications for Clinical Practice.....................................................157

Implications for Research..............................................................158

Implications for Policy..................................................................159

Strengths of the Study..................................................................160

Limitations of the Study................................................................161

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