"My hair or my health:" Overcoming barriers to physical activity in African American women with a focus on hairstyle-related factors

Barriers and facilitators to physical activity among Black women: A qualitative systematic review and thematic synthesis

American Black women are less physically active than other American women. While a number of qualitative studies have investigated this issue, there has been no effort to synthesize this literature. Purpose: This study aimed to utilize qualitative thematic synthesis to employ the intersectionality framework in synthesizing existing published qualitative studies on barriers to and facilitators of physical activity for Black women and reflect constructs related to (a) all American women, (b) Black Americans, and (c) Black women. This qualitative thematic synthesis included 18 studies published from 2011 to 2023. Studies were coded for quality and then reviewed with their themes identified and inductively integrated across the studies. The resulting themes were then deductively placed within a broader structure of the intersectionality framework. Reflecting this framework, three categories were identified: (1) general experience of physical activity for women, regardless of race, with themes of (a) motivation, (b) structed support, (c) overall health, (d) environment; (2) general experiences of physical activity for Black Americans, with a sub-theme of (a) low access; and (3) specific, intersectional experiences of physical activity for Black women, with sub-themes of (a) black hair, and (b) body ideal. Our synthesis of the existing qualitative research revealed that Black women experience PA related to being a woman, to being Black, and to the intersectional nature of being a Black woman. Interventions might target these intersectional themes to tailor interventions to support PA in Black women.

Physical Activity and Sedentary Behaviors Trends Among Black High School Students, 2009-2019

Purpose: Physical inactivity and sedentary behaviors are key contributors to the rising rates of childhood obesity. Though many adolescents are aware of the benefits of exercise, youth in America are not sufficiently active. This study examined changes in physical activity (PA), physical education (PE), and sedentary behaviors among Black adolescents. Methods: Pooled data from Black high school students (n = 2,233) who completed the Youth Risk Behavior Survey (YRBS) from 2009-2019 in Broward County, Florida, were analyzed. Logistic and linear regression models examined trends in selected physical activity indicators. Results: There were no significant changes in recommended physical activity levels (p = .829), daily physical activity (p = .44), PE class attendance (p = .054), or the average number of days of PA engagement (p = .304) for this time period. However, there was a significant decline in daily PE class attendance, the average number of days of PE attendance, and excessive television watching (p < .001). There were also increases in excessive video gaming and computer usage (p = .002). Conclusion: Adolescents' physical activity behaviors have not declined substantially over the past decade. However, sedentary behaviors, such as computer use and video gaming, have markedly increased. Results presented here should assist in broadening the understanding of Black adolescents' views on weight and physical activity and developing local programs and interventions to promote regular physical activity aimed at this population.

Life's essential eight as targets for cardiometabolic risk reduction among non-Hispanic black adults: A primary care approach

Cardiovascular diseases remain the leading cause of death in the United States. Several studies have shown racial disparities in the cardiovascular outcomes. When compared to their Non-Hispanic White (NHW) counterparts, non-Hispanic Black (NHB) individuals have higher prevalence of cardiovascular risk factors and thus, increased mortality from atherosclerotic cardiovascular diseases. This is evidenced by lower scoring in the indices of the American Heart Association's Life Essential 8 among NHB individuals. NHB individuals score lower in blood pressure, blood lipids, nicotine exposure, sleep, physical activity level, glycemic control, weight, and diet when compared to NHW individuals. Measures to improve these indices at the primary care level may potentially hold the key in mitigating the health care disparities in cardiovascular health experienced by NHB individuals.

Associations of role, area deprivation index, and race with health behaviors and body mass index among localized prostate cancer patients and their partners

PURPOSE

To examine the associations of role (localized prostate cancer (PCa) patient vs. their intimate partner), area deprivation index (ADI-higher scores indicating higher neighborhood deprivation levels), and race (Black/African American (AA) vs. White) with health behaviors and body mass index (BMI) among PCa patients and partners. The behaviors include smoking, alcohol consumption, diet quality, sedentary behaviors, and physical activity (PA).

METHODS

This study used the baseline data collected in a clinical trial. Given the nested structure of the dyadic data, multi-level models were used.

RESULTS

Significant role-race interaction effects on smoking, ADI-race effects on alcohol consumption, and role-ADI effects on BMI were found. Meanwhile, patients smoked more cigarettes, decreased alcohol consumption, had less healthful diets, spent longer time watching TV, did fewer sedentary hobbies, had more confidence in PA, and had higher BMIs than their partners. High ADI was independently associated with lower odds of drinking alcohol, using computer/Internet, and doing non-walking PA, and higher BMI compared to low ADI controlling for role and race. Black/AA dyads had less smoking amount and alcohol consumption and higher sedentary time and BMI than White dyads when adjusted for role and ADI.

CONCLUSIONS

This study identified significant interaction and main effects of role, ADI, or race on health behaviors and BMI.

IMPLICATIONS FOR CANCER SURVIVORS

Future behavioral interventions should address divergent individual needs between patients and partners, social and neighborhood barriers, and cultural indicators of racial groups to promote healthful behaviors and improve the quality of survivorship for PCa patients and partners.

Dermatology resident comfort level treating hair conditions related to patients with skin of color

Background

Although recent studies demonstrated resident satisfaction in the treatment of skin of color (SOC) related disease, comfort levels treating hair specific to populations within the SOC spectrum is unclear.

Objective

The purpose of this study is to assess dermatology residents comfort level in recognizing and treating various common hair conditions with a focus on those specific to SOC.

Methods

An Institutional Review Board-approved survey was distributed to United States residents of Accreditation Council for Graduate Medical Education-accredited dermatology programs. Data pertaining to hair care knowledge and treatment comfort levels were collected. Analysis was completed using equal variance 2-sample t tests and analysis of variance F tests, P < .05.

Results

Dermatology residents were relatively comfortable with common conditions such as androgenetic alopecia and alopecia areata, but uncomfortable with creating healthy hair regimens, discussing natural hair care products, and treating trichorrhexis nodosa. Resident self-identification as underrepresented in medicine significantly impacted resident knowledge of hair care and treatment in patients with SOC.

Limitations

This study was limited due to small sample size and potential recall bias.

Conclusion

This study highlights knowledge gaps in understanding hair-related care for patients with SOC, affirming the continued importance of diversifying dermatology programs as well as hair-specific training for residents.

Weekly hair washing: The recommended solution for women with afro-textured hair to alleviate dandruff and scalp discomfort

Dandruff and scalp discomfort are common concerns for women and men in Africa. Moreover, women with afro-textured hair are prone to scalp discomfort owing to irregular hair washing, frequent use of oil-based products on their scalp, and harsh chemical treatments. Current literature does not, however, provide data on the pathophysiological mechanisms of these conditions in this population. In this study, we investigated the mechanisms behind scalp discomfort and dandruff in women of African descent before and after hair washing. We conducted the in Durban, South Africa, over a 3-week period with 60 women of African descent aged 20-40 years. The respondents were equally divided into a "dandruff" and a "no dandruff" group, based on clinical grading of adherent dandruff by a dermatologist. Malassezia spp. and bacterial loads were quantified by quantitative polymerase chain reaction. Evaluations of scalp condition and sample collection were performed at five time points during the 3 weeks. Data on discomfort symptoms were collected via a self-assessment questionnaire. We observed that the dandruff severity peaked at the end of the first week after hair washing and plateaued from thereon in both groups. Dandruff was associated with higher Malassezia and bacterial load counts and there was a direct correlation between the Malassezia spp. load and dandruff score. Via self-assessment questionnaire responses submitted by participants, we observed that itching was the most pronounced scalp discomfort, compared with the sensation of tingling and burning at baseline, while an improvement of the scalp symptoms of dandruff and itch was observed in both groups after one hair wash. The study also showed that higher colonization with Malassezia spp. and bacteria is associated with dandruff independently of the time point, confirming a scalp microbiome contribution to the dandruff pathophysiology in the study population. The benefits of washing were, however, not sustained after 1 week and we thus recommend weekly hair washing for long-term management of dandruff and scalp itchiness in this population.

Assessing Hair Concerns and Physical Activity Measures Among African American Women: a Mixed-Method Exploratory Study

OBJECTIVES

Research on the association between hair concerns and physical activity (PA) constructs among African American (AA) women is lacking. Demographics such as age and income are indicated to influence hair concerns. In this study, quantitative methods were used to assess demographic differences in hair concerns and associations between hair concerns and PA. Qualitative interviewing explored AA women's views about their hair and engagement in PA.

METHODS

Participants (n = 48; M age = 37.57, SD = 13.72) completed a survey that included demographics, hair type and hairstyle management (HTHM), decisional balance (pros, cons), perceived benefits and perceived barriers scale, and level of physical activity. HTHM consists of six items measuring different factors related to hair concerns. 25 completed a qualitative interview. Chi-square or analysis of variance tests were conducted as appropriate. Qualitative data were analyzed using content analysis.

RESULTS

Proportion differences were noted between age groups (≤ 32 vs. ≥ 33) and average cost of haircare per month (p = .048). A statistically significant effect was noted for average monthly haircare cost and pros (p = .05), and for alter behavior due to hair concerns and perceived benefits to physical activity (p = .05). For level of physical activity, proportion differences were noted between exercisers and non-exercisers for average minutes spent on hair care (p = .009). Qualitative results showed few participants view hair concern as an important barrier to PA. Some participants suggested strategies for overcoming hair concerns to exercise (e.g., braids, twists).

CONCLUSION

Implications of findings including development of PA intervention approaches that may appeal to AA women are discussed.

Benefits and barriers to physical activity among African women: A systematic review

Black women have always been likened to being a less physically active group compared to women of other races/ethnicity, with reports of a high prevalence of obesity and other cardiometabolic diseases among them. The purpose of this study is to examine the health benefits of physical activity on women of color, as well as barriers that inhibit their participation. We searched PubMed and Web of Science databases for relevant research articles. Included articles were: Published in the English Language from 2011 to February 2022; conducted predominantly on black women, African women, or African American women. Articles were identified, screened, and data extracted following the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) guidelines. The electronic search produced 2 043 articles, and 33 articles were reviewed after meeting the inclusion criteria. 13 articles focused on the benefits of physical activity while 20 articles addressed the barriers to physical activity. It was found that physical activity has various benefits for black women participants but they are being hindered from participation by some factors. These factors were grouped into four themes, namely Individual/Intrapersonal barriers, Socio-economic barriers, Social barriers, and Environmental barriers. Various studies have examined the benefits and barriers of physical activity among women of different racial and ethnic backgrounds, but there have been very few studies of African women, with the majority focusing on one geographical area. In addition to exploring these benefits and barriers, this review offers recommendations on the areas researchers should focus on to promote physical activity in this population.

Physical Activity, Coronary Artery Calcium, and Cardiovascular Outcomes in the Multi-Ethnic Study of Atherosclerosis (MESA)

INTRODUCTION

Although the inverse relationship between physical activity (PA) and cardiovascular disease (CVD) is well established, observational studies suggest that very high levels of PA may be harmful. This study sought to understand the relationship between PA, coronary artery calcium (CAC), and cardiovascular outcomes among individuals at different levels of risk.

METHODS

PA and CAC were assessed in 6777 baseline participants of the Multi-Ethnic Study of Atherosclerosis. Total PA in MET-minutes per week was categorized into quartiles, and CAC was categorized as "low risk" (<100 Agatston units; n = 5180) and "high risk" (≥100 Agatston units; n = 1597). Cox proportional hazard regression analyses and Kaplan-Meier curves were generated to understand relationships between PA and CAC with CVD and all-cause mortality.

RESULTS

In low-risk participants in the highest PA quartile, there was a decrease in the adjusted hazard ratio (HR) for CVD (HR, 0.72; 95% confidence interval (CI), 0.56-0.94) and all-cause mortality (HR, 0.69; 95% CI, 0.57-0.84) compared with those in the lowest PA quartile. In high-risk participants in the highest PA quartile, there was a decrease in the adjusted HR for all-cause mortality (HR, 0.59; 95% CI, 0.47-0.74) compared with those in the lowest PA quartile. High PA was not associated with an increased risk of either outcome, regardless of CAC category, sex, or race/ethnicity.

CONCLUSIONS

Our research suggests that there is no increased risk associated with high levels of PA, even among individuals at high risk of CVD.

Factors Associated with Weight Loss Maintenance and Weight Regain Among African American and White Adults Initially Successful at Weight Loss

BACKGROUND

Providing ongoing treatment through extended care programs can improve weight loss maintenance (WLM), but the effectiveness of these programs for African Americans (AA) are mixed and may be due to unique cultural factors.

PURPOSE

To identify, prioritize, and organize factors associated with WLM as experienced by AA and White adults initially successful with weight loss.

METHODS

Adults identified their greatest amount of lifetime weight loss, and those achieving ≥5% weight loss were classified as maintainers (continued >5% weight reduction for ≥1 year) or regainers (≤5% weight reduction) based on current weight. The nominal group technique was conducted to identify and rank WLM facilitators and barriers. Online card sorting tasks and hierarchical clustering were performed to illustrate conceptual relationships between facilitators (maintainers only) and barriers (regainers only).

RESULTS

Participants (maintainers, n = 46; regainers, n = 58; 81.7% women, 48.1% AA) identified known factors associated with successful weight management (daily weighing, self-monitoring, regular physical activity, mindful eating). However, the perceived importance of these factors differed between groups (maintainer vs. regainers; AA vs. Whites). Unique factors affecting WLM were also identified (refresher groups recommended by White maintainers and regainers; self-accountability identified by AA maintainers). Salient facilitators and barriers were best represented in 2-3 clusters; each group had ≥1 unique cluster(s) revealing group-specific higher-order domains associated with successful WLM.

CONCLUSIONS

As lifestyle interventions for WLM (particularly for AA) are developed, attention to the preferences, and lived experiences of these groups is recommended. Strategies targeting physical activity maintenance and autonomy-supportive approaches may improve WLM among AA.

"That chart ain't for us": How Black women understand "obesity," health, and physical activity

In this article, we use qualitative methodology to explore how eight physically active Black women, who self-identify as "obese," understand and experience health and physical activity, as well as how they position themselves in relation to discourses pertaining to "obesity" and Black femininity. Drawing on Foucauldian-informed critical obesity scholarship and Black feminist thought, we explore the ways in which physically active Black women concurrently resist, reproduce, and navigate racialized and gendered obesity discourse. Our findings advance critical obesity scholarship as we indicate that participants simultaneously adapt to, negotiate, and resist obesity discourse by re-defining health, questioning the BMI, and centering their desire for corporeal "thickness" as critical to their identity as Black women.

Perfectionism, Motives, and Barriers to Exercise from a Person-Oriented Approach

Perfectionism is considered to be a significant personality factor within the sport and exercise field. However, very little is known about the reasons why individuals with different perfectionistic tendencies engage or not in physical activity. This study aims, from a person-oriented approach, to analyze if participation motives and barriers may differ among four perfectionistic profiles: Non-Perfectionists (low perfectionistic strivings, PS, and perfectionistic concerns, PC), Adaptive Perfectionists (high PS and low PC), Maladaptive Perfectionists (high PS and PC), and Moderate Perfectionists (moderate PS and PC). A sample composed of 597 (M_age = 22.08, SD = 3.33) undergraduates enrolled in a sport science degree from Ecuador participated in this study. Non-Perfectionists reported lower levels of motives, whereas Adaptive and Maladaptive Perfectionists reported higher scores on all participation motives. Significant and positive correlations were found between PS and both autonomous and controlled motives, whereas PC was positively correlated with controlled reasons and only significantly correlated with some autonomous reasons by the effect of PS. In terms of barriers, Maladaptive Perfectionists reported significantly higher scores on all barriers analyzed in comparison with the other three profiles, with moderate and large effect sizes. The results of the bivariate and partial correlations suggest that these inter-profile differences were explained by PC. Considering the results, it is advised to develop strategies to identify Maladaptive Perfectionists in order to increase their intrinsic reasons for practicing physical exercise, and to minimize their perceived barriers.

Increasing physical activity with African-American women using Facebook™ and Pedometers

More than 80 percent of African American women struggle with overweight and obesity. We implemented a 5-week physical activity intervention using Facebook™ and pedometers with African American women. Twenty-seven African American women participated in a single-group pre/post design intervention to promote walking and physical activity. Participants were given access to a private Facebook™ group along with a free Omron Alvita pedometer. The five-week intervention challenged participants to increase weekly daily steps and the number of days they were physically active. At the end of the intervention, participants had significantly increased their weekly steps by 190% as compared to baseline (p = .005). Nearly, 80% of participants reported being active two or more days per week as compared to baseline (35.7%). Technologies such as social media and pedometers can assist in educating individuals and improving physical activity. These findings are relevant to public health nurses when implementing programs to increase physical activity for African American women.

Hair Maintenance and Chemical Hair Product Usage as Barriers to Physical Activity in Childhood and Adulthood among African American Women

Qualitative studies have identified haircare practices as important culturally specific barriers to physical activity (PA) among Black/African American (AA) women, but quantitative investigations are lacking. Using the Study of Environment, Lifestyle and Fibroids data among 1558 Black/AA women, we investigated associations between hair product usage/hair maintenance behaviors and PA during childhood and adulthood. Participants reported childhood and current chemical relaxer and leave-in conditioner use. Self-reported PA included childhood recreational sports participation, leisure-time PA engagement during adulthood, and, at each life stage, minutes of and intensity of PA. Adjusting for socioeconomic and health characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each PA measure for more vs. less frequent hair product use/hair maintenance. Thirty-four percent reported ≥twice/year chemical relaxer use and 22% reported ≥once/week leave-in conditioner use at age 10 years, and neither were associated with PA at age 10 years. In adulthood, ≥twice/year chemical relaxer users (30%) were less likely (PR = 0.90 [95% CI: 0.79-1.02]) and ≥once/week leave-in conditioner users (24%) were more likely (PR = 1.09 [95% CI: 0.99-1.20]) to report intense PA compared to counterparts reporting rarely/never use. Hair product use/maintenance may influence PA among Black/AA women and impact cardiometabolic health disparities.

Perceived Benefits and Barriers in the Mediation of Exercise Differences in Older Black Women with and Without Obesity

OBJECTIVES

Weight control is an exercise benefit, important for older Black women, a group experiencing obesity disparities. We compared perceived exercise benefits and barriers between Black women with and without obesity and determined which mediated the weight group-exercise relationship.

METHODS

A survey (n = 234) was administered to determine attitudinal agreement between weight groups (obese or non-obese). Multiple mediation analysis was used to investigate if attitudes mediated the weight group-exercise relationship.

RESULTS

High agreement with all exercise benefits was observed between women with and without obesity. Compared with women without obesity, women with obesity were more likely to report the barriers of only exercising to lose weight (OR = 2.52, 95% CI 1.40-4.55), lack of will power (OR = 1.82, 95% CI 1.05-3.19), weight (OR = 3.04, 95% CI 1.34-6.83), and cost (OR = 2.14, 95% CI 1.02-4.47). Exercising to lose weight and lack of will power mediated the weight group-exercise relationship.

CONCLUSIONS

Women largely agreed on the exercise benefits. Lack of will power and engaging in exercise only for weight loss were barriers that were more common among older Black women with obesity. The barriers partially explained the lower exercise engagement in women with obesity. Future work may address these barriers to increase exercise in older Black women.

Chemical/straightening and other hair product usage during childhood, adolescence, and adulthood among African-American women: potential implications for health

Few studies have characterized life course hair product usage beyond ever/never. We investigated hair product use from childhood to adulthood, usage patterns in adulthood, and socioeconomic status (SES) correlates among African-American (AA) women. Using self-reported data from 1555 AA women enrolled in the Study of Environment, Lifestyle, and Fibroids (2010-2018), we estimated the usage frequency of chemical relaxer/straightener (≥twice/year, once/year, and rarely/never) and leave-in/leave-on conditioner (≥once/week, 1-3 times/month, and rarely/never) during childhood, adolescence, and adulthood. Latent class analysis was used to identify patterns of adulthood usage of multiple hair products. SES was compared across latent classes. With a mean age of 33 ± 3.4 years, most women reported ever using chemical relaxers/straighteners (89%), and use ≥twice/year increased from childhood (9%) to adolescence (73%) but decreased in adulthood (29%). Leave-in/leave-on conditioner use followed the same pattern. Each of three identified latent classes reported frequent styling product use and infrequent relaxer/straightener use. Class One was unlikely to use any other products, Class Two moderately used shampoo and conditioner, and Class Three frequently used multiple product types (e.g., moisturizers and conditioners). Participants in the latter two classes reported higher SES. Ever/never characterization may miss important and distinctive patterns of hair product use, which may vary by SES.

Acceptance-enhanced behavior therapy for trichotillomania: Randomized controlled trial rationale, method, and strategies for recruiting minority participants

Trichotillomania (TTM) involves the chronic pulling out of hair to the point of hair loss or thinning, which continues despite repeated attempts to stop. Behavior therapy is a promising treatment for the condition, but studies have been limited by the lack of a credible control condition, small sample sizes, follow-up periods of short duration, and low participation by underrepresented populations. In the current article, the authors describe the theoretical rationale for an acceptance-enhanced form of behavior therapy for TTM in adults and describe the methodology used to test the efficacy of this intervention against a psychoeducation and supportive control condition. In addition, the authors discuss the importance of and difficulties encountered with enrolling minority participants into TTM research, as well as strategies used to enhance minority recruitment. Finally, the authors discuss the instruments, procedures, and related outcomes of the fidelity measures used in the randomized controlled trial.

The Use of a Community-Based Preconception Peer Health Educator Training Intervention to Improve Preconception Health Knowledge

This paper highlights the use of an adapted Office of Minority Health (OMH) Preconception Health Peer Educator program to address persistent infant mortality health disparities. The community-based Attack Infant Mortality (AIM Escambia) initiative was established to increase preconception health knowledge among African American women at risk for adverse birth outcomes. Participants (N = 122) attended a 6-h AIM peer educator training, completed pretest and posttest questionnaires about their health knowledge, health attitudes, and planned engagement in health behaviors. Study results support the use of preconception health education training to inform health knowledge, health attitudes, and planned health sharing behaviors. Multidisciplinary collaborations and targeted interventions should be considered when seeking to improve community health conditions and increase health knowledge and health literacy for minority populations.

Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women

BACKGROUND

African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women.

OBJECTIVE

To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women.

DESIGN AND METHODS

Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors.

SUMMARY

Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.

Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration

Background

African American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention.

Methods

A qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m²). Content analysis was used to analyze these focus group data.

Results

Three key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman’s hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants.

Conclusion

Findings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.

Identifying Motives of Midlife Black Triathlete Women Using Survey Transformation to Guide Qualitative Inquiry

Demonstrating health disparities related to race, age, and gender, older Black women (BW) are the most sedentary demographic group in the United States. Increasing PA in mid-life is important, as it improves health as BW age into their later years. Advancing our understanding of the exercise motives of BW triathletes presents a "reverse engineering" opportunity to identify motives that could influence sedentary mid-life BW to increase their activity. The purposes of this study were to: (a) utilize an innovative survey transformation method to adapt a measure developed primarily in Caucasian males, i.e., the Motivations of Marathoners Scale for Triathletes (MOMS-T) into a qualitative interview guide for use with BW triathletes; (b) use this interview guide to identify culturally based motives for triathlon participation among BW not previously addressed by the MOMS-T and; (c) interpret the novel motivational domains of the MOMS-T discovered, in order to gain understanding and influence subsequent interventions. Purposive sampling was used to select 12 interview participants from 121 self-identified Black female US residents aged ≥36 years with recent experience completing or training for a triathlon. The interviews identified four culturally based themes, including improving body composition to become "more lean", physical attractiveness, triathlete family, and camaraderie. These novel themes were related to existing MOMS-T scales, but the current MOMS-T questions did not illuminate their culturally distinct aspects. The process of survey transformation provides a viable approach to identify important culturally based characteristics and to adapt surveys to cultural minority populations, particularly when study resources are limited.

Cultural hair practices, physical activity, and obesity among urban African-American girls

BACKGROUND AND PURPOSE

Hair holds cultural meaning and value for women of African descent. The values placed on hair type and hair style date back to preslavery days. There is a small body of literature that addresses the relationship between cultural hair practices and physical inactivity among black women. Understanding this is important because inactivity during childhood and adolescent years contributes to increased weight-related morbidity and mortality during adult years. The purpose of this study was to determine the relationship between cultural hair practices, physical activity, and obesity among urban African-American adolescent girls.

METHODS

A convenience sample of 50 African-American girls completed questionnaires and were weighed and measured for body mass index (BMI) calculation.

CONCLUSION

Cultural hair practices such as the amount of money (p = .047) and time (p = .015) spent on hair maintenance were associated with decreased physical activity but were not associated with BMI.

IMPLICATIONS FOR PRACTICE

Inactivity during adolescence can result in obesity, a major cause of chronic health conditions that contribute to morbidity and mortality as an adult. When nurse practitioners understand and appreciate the cultural differences and beliefs around cultural hair practices they will be able to develop culturally appropriate strategies that will aid in weight loss.