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Hispanic males have the highest prevalence of overweight and obesity among men in the United States; yet are ificantly underrepresented in weight loss research. From October to Aprilsemistructured interviews were conducted with 14 overweight Hispanic men of ages 18 to 64 years. The interviews lasted approximately 60 minutes. Grounded in a deductive process, a preliminary codebook was developed based on the topics included in the interview guides. A thematic analysis facilitated the identification of inductive themes and the finalization of the codebook used for transcript analysis.
Four overarching themes were identified: a general health beliefs of how diet and physical activity behaviors affect health outcomes, b barriers to healthy eating and physical activity, c motivators Mature hispanic male looking for company change, and d viable recruitment and intervention approaches. Future research should examine feasible and appropriate recruitment and intervention strategies identified by Hispanic males to improve weight management in this vulnerable group.
Within the overall obesity epidemic in the United States, the prevalence of overweight and obesity is highest in Hispanic men.
Obesity is linked to cardiovascular disease, metabolic syndrome, type 2 diabetes, hypertension, dyslipidemia, osteoarthritis, sleep apnea, gallstones, and certain forms of cancer Klein et al. While there are many treatments available for overweight and obese individuals including behavior therapy, pharmacotherapy, and weight loss surgery, behavioral treatments are largely considered the first line of intervention Jensen et al. In general, men are more likely to engage in weight loss programs deed to appeal to specific interests e.
Hispanic men are grossly underrepresented in published trials Donnelly et al. Participant eligibility was determined by an initial telephone screening conducted by trained research staff. Twenty men completed the initial telephone screening and 15 met the eligibility criteria described above.
One man declined participation citing lack of time as the reason. The remaining 14 men provided written informed consent prior to participation. All study materials were available in English and Spanish and were approved by the institutional review board at the University of Arizona UA; institutional review board protocol : The UA Collaboratory is located in a high need, underserved area whose residents suffer a disproportionate burden of chronic disease and is in a close proximity to community-based settings frequented by the Hispanic community in Tucson, Arizona.
A Mature hispanic male looking for company interview guide Table 1 was used to elicit perspectives of general health, diet and physical activity behaviors, and intervention strategies e. On completion of the interview session, a member of the research team administered a questionnaire to collect demographic information, behaviors related to general health, current use of technology e.
Participants also had their height measured to the nearest 0.
Body weight was measured to the nearest 0. Interviews were audio-recorded and transcribed verbatim in their respective languages by trained staff. While most interviews were primarily in English, one transcript of an interview that was conducted in Spanish was translated to English to facilitate data analysis. However, Spanish phrases, idioms, and words that were contextually important were left in Spanish to avoid misrepresentation and loss of meaning throughout all transcripts.
Grounded in a deductive process Patton,the research team constructed a preliminary codebook in which broad and their respective codes were developed based on the topics included in the interview guide Table 1. In addition to the interview guide—related codes, thematic content analysis Patton, of the data was used to supplement the codebook with additional themes that surfaced during repeated reading of transcripts.
Hispanic male’s perspectives of health behaviors related to weight management
During this process, two members of the research team iteratively read the transcripts to identify recurring regularities Patton, in the data revealing patterns that were sorted into and Mature hispanic male looking for company codes. This supplemental thematic content analysis was completed to ensure that the interview guide—based codes did not completely drive the assessment. The deductive and inductive processes led to the development of the final codebook that was developed through a series of ongoing discussions and a collaborative resolution of any disagreements among the research team.
Each transcript was examined on completion and ongoing discussion continued throughout this process to ensure the research team remained in agreement with emerging themes. Recruitment efforts targeted 20 individuals to ensure that saturation would be reached Patton, However, data saturation was reached at approximately 14 coded transcripts as derived by the diminishing of variation in the transcribed and subsequently coded data.
Coded data were collapsed and categorized into four broad themes: a general health beliefs of how diet and physical activity behaviors affect health outcomes, b barriers to healthy eating and physical activity, c motivators for change, and d viable recruitment and intervention approaches. Fourteen overweight and obese Hispanic men completed the study. Demographic characteristics are reported in Table 2. Mean age of the sample was Four Approximately 11 There were no apparent differences in the data gathered from this interview compared with data gathered in bilingual interviews.
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The are organized into two broad sections; the first covers health beliefs as well as barriers and motivators for weight management Table 3 ; the second encompasses viable recruitment and intervention approaches Table 4. Themes were identified in the data and organized into four overarching : a general health beliefs of how diet and physical activity behaviors affect health outcomes, b barriers to healthy eating and physical activity, c motivators for change, and d viable recruitment and intervention approaches.
The are further organized into the subthemes that exist within each category. The discussion of general health beliefs led to a dialogue about body weight and health Table 3. When discussing the relationship between weight management and health outcomes, a small margin of participants credited their knowledge of the topic to media and public health campaigns. However, dialogue about obesity-related disease was largely focused on experiences with disease such as diabetes, hypertension, and several types of cancers.
Participants shared their experience of being diagnosed as well as witnessing the health of friends and family members deteriorate from disease. It was mentioned that diagnoses drive people to want to learn about the disease, prognoses, and complications. The men expressed that often it is not until disease has Mature hispanic male looking for company diagnosed that knowledge and information is sought.
According to participants their most influential barriers to healthy eating were rooted in issues of access, perceived dietary norms, familial influence, and choosing convenient foods over healthy alternatives Table 3. Participants identified issues with food accessibility and affordability as a barrier to healthy eating.
The men mentioned that the distance to grocers who have healthier options was detrimental to their food choices. Participants stated that economic parameters often lead to the choice of inexpensive, calorie-dense foods over foods they perceived to be healthier options. The men added that familial cohesion coupled with culturally bound dietary norms also influenced food choices.
Meal times were identified as a time for interaction and familial bonding, and participants mentioned that intersection of food and family makes it difficult to follow a healthy diet regimen unless the family in its entirety is doing the same. Participants also mentioned that foods common in the household have a lot of manteca added lard and the unavoidability of unhealthy food staples makes it difficult to follow a healthy diet regimen.
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Furthermore, the men cited a lack of control over their food choices because they often do not prepare their own meals. As noted above, food choice and meal preparation are commonly in the hands of a spouse or another family member. However, when in control of their own food choices, participants reported lack of time and the preference for convenient and unhealthy options that they perceived to be more time consuming.
Participants reported that they do not have adequate access to safe spaces for physical activity in their communities Table 3. While some participants mentioned their ability to travel to spaces where they feel safe to be physically active, most mentioned that transportation to and from these places could be an issue for men in the Hispanic community. According to the men, the most influential triggers to making lifestyle changes were their knowledge of the risks, their role in the family, and reaching a turning point Table 3.
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Participants mentioned that knowing the nutritional content of their food and how it affects their bodies, knowing their personal risks of disease, and becoming aware of the implications of inaction could influence their weight management behaviors. Men noted that awareness of the increased vulnerability that comes with disease and its potential complications could motivate a person to change their behaviors.
Participants recognized that weight-related behavior change is difficult and noted that change could be triggered by turning points. The men related the turning points to personally experiencing or witnessing deteriorating health or drastic life changes. When exploring the topic of building a gender-sensitive and culturally sensitive intervention approaches, the participants shared their ideas for viable recruitment and intervention strategies, information tailoring, and the role of social support Table 4.
The participants mentioned that family involvement is a crucial recruitment strategy.
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Participants emphasized that their spouses are perhaps one of the largest influences of diet and physical activity—related behaviors. However, other participants discussed alternative outreach approaches and added that having a multimedia presence in outlets specifically tailored to the Hispanic population could aid recruitment of Hispanic males. Participants also suggested that a personalized approach may be more successful than multimedia presence. In discussing tailoring information to ensure cultural, regional, socioeconomic, and Mature hispanic male looking for company responsiveness, the men added that all recruitment, intervention, and educational information must be tailored to Hispanic males in order to adequately reach the target population.
The men added that the information that is available to them is not commonly culturally or socioeconomically appropriate. Participants revealed how taking socioeconomic and cultural parameters into consideration when preparing information will make it more accessible to Hispanic males. The entire sample reported they owned a cell phone for personal use and 11 Overall, 11 When presented with the possible integration of mHealth technology to support intervention components, the men discussed both the perceived benefits and barriers of integrating technology into their lives Table 4.
It was mentioned that having the ability to track data, see progress in real time, and compare day-to-day data with themselves and others could be useful to their behavior change. It also could facilitate the ability to track and visualize their daily intake and output would create a system of self-ability that would help them retain positive behavior changes over time.
Participants added that communications using mobile technology, the Internet, and personalized phone calls would be helpful to facilitate social support for weight management—related behavior changes.
While the participants largely discussed the benefits of the use of technology, there also were some mentions of potential barriers to their use, which were most commonly related to their cost. Participants discussed the need for social support in a viable intervention approach. The men commented that hearing from people in parallel situations would allow them to relate to and understand the information that is being delivered. Others agreed and added that social support also could add a positive competitive edge to a program.
While the men shared a wide variety of viable intervention approaches, the need to integrate spousal involvement was overwhelmingly discussed due to the perceived influence that their spouse has on their behaviors. The analysis of interviews revealed that Hispanic men had a rich understanding of how obesity-related diseases, poor dietary choices, and lack of physical activity affects their health.
The men identified motivators for behavior change including learning the impact of their lifestyle choices on health outcomes, having the ability to provide and Mature hispanic male looking for company present for their families, and life-changing events e. Furthermore, the men identified feasible and appropriate recruitment intervention strategies to promote weight management and improve obesity-related health risks. Findings are similar to Martinez et al. In focus groups with 16 Mexican immigrant adult men aged 19 years or more, men expressed interest in participating in obesity prevention programs, but identified barriers to physical activity such as strenuous manual labor occupations, busy work schedules, fatigue, lack of motivation, and environments not favorable to activity.