RESUMO
Unhealthy eating and weight control behaviors are important but modifiable factors that contribute to obesity in majority and minority populations. Studies suggest that these behaviors are common in Mexican American women, but most studies completed to date have focused on college enrolled Mexican American women. Little is known about body weight concerns, eating and weight control behaviors in low acculturated immigrant Mexican women. This qualitative descriptive study utilized two focus groups with 15 women to identify and describe body weight and shape perceptions, and thoughts and behaviors related to eating and weight control of low acculturated Mexican American living in disadvantaged economic situations. Conventional content analysis was used to analyze data and three main themes were identified: (1) body weight values and concerns, (2) eating and food, and (3) weight loss strategies and consequences. The first two themes shared five subthemes including emotion, health, age, family, and culture. Results suggest Mexican American women experience weight concerns that are in conflict with food/eating values and experiences. This conflict is influenced by cultural, family, and inter/intrapersonal factors and contributes to unhealthy eating and weight control behavior. The transition and assimilation to the United States is complex and dynamic. Thus understanding how the conflict regarding body weight and food influence Mexican American women's health behaviors is important and provides valuable knowledge essential to guide further research and intervention development.
Assuntos
Imagem Corporal/psicologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/etnologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Americanos Mexicanos/psicologia , População Rural/estatística & dados numéricos , Aculturação , Adolescente , Adulto , Fatores Etários , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Estudos de Avaliação como Assunto , Fazendas , Comportamento Alimentar/etnologia , Feminino , Grupos Focais , Humanos , Americanos Mexicanos/estatística & dados numéricos , México , Pessoa de Meia-Idade , New York , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: Ecological momentary assessment (EMA) is a popular method for understanding population health in which participants report their experiences while in naturally occurring contexts in order to increase the reliability and ecological validity of the collected data (as compared to retrospective recall). EMA studies, however, have relied primarily on text-based questionnaires, effectively eliminating low-literacy populations from the samples. OBJECTIVE: To provide a case study of design of an EMA mobile app for a low-literacy population. In particular, we present the design process and final design of an EMA mobile app for low literate, Mexican American women to record unhealthy eating and weight control behaviors (UEWCBs). METHODS: An iterative, user-centered design process was employed to develop the mobile app. An existing EMA protocol to measure UEWCBs in college-enrolled Mexican American women was used as the starting point for the application. The app utilizes an icon interface, with optional audio prompts, that is culturally sensitive and usable by a low-literacy population. A total of 41 women participated over the course of 4 phases of the design process, which included 2 interview and task-based phases (n=8, n=11), focus groups (n=15), and a 5-day, in situ deployment (n=7). RESULTS: Participants' mental models of UEWCBs differed substantially from prevailing definitions found in the literature, prompting a major reorganization of the app interface. Differences in health literacy and numeracy were better identified with the Newest Vital Sign tool, as compared with the Short Assessment of Health Literacy tool. Participants had difficulty imagining scenarios in the interviews to practice recording a specific UEWCB; instead, usability was best tested in situ. Participants were able to use the EMA mobile app over the course of 5 days to record UEWCBs. CONCLUSIONS: Results suggest that the iterative, user-centered design process was essential for designing the app to be made usable by the target population. Simply taking the protocol designed for a higher-literacy population and replacing words with icons and/or audio would have been unsuccessful with this population.
RESUMO
Recent research has shown that disordered eating behaviors are as prevalent in heterogenous samples of Latinas living in the U.S. as in non-Hispanic white women, yet less is known about the prevalence in women of Mexican origin. The primary purpose of this study is to report the prevalence and associations among DE behaviors and health risk of alcohol, tobacco use and obesity in a sample of N = 472 young adult college enrolled Mexican American (MA) women living in the United States. This report focuses on baseline data from a 12-month repeated measures longitudinal study. Ecological momentary assessment (EMA) was used to capture the prevalence of disordered eating and health risk behaviors in the context of everyday activities. Disordered eating behaviors including purging, binge eating, fasting and exercise were reported by approximately 15% of the sample. Food/calorie restricting, was the most prevalent behavior reported by 48% of the sample and along with binge eating was a positive predictor of BMI. Fasting was the only disordered eating behavior associated with tobacco use. These findings suggest that subclinical levels of DE behaviors are prevalent in a community sample of women of Mexican origin and are associated with health risks of tobacco use and higher BMI. Early identification of DE behaviors and community-based interventions targeting MA women may help reduce disparities associated with overweight and obesity in this population.