U.S. Black women are at excess risk of obesity and its cardiovascular consequences, but current weight management approaches have limited applicability to Black women. Weight gain prevention in Black women has not been formally studied. It has been proposed that programs developed within the socioecologic, cultural, and pyschosocial frameworks of Black women can facilitate their long term weight management, but this proposition has not been tested. The goal of this study will be to develop and pilot test a weight management program for use by established Black women's organizations, which offer a novel and natural venue for addressing culturally-mediated weight issues with a holistic and empowerment-oriented approach. The organizational context will be the National Black Women's Health Project (NBWHP), which has a 15+ year history of advocacy and programming for Black women's wellness and reaches Black women across socioeconomic strata.
Specific aims will be to: 1) guide NBWHP members in the development of a weight management program that addresses the psychosocial, sociocultural, and health perspectives and life circumstances of Black women; 2) assess the feasibility of program implementation by NBWHP chapters; 3) assess program acceptance and adherence by participants, and 4)assess program effects on weight change (primary outcome), systolic blood pressure, waist circumference, physical activity, eating patterns, physical fitness, and well-being. The core intervention will build upon existing NBWHP programs such as self-help groups and """"""""Walking for Wellness"""""""". Content will address energy overconsumption, inactivity and activity, motivations for long-term weight management (e.g., body image; health outcome expectancies), will relate these to overall wellness, and will incorporate individual, extended family, social network, and community action perspectives. The intervention development process (year 1) will include retreats with NBWHP members, on which basis leader and participant manuals will be produced. The pilot study (years 2 and 3) will be a two- group, repeated-measures (at 6, 12, and 18 months from baseline) design in which the weight control program (implemented by specially-trained chapter representatives) will be compared to a """"""""healthy lifestyle"""""""" group. Two chapters will be randomized to each arm and will each recruit and follow 25 women. Individual adherence and chapter-level implementation variables will be assessed.
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