Penny A. Ralston

Interventions for Improving Nutrition and Physical Activity Behaviors in Adult African American Populations: A Systematic Review, January 2000 Through December 2011

Introduction The incidence of preventable chronic diseases is disproportionally high among African Americans and could be reduced through diet and physical activity interventions. Our objective was to systematically review the literature on clinical outcomes of diet and physical activity interventions conducted among adult African American populations in the United States. Methods We used the Preferred Reporting Items for Systematic Review and Meta Analysis construct in our review. We searched Medline (PubMed and Ovid), Cochrane, and DARE databases and restricted our search to articles published in English from January 2000 through December 2011. We included studies of educational interventions with clinically relevant outcomes and excluded studies that dealt with nonadult populations or populations with pre-existing catabolic or other complicated disorders, that did not focus on African Americans, that provided no quantitative baseline or follow-up data, or that included no diet or physical activity education or intervention. We report retention and attendance rates, study setting, program sustainability, behavior theory, and education components. Results Nineteen studies were eligible for closer analysis. These studies described interventions for improving diet or physical activity as indicators of health promotion and disease prevention and that reported significant improvement in clinical outcomes. Conclusion Our review suggests that nutrition and physical activity educational interventions can be successful in improving clinically relevant outcomes among African Americans in the United States. Further research is needed to study the cost and sustainability of lifestyle interventions. Further studies should also include serum biochemical parameters to substantiate more specifically the effect of interventions on preventing chronic disease and reducing its incidence and prevalence.

Beauty Salon Health Intervention Increases Fruit and Vegetable Consumption in African-American Women

African Americans, especially women, have low fruit and vegetable consumption, which is related to higher rates of obesity, morbidity, and mortality in comparison to whites. Community-based approaches are recommended to address this problem, including beauty salons, which are conducive environments for health information dissemination. The purpose of this pilot study, conducted in 2007, was to determine the effectiveness of a 6-week beauty salon-based health intervention, Steps for a New You, in improving diet, physical activity, and water consumption behaviors in African-American women using a quasiexperimental design. A random sample of 20 African-American women was selected from a list of regular clients at two beauty salons (n=10 each for treatment and comparison salons) located in a Southern rural community. The intervention included scripted motivational sessions between the cosmetologist and clients, information packets, and a starter kit of sample items. Data were collected using pre- and posttest questionnaires. The results showed that mean intake of fruit and vegetables was significantly higher at posttest for the treatment group but not for the comparison group. These findings suggest that the intervention may have had a positive effect on fruit and vegetable consumption by treatment group participants. However, further work is needed to refine the methodology, especially strengthening the intervention to increase physical activity and water consumption.

Health Promotion and Black Elders Subgroups of Greatest Need

This article profiles three subgroups of African American elders that are at risk in terms of health. Major barriers to optimum health for older rural Blacks are a lack of confidence in the formal health care system, greater rates of poverty than urban elders, geographic isolation, and lack of access to health care and to social supports; for older Black women, barriers include attitudes that reflect an overestimation of health, health pessimism, a lack of confidence in the health care system, lower economic resources, and major family responsibilities that affect the availability of money for, and time to seek, health care; and for older-aged Blacks, barriers are lack of confidence in the formal health care system, dependence on informal supports for health care and an underutilization of formal supports, and lower socioeconomic levels due to this cohort’s education and occupational status. Implications for theory, policy, and practice are discussed.

Validation of body adiposity index as a measure of obesity in overweight and obese postmenopausal white women and its comparison with body mass index

ObjectiveThe purpose of this study was to evaluate whether the recently developed body adiposity index (BAI) in Mexican American and African American women could be validated in postmenopausal American white women and to determine if it is a better obesity classification measure than body mass index (BMI) is in the latter population. MethodsTotal body percentage adiposity (%adiposity) measured by dual-energy x-ray absorptiometry (DXA) was compared with total body %adiposity predicted by BAI in 187 overweight/obese postmenopausal white women (mean ± SD %adiposity, 45.9 ± 4.9% and 38.3 ± 6.2% for DXA and BAI, respectively). SPSS 19.0 and Medcalc 11.6.1.0 were used to conduct Pearson’s correlations (r), paired t test, receiver operating curve, and Lin’s concordance coefficient (&rgr;c) and to create Bland and Altman’s limit-of-agreement plot. ResultsPearson’s correlation analysis revealed a strong association between DXA %adiposity and BAI (r = 0.78, P < 0.001), DXA %adiposity and BMI (r = 0.75, P < 0.001), and BMI and BAI (r = 0.90, P < 0.001). Bias correction factor was 0.51 between DXA %adiposity and BAI. Paired t test showed a significant mean difference between measurements (P < 0.0001), and the plot showed that BAI underestimated DXA %adiposity by 7.56%. Concordance coefficient (&rgr;c = 0.39; 95% CI, 0.33-0.46) revealed a poor agreement strength. There was no difference between the area under the curve statistic for BAI and BMI. ConclusionBased on our results, BAI has limitations for use in a clinical setting in overweight/obese postmenopausal white women but may be practical for research applications and eventually developed into an easy method to estimate overweight/obesity in other settings.

Determinants of senior center attendance and participation

This study determined factors associated with two major dimensions of senior center involvement ; (a) frequency and duration of attendance and (b) use of activities and services, using participants (N = 623) from 15 centers located in a county in a Midwestern state. Results of multiple regression, which controlled for the effect of centers through use of dummy variables, showed that those who felt that the meal was important to daily food intake and who lived closer to the center attended more freguently, and those who were older had attended longer. Respondents who participated in activities had higher educational levels, and those who used services were less mobile, made friends at the senior center, and had hrgher life satisfaction. The multiple regression as well as subsequent analyses, however, demonstrated that the variability among senior centers rather than participant characteristics had the larger effect on the dimensions of senior center involvement.

The Family and Consumer Sciences Body of Knowledge and the Cultural Kaleidoscope: Research Opportunities and Challenges

As a profession established during the Progressive Era when industrialization, immigration, urbanization, and other social forces were prevalent, family and consumer sciences is once again faced with similar social, economic, and technological societal conditions. This article addresses how family and consumer sciences, through its body of knowledge, is positioned to address the social changes of the 21st century. In particular, the article examines the family and consumer sciences body of knowledge in light of the growth in diversity or the cultural kaleidoscope by (a) providing a historical context for the body of knowledge for the profession, (b) presenting the current body of knowledge for family and consumer sciences and highlighting related research, and (c) discussing opportunities and challenges for applications in the body of knowledge for broadening the scope of research and practice to embrace the cultural kaleidoscope. The article not only contributes to the intellectual foundations of the field but also makes recommendations and identifies implications for research and practice.

EDUCATIONAL NEEDS AND ACTIVITIES OF OLDER ADULTS: THEIR RELATIONSHIP TO SENIOR CENTER PROGRAMS

The major purposes of this study were to investigate the self‐perceived educational needs and activities of older adults within a community setting and to explore the relationship of these needs and activities to selected senior center programs. A secondary purpose of this study was to investigate self‐perceived educational needs and activities of older adults according to race, sex, educational level, and socioeconomic status. A sample of 110 older adults (age 65 and over) from a Midwestern community was interviewed using Toughs learning project procedure, Hiemstras instrumental and expressive education instrument, and a general educational needs checklist developed by the investigator. To determine the educational offerings of senior centers, a questionnaire was administered to the directors of five selected senior centers located in the community. Findings indicated that the self‐perceived educational needs and activities of older adults varied by race, sex, educational level, and socioeconomic statu...

Health Promotion for Rural Black Elderly

Over the past ten years, there has been a proliferation of health promotion programs, with many of these programs targeting old adult audiences. Little is known, however, about the extent to which certain segments of the older population are recipients of health promotion. This paper examines the status of health promotion programs for rural elderly blacks and identifies factors that might contribute to health promotion programming. Recommendations are discussed in light of the distinctive characteristics of this group.

Reducing cardiovascular disease risk in mid-life and older African Americans: A church-based longitudinal intervention project at baseline

INTRODUCTION African Americans (AAs) experience higher age-adjusted morbidity and mortality than Whites for cardiovascular disease (CVD). Church-based health programs can reduce risk factors for CVD, including elevated blood pressure [BP], excess body weight, sedentary lifestyle and diet. Yet few studies have incorporated older adults and longitudinal designs. PURPOSES The aims of this study are to: a) describe a theory-driven longitudinal intervention study to reduce CVD risk in mid-life and older AAs; b) compare selected dietary (fruit and vegetable servings/day, fat consumption), physical activity (PA) and clinical variables (BMI, girth circumferences, systolic and diastolic BP, LDL, HDL, total cholesterol [CHOL] and HDL/CHOL) between treatment and comparison churches at baseline; c) identify selected background characteristics (life satisfaction, social support, age, gender, educational level, marital status, living arrangement and medication use) at baseline that may confound results; and d) share the lessons learned. METHODS This study incorporated a longitudinal pre/post with comparison group quasi-experimental design. Community-based participatory research (CBPR) was used to discover ideas for the study, identify community advisors, recruit churches (three treatment, three comparison) in two-counties in North Florida, and randomly select 221 mid-life and older AAs (45+) (n=104 in clinical subsample), stratifying for age and gender. Data were collected through self-report questionnaires and clinical assessments. RESULTS AND CONCLUSIONS Dietary, PA and clinical results were similar to the literature. Treatment and comparison groups were similar in background characteristics and health behaviors but differed in selected clinical factors. For the total sample, relationships were noted for most of the background characteristics. Lessons learned focused on community relationships and participant recruitment.

Life dissatisfaction and eating behaviors among older African Americans: The protective role of social support

ObjectivesTo examine (a) the influences of life dissatisfaction and dietary social support on eating behaviors (a high-fat diet and fruit/vegetable consumption) of older African Americans and (b) the moderating role of perceived dietary social support on the association between their life dissatisfaction and unhealthy eating behaviors.DesignBaseline data from a larger intervention study of mid-life and older African Americans. The study incorporated a quasi-experimental design with random selection of participants, stratifying for age and gender.SettingSix churches in North Florida.ParticipantsOne hundred and seventy-eight (132 females and 46 males with a median age of 60) older African Americans.MeasurementsA structured questionnaire elicited personal data as well as information on eating behaviors, life dissatisfaction, and perceived dietary social support.ResultsOlder African Americans with more cumulative life adversity, as reflected by high life dissatisfaction, had significantly poorer eating behaviors including the consumption of a high-fat diet and low intake of fruits and vegetables. Older African Americans’ dietary choices were also associated with their perceived social support. More importantly, perceived social support acted as a buffer to mitigate the influence of life dissatisfaction on older African Americans’ eating behaviors.ConclusionLife dissatisfaction places older African Americans at risk for unhealthy eating behaviors. However, high levels of dietary social support can protect older African Americans from the influence of life dissatisfaction on unhealthy eating behaviors. There are practical implications of this research for health interventions and programming.