Sara J. Corwin

Ideal body size beliefs and weight concerns of fourth‐grade children

OBJECTIVE The purpose of this study was to assess racial and gender differences in perceptions of ideal body size among White and Black fourth-grade children. METHOD A random sample of 817 children (51.4% female, 51.8% White, and mean age 9 years) participated in a body image and weight concern survey. RESULTS Using socioeconomic status (SES), race, and gender as independent variables, Black children selected significantly heavier ideal sizes than White children for self, male child, female child, adult male, and adult female. Although almost one half (46%) of Black females wanted to be thinner than their current size, their body size selections were significantly larger than those of White females. Black and White males differed only in the selections of ideal-female child and adult sizes. Cross-gender comparisons indicated females and Whites experience more body dissatisfaction and weight concern than males and Blacks. DISCUSSION Our study indicates that early in the sociocultural development of children, gender, race, and SES are influential factors in selecting ideal body size and determining body satisfaction.

A Study of Body Weight Concerns and Weight Control Practices of 4th and 7th Grade Adolescents

Objective. The purpose of this study was to assess grade, race, socioeconomic status and gender differences in perceptions of body size, weight concerns, and weight control practices between 4th and 7th grade students in South Carolina. Design. Two random samples, consisting of a total of 1,597 children (53.1% white, 51.97% female, 44.9% 4th graders) participated in two questionnaire surveys. Both surveys included a series of seven female and seven male body size drawings, body image and weight concern questions, and questions pertaining to weight control practices. Responses to the questionnaire were analyzed using chi-square analysis and the General Linear Model. Results. Using socioeconomic status (SES), race, gender, and grade as independent variables, differences in ideal adult body size, opposite gender ideal adult body size, weight concerns, perceptions of family/peer weight concerns, perceptions of own body size and weight control practices were studied. Analyses revealed that 4th grade males select a larger ideal adult body size and opposite gender ideal adult body size when compared to 7th grade males ( p < 0.0001 and p = 0.0078, respectively). Fourth grade females indicated less personal concern about their weight than 7th grade females ( p = 0.0009). Fourth graders also perceived less family/peer concern about weight than 7th graders ( p = 0.0027) and 7th graders described themselves as being more overweight than 4th graders ( p = 0.0039). Blacks selected a significantly larger body size than white children for ideal adult ( p = 0.0287) and ideal opposite gender adult body size ( p < 0.0001 for males, p = 0.0030 for females). Blacks also perceived less personal and family/peer concern about weight when compared to whites ( p = 0.0083). More whites reported that they were trying to lose weight, as compared to blacks ( p = 0.0010). Males also selected significantly larger body size silhouettes than females for ideal adult body size ( p = 0.0012). Males expressed less personal concern about weight ( p < 0.0001), perceived less family/peer concern about weight ( p < 0.0001), and were less likely than females to be engaged in weight loss ( p < 0.0001). Females in the high SES category selected a significantly smaller ideal male adult body size than females in the low SES group ( p = 0.0124) and more females in the high SES category were trying to lose weight when compared to females in the low SES group ( p = 0.0055).) Conclusion. This study indicates that early in a childs sociocultural development, grade level, gender, race, and SES are influential in the perception of ideal adult body size and opposite gender ideal adult body size. These factors are also influential in determining concerns about weight and weight control practices. The findings of this study support the need to begin health and wellness education efforts early in childhood while taking into account racial, gender, age, and SES disparities. This knowledge can also be useful in targeting interventions for both obesity and eating disorders.

Selected Health Behaviors that Influence College Freshman Weight Change.

Objective and Participants: The authors investigated the effect of physical activity (PA), fruit and vegetable intake, and alcohol use on 6-month weight change in 193 college freshmen (78.8% white, 88.2% women, 94.5% on a meal plan). Methods: The authors administered a Web-based survey in fall 2002 (baseline) and spring 2003 (follow-up). Results: There was an overall average weight gain of 2.5 lbs (p < .05), although only 57% reported weight gain (M = 7.1 lbs). Fruit and vegetable intake decreased (p = .034), alcohol use increased (p > .05), and PA was unchanged. Weight gain for students with body mass indexes (BMI) ≥25 kg/m2 was nearly twice that of students with BMIs < 25 (p < .05). Students with low-frequency baseline PA were twice as likely to be overweight. Follow-up data showed that students reporting ≥ 4 sessions per week (ie, high frequency) of low-intensity PA were twice as likely to have healthy BMIs as students engaging in low- and moderate-frequency PA. Conclusions: PA interventions should target freshmen with BMIs ≥ 25.

Relationships Between Stigma, Social Support, and Depression in HIV-Infected African American Women Living in the Rural Southeastern United States

&NA; This cross‐sectional study examined relationships between HIV‐related stigma, social support, and depression in a sample of 340 HIV‐infected African American women living in rural areas of the Southeastern United States. Three aspects of social support (availability of different types of support, sources of support, and satisfaction with support) and two aspects of HIV‐related stigma (perceived stigma and internalized stigma) were measured. Perceived availability of support (p < .0001), sources of support (p = .03), satisfaction with support (p = .003), perceived stigma (p < .0001), and internalized stigma (p < .0001) were all significantly correlated with depression. Social support variables were negatively correlated and stigma variables were positively correlated with depression. HIV‐related perceived stigma and internalized stigma were found to mediate the effect of sources of available support on depression. Study findings have implications for designing and implementing interventions to increase social support and decrease HIV‐related stigma in order to decrease depression among African American women with HIV disease.

HIV-DISCLOSURE, SOCIAL SUPPORT, AND DEPRESSION AMONg HIV-INFECTED AFRICAN AMERICAN WOMEN LIVINg IN THE RURAL SOUTHEASTERN UNITED STATES

This cross-sectional study examined the relationships between social support, HIV disclosure, and depression among 340 rural African American women with HIV disease living in the southeastern United States. Three aspects of social support (perceived availability of support, sources of available support, and satisfaction with available support) were measured along with HIV disclosure and depression. Perceived availability of support (p < .0001), sources of support (p = .03), satisfaction with support (p = .003), and HIV disclosure (total and to children; p = .05 and .04, respectively) were significantly and inversely correlated with depression. Perceived availability of support and satisfaction with support mediated the relationship between HIV disclosure and depression. If confirmed in longitudinal studies, these findings have implications for designing and implementing interventions supporting African American women with HIV disease in disclosing their HIV status appropriately, particularly to their children. In long run, appropriate self-disclosure may help decrease depression and improve quality of life among HIV infected African American women living in limited resource settings.

Prostate Cancer Communication Strategies Recommended by Older African-American Men in South Carolina: A Qualitative Analysis

Background. Mortality from prostate cancer (PrCA) in African-American (AA) men is significantly higher than in European-American (EA) men. Methods. Purposive sampling identified 25 AA men ≥45 years for interviews/focus groups. Participants were asked about cancer information-seeking behaviors, capacity to use information, and recommendations for messages and message delivery. Transcripts were analyzed for themes about PrCA communication. Results. Barriers to information seeking were fear, poor resources, and limited family communication. Participants requested messages stressing men’s “ownership” of PrCA delivered “word-of-mouth” by clergymen, AA women, and AA PrCA survivors. Conclusions. Direct and timely messages about PrCA should be developed for AA men.Background. Mortality from prostate cancer (PrCA) in African-American (AA) men is significantly higher than in European-American (EA) men. Methods. Purposive sampling identified 25 AA men ≥45 years for interviews/focus groups. Participants were asked about cancer information-seeking behaviors, capacity to use information, and recommendations for messages and message delivery. Transcripts were analyzed for themes about PrCA communication. Results. Barriers to information seeking were fear, poor resources, and limited family communication. Participants requested messages stressing men’s “ownership” of PrCA delivered “word-of-mouth” by clergymen, AA women, and AA PrCA survivors. Conclusions. Direct and timely messages about PrCA should be developed for AA men.

Methods and Management of the Healthy Brain Study: A Large Multisite Qualitative Research Project

PURPOSE OF THE STUDY To describe processes used in the Healthy Brain project to manage data collection, coding, and data distribution in a large qualitative project, conducted by researchers at 9 universities in 9 states. DESIGN AND METHODS Project management protocols included: (a) managing audiotapes and surveys to ensure data confidentiality, data tracking and distribution; (b) managing qualitative data to ensure the accuracy and confidentiality of transcription; (c) training in qualitative methods and use of qualitative software; and (d) managing participant survey data and analysis. RESULTS The project team coded and managed qualitative and survey data for 69 focus groups with more than 500 participants. Multiple interactive training sessions in qualitative data analysis and use of qualitative software (ATLAS.ti) were conducted. To develop a codebook, 2 teams used an open-coding process to identify codes and develop definitions; 2 team members integrated and conceptually organized these results into an initial codebook. For the audio-recordings from each research site, 2 or 3 team members hand coded 1 transcript and calculated interrater agreement (.80 or higher). IMPLICATIONS Using clear protocols, participatory training sessions, team-based coding, and frequent communication among team members via e-mail and regular in-person meetings promotes effective management of large-scale qualitative research projects.

Older adults' concerns about cognitive health: Commonalities and differences among six United States ethnic groups

ABSTRACT We studied concerns about cognitive health among ethnically diverse groups of older adults. The study was grounded in theories of health behaviour and the representation of health and illness. We conducted 42 focus groups (N=396, ages 50+) in four languages, with African Americans, American Indians, Chinese Americans, Latinos, Whites other than Latinos (hereafter, Whites) and Vietnamese Americans, in nine United States locations. Participants discussed concerns about keeping their memory or ability to think as they age. Audio recordings were transcribed verbatim. Constant comparison methods identified themes. In findings, all ethnic groups expressed concern and fear about memory loss, losing independence, and becoming ‘a burden’. Knowing someone with Alzheimers disease increased concern. American Indians, Chinese Americans, Latinos and Vietnamese Americans expected memory loss. American Indians, Chinese Americans and Vietnamese Americans were concerned about stigma associated with Alzheimers disease. Only African Americans, Chinese and Whites expressed concern about genetic risks. Only African Americans and Whites expressed concern about behaviour changes. Although we asked participants for their thoughts about their ability to think as they age, they focused almost exclusively on memory. This suggests that health education promoting cognitive health should focus on memory, but should also educate the public about the importance of maintaining all aspects of cognitive health.

Older Adults’ Perceptions of Physical Activity and Cognitive Health: Implications for Health Communication

Messages promoting physical activity (PA) to maintain cognitive health (CH) may increase PA and enhance CH among older persons. This study examined older adults’ perceptions of PA and CH. We conducted 10 focus groups with irregularly active older Black and White women and men (N = 55), ages 65 to 74 in South Carolina. Constant comparison methods compared themes by gender and race/ethnicity groups. Most participants perceived cognitive decline as a severe threat, and they were primarily concerned about losing their independence. Most reported feeling susceptible to cognitive decline. Although most recognized the link between PA and CH, several White men said the association was not clear. Participants recommended a wide range of PA amounts needed to achieve CH benefits. Many suggested that evidence of PA benefits for CH would enhance message credibility. Participants suggested messages be paired with social support to increase PA. Results suggest a need for evidence-based, credible communication promoting PA and CH.

How do older people describe others with cognitive impairment? A multiethnic study in the United States

ABSTRACT We studied how older people describe others with cognitive impairment. Forty-two focus groups represented African Americans, American Indians, Chinese Americans, Latinos, Vietnamese Americans, and Whites other than Latinos (Whites) (N = 396, ages 50+), in nine locations in the United States of America. Axial coding connected categories and identified themes. The constant comparison method compared themes across ethnic groups. African Americans, American Indians and Whites emphasised memory loss. African Americans, American Indians, Latinos and Whites stressed withdrawal, isolation and repetitive speech. African Americans, American Indians, Vietnamese Americans and Whites emphasised ‘slow thinking’. Only Whites described mood swings and personality changes. Many participants attributed dementia to stress. Terms describing others with dementia included ‘Alzheimers’, ‘dementia’, ‘senile’ and ‘crazy’. Euphemisms were common (‘senior moment’, ‘old timers disease’). Responses focused on memory, with limited mention of other cognitive functions. Differences among ethnic groups in descriptions of cognitive health and cognitive impairment underscore the need to tailor public health messages about cognitive health to ways that people construe its loss, and to their interest in maintaining it, so that messages and terms used are familiar, understandable and relevant to the groups for which they are designed. Health promotion efforts should develop ethnically sensitive ways to address the widely held misperception that even serious cognitive impairment is a normal characteristic of ageing and also to address stigma associated with cognitive impairment.