The prevalence of obesity and many obesogenic behaviors is higher among adults living in rural compared to urban areas of the United States and likely contribute to multiple rural health disparities. Interventions are needed to address these disparities, particularly for rural African American men who are largely underrepresented in behavioral weight loss trials. In the rural South, where the proposed research will be conducted, there is evidence that that men are less motivated than women to lose weight. Lower motivation to lose weight may explain men?s lower participation rates in rural weight loss trials. Thus, we will develop a behavioral weight loss intervention for rural African American men that incorporates motivational elements from Self-Determination Theory, in addition to elements from Ecological Systems Theory and Social Cognitive Theory. We hypothesize that our theoretically-based behavioral weight loss intervention will be effective in attracting, retaining, and motivating rural African American men to engage in healthy weight loss behaviors.
The specific aims of the study are to (1) Conduct focus group interviews to understand barriers and facilitators for developing a weight loss intervention that will attract, retain, motivate, and meet the needs of Southern rural African American men for engaging in healthy weight loss behaviors; 2) Develop, evaluate, and refine a behavioral weight loss intervention for Southern rural African American men; and 3) Conduct a pilot randomized wait-list control trial to determine preliminary weight loss effects of the comprehensive behavioral weight loss intervention for Southern rural African American men. The research and training proposed in this K23 career development award will support the candidate?s long-term career goal of becoming an independent nurse scientist with expertise in developing and testing behavioral interventions to reduce obesity for vulnerable adults living in rural areas. In collaboration with his mentoring team of internationally-known experts in behavior change, community-based research, and rural health, the candidate has developed a training plan involving coursework, seminars, and mentored research experiences that are designed to address the following career goals: 1) broaden his understanding of factors influencing rural and minority health disparities; 2) expand knowledge and skills in assessing dietary behaviors and physical activity; 3) develop expertise in the design, conduct, and evaluation of behavioral weight loss trials; 4) enhance knowledge and skills in biostatistical methods used in behavioral trials; and 5) increase scholarly productivity related to obesity in rural areas. Upon completing the research and training activities proposed in this award, the candidate will be well positioned to further develop and test novel interventions that address obesity for rural adults.
African American men are largely underrepresented in behavioral weight loss trials conducted in rural areas, which may be related to men?s lower motivation for weight loss compared to women. Findings from this project will provide insight on the feasibility, acceptability, and preliminary effects of a theoretically-based behavioral weight loss intervention tailored to factors that motivate obese African American men living in the rural South. Developing effective obesity interventions that can attract and engage Southern rural African American men could have significant impact in addressing multiple obesity-related rural and minority health disparities.