Background of Study
The research problem of the given study is the barriers and specifics that affect overweight African American and Hispanic women who are willing to adopt physical activity and/or dietary changes but cannot do so. Minority groups, especially communities, are rarely studied in qualitative researches dedicated to the problem. The given study can help researchers understand what socio-cultural factors prevent representatives of minorities from changing their lifestyle and adopting physical activity.
The authors point out that individual programs rarely achieve sustained improvements, mostly because they do not consider various factors (influence, community relations, environment) that affect individuals’ ability to change their lifestyle (Mama et al., 2015). Physical inactivity is directly related to various causes of death (diabetes type 2, cancer, stroke, etc.); African American and Hispanic men and women do not participate in the exercise as often as Caucasians do, which leads to an elevated risk of disease and death among these individuals (Mama et al., 2015).
The authors directly state the purpose of their study: “[it] was to gain community insight into individual, social, and environmental factors that influence physical activity adoption and maintenance in African American and Hispanic women using the ecological model as a guiding framework” (Mama et al., 2015, p. 323). The research questions are not stated explicitly, but they seem to be the following: What factors affect women’s decision to change their lifestyle? Why some of them participate in physical activity more often than others? What can be done to improve their lifestyles? Are diets and exercise integrated into their lives; why or why not? The purpose and the research question are related to the problem as they directly target such issues as obesity, physical activity, dieting, and factors that influence individuals’ decision to change their lifestyle.
Method of Study
The authors used in-depth interviews to answer research questions; the interviews were analyzed by an expert in qualitative studies to answer research questions (Mama et al., 2015). The qualitative methods were appropriate as they included direct answers from participants, allowing the researchers to study the minority community. The ecologic model of physical activity (EMPA) was used in this study to determine how social factors affected women’s decision to stay physically active or change their lifestyle with diets, thus giving the study a specific perspective. The authors used various qualitative and quantitative studies in their research to support their point or explain details (for example, the EMPA model) (Mama et al., 2015). They also cite a randomized controlled trial, which results in they used for the qualitative study (Mama et al., 2015). The references include both newer and older studies (published between 1997 and 2015). When evaluating previous studies, the authors notice that “the associations explored have been solely informed by previous research and theory and rarely include community perceptions” (Mama et al., 2015, p. 324).
As such, there is no literature review used by the authors, since they only cite relevant studies at the beginning of the paper and use them to explain the ecological model (Mama et al., 2015). No framework was developed based on the findings of the study.
Results of Study
The study findings were as follows: while women agreed that both exercise and lifestyle interventions were helpful to them and helped them lose weight, various factors such as the lack of motivation, time, confidence, or support from friends and coworkers prevented them from changing their lifestyle. Moreover, if the family of the individual was not interested in doing sports, the woman’s interest in physical activity also declined. The role of the family was particularly emphasized by Hispanic women (Mama et al., 2015). At the same time, participants in the study also indicated that the safety of communities was crucial for their motivation. Some of them mentioned that their neighborhoods were not safe enough and they did not want to be at risk when exercising, which is why they rarely exercised in their neighborhoods (Mama et al., 2015).
The implications for nursing are the necessity to provide obese patients with support (emotional and physical), engage family, and emphasize the importance of self-confidence to make exercise and lifestyle changes effective. The growing epidemic of obesity leads to the development of comorbidities in Americans, which can (and do) result in death (Imes & Burke, 2014). Goal setting is considered to be an effective intervention in controlling weight loss (Ries et al., 2014). The reviewed study also showed that besides direct intervention, indirect support coming from family members and friends is equally important for effective outcomes (Mama et al., 2015).
Using the results of the study, nurses can advocate for change in healthcare and city environments, emphasizing the importance of safe neighborhoods. Furthermore, the findings of the study can help nurses understand why a different approach might be demanded to representatives of ethnic minorities. For example, when counseling Hispanic women about weight loss, nurses might need to ask their families to actively participate in the lifestyle intervention to achieve better results. When educating about the problem, nurses might need to emphasize the relation between the safety of the neighborhoods, social ties, and motivation, and their overall impact on individuals’ ability and willingness to lose weight.
Ethical Considerations
The authors do not state whether the study was approved by an Institutional Review Board (Mama et al., 2015). The patient’s privacy was protected because no names or other indications that could disclose patients are stated in the study. All participants are from a previous RCT conducted by the authors; as they volunteered to participate, it is certain that no individuals were forced to take part in the research after the RCT had been conducted. There was no treatment; the study itself seems to be ethical.
Conclusion
Although both physical activity and dietary management are effective lifestyle interventions and can help lose weight, various factors such as lack of motivation, support, and suitable environment prevent adult representatives of ethnic minorities from being physically active. Nursing professionals need to consider these sociological factors as potential barriers to weight loss. African American and Hispanic women might need support from their families, friends, and coworkers to participate in physical activities successfully.
Other factors such as the need to look for children, cook, and lack of safe neighborhoods and parks also negatively affect individuals’ willingness to change their lifestyles actively. The findings can help nurses approach ethnic minorities with the understanding of their needs and alter existing weight loss programs in such a way that they apply to these individuals. The inactivity of such individuals is explained by various social, personal, and environmental factors, which nurses need to consider if they aim to deliver effective and patient-centered care. The knowledge gained during this analysis demonstrates that nurses should not underestimate the importance of interpersonal relations and their influence on patients’ health.
References
Imes, C. C., & Burke, L. E. (2014). The obesity epidemic: The USA as a cautionary tale for the rest of the world. Current Epidemiology Reports, 1(2), 82-88.
Mama, S. K., McCurdy, S. A., Evans, A. E., Thompson, D. I., Diamond, P. M., & Lee, R. E. (2015). Using community insight to understand physical activity adoption in overweight and obese African American and Hispanic women: A qualitative study. Health Education & Behavior, 42(3), 321-328.
Ries, A. V., Blackman, L. T., Page, R. A., Gizlice, Z., Benedict, S., Barnes, K.,… Carter-Edwards, L. (2014). Goal setting for health behavior change: Evidence from an obesity intervention for rural low-income women. Rural Remote Health, 14(2), 2682-2696.