Research BriefA Qualitative Assessment of Weight Control among Rural Kansas Women
Introduction
Obesity is a leading preventable cause of death in the United States (US), second only to tobacco smoking.1, 2 Rural populations suffer disproportionately from obesity, physical inactivity, and obesity-related comorbidities compared to their urban counterparts,3, 4 which is felt to be a result in part of a “later adoption” of new technologies and treatment compared with their urban counterparts.5 Nonetheless, there are relatively few studies exploring weight control beliefs and practices among rural communities, rendering a thorough understanding of these rural-urban differences in obesity and obesity-related complications difficult.
In the general US population, women have a higher prevalence of obesity than men.6 This gender disparity in obesity risk has also been demonstrated in rural populations.7 Furthermore, gender-based differences in weight management and beliefs have been identified for rural populations.8 Compared with men, women are more likely to demonstrate weight-related concerns and to be involved in a weight control attempt at any given time.9 Women have a more extensive history of weight cycling and tend to engage in different weight control strategies than men.10, 11 Obese women are more likely to suffer social stigma related to weight compared to their male counterparts, and they have a greater psychological burden as a result.10, 12 This disparity is thought in part to be a result of societal discrimination against obese individuals, especially against women.12 Nonetheless, gender differences in weight control experiences have been understudied among rural populations, which is important, given that over 20% of the US population resides in a rural community.13
This study used a qualitative approach to explore weight control beliefs, attitudes, and knowledge among rural Kansas women, with a special focus on characterizing the relationship of these women with their primary-care providers and practices around weight control. Improving the recognition and treatment of overweight and obesity in primary-care settings is a critical initiative.14 Lack of attention by clinicians has been identified as a contributing factor to the escalating obesity epidemic.15 Furthermore, because this project represented the developmental phase of a pilot trial for weight control in rural primary care, community and social activation around weight control were explored.
Section snippets
Description of Evaluation
This project completed 6 focus groups to explore weight control among women from 3 separate communities of rural Kansas during the fall of 2006. Two focus groups in each community were held to ensure adequate representation from each community and to have some scheduling flexibility for recruitment purposes. Patients were recruited from 3 primary-care practices in 3 separate rural Kansas counties.
Two study sites were in frontier rural counties in western Kansas, with overall populations of 1534
Lessons Learned
Six focus groups were conducted in 3 separate communities in rural Kansas between September and December 2006. There were 31 women overall, with focus group sizes containing on average from 4 to 9 women. The pre–focus-group 17-item survey identified participant mean ± SD age was 60 ± 14 years, and their mean ± SD body mass index was 33 ± 5. All of the women were white, and most reported at least 1 obesity-related comorbidity. Hypertension was most commonly self-reported (62%). Their mean ± SD
Implications for Research and Practice
This study used focus groups to explore weight control beliefs, attitudes, and experiences among a group of women from 3 rural Kansas primary-care practices. These women had long experience with weight control attempts and had specific thoughts and ideas about how to improve weight control in rural communities. Similar to nonrural environments, these women felt a lack of support for weight control from primary-care providers. The women shared that accountability and guidance from their
Acknowledgments
This work was funded by a Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 grant to Dr. Ely (University of Kansas Medical Center, PI Drs. Soares and Thomas) and a National Heart, Lung, and Blood Institute K23 grant to Dr. Ely (PI, 1 K23HL085125-01A1). We gratefully acknowledge the physicians and staff at the 3 collaborating rural primary-care practices of this project. This research would not have been possible without their eager participation and supportive efforts.
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Protocol for the Rural Engagement in Primary Care for Optimizing Weight Reduction (RE-POWER) Trial: Comparing three obesity treatment models in rural primary care
2016, Contemporary Clinical TrialsCitation Excerpt :Rural families traditionally consume high-fat, high-calorie diets that, in the past, were largely offset by the physical demands of vigorous physical labor such as farming [99]. However, cultural eating patterns (e.g., “country cooking”) [14,100] as well as less access to healthful foods many have maintained these dietary patterns [101]. In addition, in rural communities cultural norms seldom encourage leisure time physical activity and one is less likely to encounter other people exercising [11], a key determinant of physical activity adoption [11].
Protocol and recruitment results from a randomized controlled trial comparing group phone-based versus newsletter interventions for weight loss maintenance among rural breast cancer survivors
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Lessons learned: Experiences of gaining weight by kidney transplant recipients
2012, Progress in Transplantation
This work was funded by a Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 grant to Dr. Ely (University of Kansas Medical Center, PI Drs. Soares and Thomas) and a National Heart, Lung, and Blood Institute K23 grant to Dr. Ely (PI, 1 K23HL085125-01A1).