Elsevier

Journal of Nutrition Education and Behavior

Volume 44, Issue 5, September–October 2012, Pages 448-453
Journal of Nutrition Education and Behavior

Research Brief
Using Focus Groups to Identify Factors Affecting Healthful Weight Maintenance in Latino Immigrants

https://doi.org/10.1016/j.jneb.2011.11.008Get rights and content

Abstract

Objective

To explore (1) how migration influenced physical activity and dietary behaviors among Latino immigrants and (2) participants' perception of concepts related to a Health at Every Size (HAES) approach to weight maintenance (mindful eating, taking care of oneself).

Methods

Four focus groups (n = 35), homogenous by sex, were conducted in Spanish.

Results

Male and female participants spoke of being less physically active and eating less healthful diets since immigrating. Noted barriers to being physically active and eating a healthful diet included time and financial constraints. Participants were interested in the HAES concepts but thought these ideas conflicted with their cultural upbringing. For women, putting family first was identified as a barrier to taking care of oneself.

Conclusions and Implications

An HAES approach may be a useful in promoting weight maintenance in this population, as participants were interested in key concepts, but it would be important that HAES interventions incorporate cultural traditions.

Introduction

Overweight and obesity is a major public health concern in the United States (US).1, 2 Latinos are at high risk of being overweight and obese: an estimated 37.9% of Latinos are obese and 76.9% are obese/overweight.3 The causes of obesity are multifactorial; physical inactivity and unhealthful dietary patterns are recognized as significant contributors to obesity-related morbidity and mortality. Thus, obesity prevention guidelines include recommendations for these 2 modifiable behaviors.1, 2, 4, 5, 6

The immigrant population is the fastest growing segment of the US population. Currently, immigrants constitute 12.5% of the US population, and 53.1% of immigrants are from Latin America.7 Although the prevalence of obesity and overweight is lower in immigrants than among US-born adults, there has been a dramatic increase in obesity and overweight prevalence among immigrants.8 Notably the length of US residency has been found to be associated with increased rates of overweight and obesity.8, 9, 10 The increased prevalence of obesity among immigrants may be associated with acculturation to US norms.11

Most intervention research has focused on promoting weight loss among overweight and obese individuals, and only a limited number have focused on preventing overweight and obesity among high-risk populations such as Latino immigrants. Interventions that include treatment components addressing diet, exercise, and behavioral change have been effective in promoting and maintaining weight loss.12, 13 Unfortunate-ly, many individuals who successfully lose weight regain it within 5 years post-treatment.14 This regaining of lost weight suggests that alternate approaches to promote and maintain healthful weight should be explored. A Health at Every Size (HAES) approach (also referred to as a nondiet approach) may provide a useful approach to obesity prevention. This approach directs the focus away from weight loss to enhancing self-regulation through avoidance of dieting, increasing awareness of hunger and satiety (defined as eating when hungry and stopping eating when full), and respecting one's own and others' body size.15 Outcomes are weight neutral, and weight loss, which may or may not occur, is not the goal.16 Interventions using an HAES approach promote healthful practices, including increasing physical activity and eating a healthful diet.17 Although results are mixed, some interventions developed using this approach have been effective in preventing weight gain.15, 16

Recent immigrants to the US are ideal candidates for obesity prevention efforts, as obesity among immigrant groups increases with increasing time spent living in the US.8, 9, 10 There is a 4-fold greater risk of obesity among Latino immigrants who have lived in the US for 15 years or more.10, 18 It is important to understand changes in diet and physical activity associated with immigration, as less healthful diets and reduced physical activity may be associated with increased weight. Thus, the primary purpose of this study was to use focus groups to explore how migration to the US changed diet and physical activity among Latinos. A secondary purpose was to explore participants' percep-tions of HAES-related concepts.

Section snippets

Methods

Participants were recruited from a well-established, nonprofit, community-based organization located in Central Falls, Rhode Island that provides an array of services to assist the Latino and immigrant communities in the state. According to data from the 2000 census, Central Falls is 47.8% Hispanic/Latino, and 29% of the population lives below the poverty level.19 Study eligibility requirements included self-identifying as Latino, being between 18-45 years of age, having no known chronic

Participants

In total, 35 people (20 women, 15 men) participated in the focus groups, and all participants were originally from South America, Central America, Mexico, or the Caribbean. The majority (97%) reported an annual household annual of less than $20,000, and 60% had not graduated from high school. Additional details about the sample can be found in the Table.

Changes in Diet and Physical Activity since Coming to the US

Overwhelmingly, participants felt that their diets were more healthful in their home countries. Before coming to the US, participants said they

Discussion

Latinos are the largest and most rapidly growing population group in the US, and the process of acculturating to the US is associated with developing obesity.24 Thus, interventions are needed to prevent obesity, and as increased length of time in the US is associated with increased risk of obesity, intervention efforts are needed for more recent immigrants in an effort to promote weight maintenance. As with all interventions, cultural preferences and cultural values should be taken into account.

Implications for Research and Practice

To the authors' knowledge, an HAES intervention has not been tested in Latino immigrant populations. Although this present study has limited generalizeability, using an HAES approach may be appropriate to promote weight maintenance among Latino/Latina immigrants. It would be important that intervention messages recognize that changes in diet and physical activity derive from multilevel factors. Cultural influences on behavior also would need to be acknowledged. For example, the intervention

Acknowledgments

The study was supported by funding from the Rhode Island Agricultural Experiment Station grant: RH00131. The authors would like to acknowledge and thank all individuals who participated in the focus groups.

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