Church Bridge Project Focus Group Findings: African American Perspectives of Weight Management Programs to Improve Nutrition and Physical Activity Behaviors | BMC Nutrition
This study examined perceptions about a faith-based weight management program that were helpful in identifying factors related to the design and implementation of the weight management intervention. The themes gleaned from the focus groups suggested that the participants in the intervention, the “graduates”, had a positive perception of the program. However, the use of technology appeared to be both a barrier and a facilitator for the success of the program. Competing priorities were discussed as barriers to participation in the weight management program for “graduates” and “non-participants”. Another theme was the negative connotation associated with the terminology “weight management program”. Suggestions included wording the wording as a nutrition and physical activity program. Social support and personal health have also been identified as key factors for the success of a weight management program.
The results of the focus groups indicate that careful considerations are needed when integrating technology into health intervention research. Mobile technology was seen as a way to facilitate motivation, participation in sessions and social support; however, a predominant theme among the “graduates” was that the mobile app’s food diary feature was difficult to use. A review of articles on dietary assessment using cellphones found that six of the seven included studies reviewed had high participant satisfaction with using cellphones for dietary assessment. . The results of two additional studies also support general acceptance of mobile food recording methods among adults, including a community sample. [22, 23]. Previous research found that higher user satisfaction was associated with more accurate food intake reporting ; however, it was not related to participants’ perceived burden of remembering and recording food intake . In addition, Krebs and Duncan  found that 44.5% of users surveyed stopped using a health-related app because it took too long to enter data. Thus, although the use of mobile apps for dietary assessment may be seen as a satisfactory mode of data collection for participants, it may not reduce the perceived burden of data collection, which has implications. on data integrity.
While mobile technology does not reduce the burden of data collection, supplementing behavioral interventions with technology can help maintain program intensity / contact and provide individualized support to participants without increasing participant burden. . One review indicated that technology-based weight loss interventions induced positive weight-related outcomes, improved social support and opportunities for self-monitoring, and improved program adherence. . Our previous research as well as the conclusions of another study  The examination of virtual health-related communities supports the hypothesis that technology, by increasing convenience and access, can improve perceived support, thereby improving outcomes. As we have found, simple strategies such as providing participants with live access to sessions when they cannot physically attend can increase program support and keep participants engaged in the program. Since previous church-based intervention research studies have concluded that greater program participation positively influences health outcomes [6, 7], an important theme was that competing priorities are major barriers to participation in the program by young, middle-aged African American adults. More research is needed to determine with the population what strategies might help them overcome barriers to participating in the program.
Various types of social support (general social and instrumental support, religious and religious) have been associated with improved eating behaviors and physical activity in minority and rural communities [8, 9] and is crucial to engage the population in healthy behaviors . Preliminary work also identified family support to be associated with weight loss intentions among an African American population. A similar theme found in this study was that the “church family” was a motivator for program participants. However, research examining the potentially beneficial health effects of perceived church social support and group interventions is minimal.
An additional theme, disease management and prevention goals were identified as motivators for participation in a weight management program. It was interesting to note that although the “non-participants” expressed a common theme about the importance of participating in weight management programs for health and longevity, they were not sufficiently motivated to actually participate in the program. program when offered. Relevant themes from focus group data and previous literature support the importance of shifting the obesity conversation from bodily ideals to health in a culturally appropriate way. . The challenges associated with this goal include perceptions among African Americans that obesity per se is not an indicator of poor health. , health is independent of obesity status , and “bigger is healthier” . Other African-American focus group participants also viewed body mass index negatively.  which corroborates our results on the preference of African Americans to define “weight management interventions” as “nutrition and physical activity interventions” to improve the determinants of a healthy lifestyle and decrease the weight. emphasis on weight. This suggestion is supported by the currently published concepts that individuals should focus on their health and not achieve a certain ideal body weight. .
Limits and strengths
In alignment with the four principles of reliability of qualitative survey , our results were credible, transferable, reliable and ultimately confirmable. Credibility relates to the quality of the fit between the ideas of the participants and the interpretation of these ideas by the researchers. We used a multi-step approach that included triangulating the research, or multiple observers, at different steps to define and confirm the themes that represent the data and reduce potential bias. Code and theme development was also documented at each step and reviewed by several researchers as the themes were refined and finalized. Transferability refers to the generalization of knowledge acquired through research. This study highlights the importance of approaching weight management from a disease prevention and preventive health perspective. In addition, faith-based programs, compared to traditional medical settings, may be advantageously provided with social support to facilitate diet, physical activity, and other health behavior change goals. Although our results are limited to a rural African American population in Mississippi and a small sample, these results are not completely isolated in the literature and may have implications for other populations, particularly in the Great South. We also conducted only one focus group for each type of group. Our research staff felt that they had saturated the pool of potential participants with recruitment efforts and did not believe that additional recruitment would result in enough participants for an additional focus group. Our sample uniquely represents a predominantly young to middle-aged African American population, who will be a critical target for health and behavior education programs to move beyond disease management towards reduction. disease risk and ultimately health disparities.
Finally, our research is both reliable and verifiable. Reliability refers to the research process in that it is clear and repeatable. Our steps are documented and follow best practice guidelines for qualitative investigation. Confirmability requires the demonstration of how the conclusions were drawn, which is achieved when credibility, portability and reliability are achieved. Our study describes a clear qualitative process for how themes were derived with multiple checkpoints and the results have clear implications for weight management in a specific population, which may have implications and guide research in other populations.