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

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          Abstract

          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/m 2). 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.

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          Most cited references 41

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          Cultural sensitivity in public health: defined and demystified.

          There is consensus that health promotion programs should be culturally sensitive (CS). Yet, despite the ubiquitous nature of CS within public health research and practice, there has been surprisingly little attention given to defining CS or delineating a framework for developing culturally sensitive programs and practitioners. This paper describes a model for understanding CS from a public health perspective; describes a process for applying this model in the development of health promotion and disease prevention interventions; and highlights research priorities. Cultural sensitivity is defined by two dimensions: surface and deep structures. Surface structure involves matching intervention materials and messages to observable, "superficial" characteristics of a target population. This may involve using people, places, language, music, food, locations, and clothing familiar to, and preferred by, the target audience. Surface structure refers to how well interventions fit within a specific culture. Deep structure involves incorporating the cultural, social, historical, environmental and psychological forces that influence the target health behavior in the proposed target population. Whereas surface structure generally increases the "receptivity" or "acceptance" of messages, deep structure conveys salience. Techniques, borrowed from social marketing and health communication theory, for developing culturally sensitive interventions are described. Research is needed to determine the effectiveness of culturally sensitive programs.
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            Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches.

            It is a truism of health education that programs and interventions will be more effective when they are culturally appropriate for the populations they serve. In practice, however, the strategies used to achieve cultural appropriateness vary widely. This article briefly describes five strategies commonly used to target programs to culturally defined groups. It then explains how a sixth approach, cultural tailoring, might extend these strategies and enhance our ability to develop effective programs for cultural groups. The authors illustrate this new approach with an example of cultural tailoring forcancer prevention in a population of lower income urban African American women.
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              Health Benefits of Light-Intensity Physical Activity: A Systematic Review of Accelerometer Data of the National Health and Nutrition Examination Survey (NHANES).

              The health effects of light-intensity physical activity (PA) are not well known today.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/223184
                URI : http://frontiersin.org/people/u/194215
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                17 January 2018
                2017
                : 5
                Affiliations
                1Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University , Phoenix, AZ, United States
                2Social and Behavioral Sciences Department, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis , Indianapolis, IN, United States
                3Exercise Science and Health Promotion Program, School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University , Phoenix, AZ, United States
                4Previously Affiliated with Arizona State University , Phoenix, AZ, United States
                Author notes

                Edited by: Dan J. Graham, Colorado State University, United States

                Reviewed by: Melissa Bopp, Pennsylvania State University, United States; Stacie Craft DeFreitas, University of Houston–Downtown, United States

                *Correspondence: Rodney P. Joseph, rodney.joseph@ 123456asu.edu

                Specialty section: This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2017.00367
                5777534
                Copyright © 2018 Joseph, Coe, Ainsworth, Hooker, Mathis and Keller.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 55, Pages: 8, Words: 7656
                Funding
                Funded by: National Institutes of Health 10.13039/100000002
                Award ID: K99 HL129012
                Categories
                Public Health
                Original Research

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