More than 55% of U.S. adults are overweight, an increase of 8% in fifteen years. Because overweight is associated with cardiovascular disease (CVD) morbidity and mortality, the alarming increase in overweight has underscore the need for innovative and effective weight- loss interventions. Tailored interventions specifically designed for high-risk subgroups can compliment existing population-based approaches. However, before designing such interventions, we need to identify the sociodemographic characteristics of those at high risk. Although past studies have shown that ethnicity is associated with overweight, these studies suffer form potential confounding from SES because ethnic minority groups as disproportionately poor. Past studies have been compromised by limited samples at the extremes of SES such as higher SES Mexican-Americans or Blacks, and/or lower SES Whites. Weight loss is affected by multiple perceptions and behaviors, such as perceptions of overweight, physical activity, dietary habits, smoking, and alcohol use. Although past epidemiological research as investigated the independent effects of such influences on weight, research to date has not identified whether distinct clusters of weight perceptions and behaviors exist among overweight adults. Given that such clusters may differ by sociodemographic characteristics, identifying clusters may contribute to the design of innovative and tailored weight-loss interventions that address the presence of multiple influences on weight loss and increase the likelihood of successful interventions. This RO3 proposal will examine four specific aims: (1) identify subgroups at high risk of overweight based on sociodemographic characteristics (e.g., ethnicity and SES): (2a) determine whether distinct clusters of weight perceptions and behaviors exist among overweight adults and (2b) determine whether the clusters differ by sociodemographic characteristics; (3) determine whether clusters in the overweight sample exist among normal-weight adults, and (4) propose tailored weight-loss interventions to be tested empirically in the future. Data will be analyzed, by gender, for 3203 Black, 2989 Mexican- American, and 3761 White men and women, ages 25-64, who participated in the third National Health and Nutrition Examination Survey (NHANES III), 1988-1994). This national survey of the U.S. population over-sampled by the two largest ethnic minorities, Blacks and Mexican-Americans, and provides sufficient sample sizes at the extremes of SES.
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