Exploring ethnic and new orleans cultural influences on health be

Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2021 Exploring Ethnic and New Orleans Cultural Influences on Health Behaviors of African American Women Keneitra Brown-Mayfield Walden University Follow this and additional works at: https://scholarworks.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact ScholarWorks@waldenu. Walden University College of Health Professions This is to certify that the doctoral dissertation by Keneitra Brown-Mayfield has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Naa-Solo Tettey, Committee Chairperson, Public Health Faculty Dr. Carla Riemersma, Committee Member, Public Health Faculty Dr. Raymond Panas, University Reviewer, Public Health Faculty Chief Academic Officer and Provost Sue Subocz, Ph.

Walden University 2021 Abstract Exploring Ethnic and New Orleans Cultural Influences on Health Behaviors of African American Women by Keneitra Brown-Mayfield Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University February 2021 Abstract In the United States (U.), African American women suffer disproportionately due to obesity and chronic diseases. Many studies have examined the culture of African Americans and its influence on their health behaviors in order to gain knowledge to inform obesity and chronic disease prevention interventions. However, a geographical segment of the U. African American population shares a unique culture that had yet to be studied.

This qualitative study used in-depth interviews to understand the perceptions of overweight and obese African American women living in the Greater New Orleans region about their culture’s role in the prevalence of obesity and obesity-related conditions in their communities and how they perceived their culture and lived experiences influenced their beliefs about obesity and obesity prevention. The study’s sample consisted of 12 overweight or obese African American women over the age of 18, who self-identified as African American or Black and were native to the New Orleans area. The health belief model guided the study, and the data were collected through semi- structured, in-depth interviews and examined using interpretive phenomenological analysis. Findings demonstrated culture was felt by participants to be a major influence on their health behaviors.

This culture influenced their beliefs and attitudes about weight standards, recommendations, and health and body image. Participants desired more culturally relatable and realistic recommendations to address obesity in their communities. This study addresses health behaviors and beliefs of this unique subculture and demonstrates the need for more specific culturally tailored interventions to address disparities in this population. Exploring Ethnic and New Orleans Cultural Influences on Health Behaviors of African American Women by Keneitra Brown-Mayfield Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University February 2021 Dedication I dedicate the second biggest accomplishment of my life to my most prized accomplishments, Tyler André and Kameron Kenneth.

You two are the loves my life and the reason why I am who I am today. You motivated me to keep pushing through every challenge and every obstacle. Because of you, I never considered giving up. When you look back, you may remember Mommy working all the time, but I pray that I have instilled upon you the value of hard work and determination.

Tyler and Kameron, it is my hope that this dissertation will inspire you to aspire for greatness. I believe in you and know that you will grow up to make this world a better place. Tyler, you inherited Mommy’s superpower of ADHD, which means your mind is capable of more than anyone could imagine. There will be challenges, but don’t let anyone put limitations on you.

Do not follow the path of others for you have the ability to dream up your own path. Kameron, you inherited Mommy’s superpower of empathy. It’s with this gift that you will change lives. Embrace your sensitivity, feed your intuitiveness, and continue to love others with the love of God.

I love you both with everything in me, forever. I dedicate this dissertation and the degree that will follow to you, Tyler and Kameron. I also dedicate this dissertation to my Nanny, Dorothy Richard and my Uncle Gregory Anderson. Unc, you fueled my passion to educate our people on how to live healthy lives and Nanny, you’ve been my inspiration to live a life of love and charity and to leave a legacy that will continue long after I have departed this world.

May you both rest in peace. Acknowledgements First, I would like thank God for giving me the wisdom, knowledge, strength and endurance that I needed to reach this goal. Secondly, I would like to thank all of my family, friends, and coworkers(family) for your love, support, and encouragement. Mommy and Daddy, you were there consistently, supporting me through every step of the way.

When things got hard around me, you helped to pick up the pieces so that I could remain on track. I couldn’t have done this without you. Juan, thank you for reminding me every day that I was worthy of this and that I had the strength within me to overcome every obstacle put before me. Thank you for providing your unconditional love when I needed it the most.

André, you provided many of the challenges and obstacles, but they motivated me to keep pushing. Thank you for that. But more importantly, thank you for the support that you provided that allowed me to finish my dissertation. I couldn’t have finished my last chapter without your help.

Tyler and Kameron, thank you for providing me all the love, hugs, and kisses that kept me alive over the last 4 years. Naa-Solo Tettey, my committee chair, thank you for your support, feedback, and encouragement throughout the dissertation process. I am grateful for your understanding through all of my struggles. Also, thank you to my committee member, Dr.

Carla Riemersma, for your time and feedback. Lastly, I would like to thank the participants of this study for your time and your willingness to tell me your stories. Table of Contents Acknowledgements. vii List of Tables.

vi List of Figures. vii Chapter 1: Introduction to the Study. 6 Purpose of the Study. 8 Nature of the Study.

10 Scope and Delimitations. 14 Chapter 2: Literature Review. 15 Literature Search Strategy. 22 Perceptions of Body Image.

22 Knowledge, Perceived Susceptibility, and Perceived Severity. 23 Perceptions and Attitudes about Behavioral Changes for Obesity and Chronic Disease Prevention. 25 Evaluating the Influence of Culture Using Qualitative Methodology. 26 Analysis of Previous Approaches to Addressing the Health Behaviors of African Americans.

28 Justification of Concepts. 31 Review and Synthesis. 32 What Remains to Be Studied. 37 Summary and Conclusions.

38 Chapter 3: Research Method. 41 Research Design and Rationale. 41 Qualitative Research Tradition and Rationale. 42 Role of the Researcher.

44 ii Participation Selection. 46 Researcher-Developed Instrument. 48 Procedures for Recruitment, Participation, and Data Collection. 49 Data Analysis Plan.

51 Issues of Trustworthiness. 62 Case Study Approach. 63 Identifying Patterns and Data Exploration. 65 Evidence of Trustworthiness.

110 Benefits to Change. 114 Motivation or Cues for Change. 118 Perceptions of Social, Regional, and Ethnic Cultural Influences. 129 Chapter 5: Discussion, Conclusions, and Recommendations.

130 Interpretation of the Findings. 133 Perceptions and Attitudes About Participating in Preventative Behaviors. 137 Perceptions of Sociocultural Influence. 156 Appendix A: Interest Form.

166 Appendix B: Demographic Questionnaire. 167 Appendix C: Interview Guide. 168 Appendix D: Recruiting Flyer. 171 Appendix E: Participant Instructions.

172 v List of Tables Table 1. Examples of Themes, Codes, and Excerpts. Final Grouping of Themes and Subthemes Using Theoretical Framework. Seasonal and Holiday Food Traditions.

Participants’ Favorite Jazz Fest Foods. Festival Food Experiences. Participant Definitions of Overweight and Obese. Participants’ Reactions to Recommended Weight Change.

97 vi List of Figures Figure 1. 73 vii 1 Chapter 1: Introduction to the Study Introduction “How does it feel to be a twin?” Although I’ve heard this question asked in different ways, the answer seems to always be the same. “I don’t know, that’s all I’ve ever been” or something similar is usually the response. When you have only seen life from one perspective, it may be difficult to initially see the uniqueness of your own experience.

It would require you to view your experience from a lens other than the one you’ve always used. Our perspectives shape how we move through life. They shape how we perceive ourselves in the world, our beliefs, our attitudes, and later our behavior and our decisions. An individual living in a rural area without television or access to the outside world may be surprised to learn that others living outside of their town live a different way of life.

An individual who has accomplished a goal by following steps A-Z may find it difficult to understand why another individual cannot follow those exact steps to reach the same goal. As a native resident of the Greater New Orleans region (GNO), my experiences growing up were quite different from those of whom I viewed on television or those with whom I visited in other places, especially outside of the state of Louisiana. However, it wasn’t until I lived hundreds of miles from where I grew up that I realized how unique my experiences were. As a health-sciences major, I learned much about health and healthy eating.

Although I absorbed the information and regurgitated it regularly, it never occurred to me that the application of these principles were real expectations. That is until I moved to Washington DC and learned that my way of living, although somewhat similar to the 2 foreign cultures residing in the country’s melting pot, was very different from how much of the rest of the country lived. It is within this concept one can understand the definition and value of truth from a relativist perspective. Within this ontological perspective, I will guide the reader by exploring the unique realities of a group of individuals who suffer from preventable conditions, yet who seem to continue to partake in the offending behaviors.

African Americans, especially African American women, are suffering and dying at high rates due to chronic preventable conditions. In this study, I examined a specific community of African American women. I describe disproportionate rates of prevalence among African American women and factors that contribute to these rates. In current day public health, it is common practice to look at health from a socioecological perspective, addressing multiple levels of health determinants.

For this reason, I described how community and family level determinants such as culture can affect individual behaviors. More specifically, I examine how the culture of a city known for its food, music, partying, and its laid-back style of living, affect the health behaviors of overweight and obese African American women. Understanding how culture influences these behaviors and how these individuals understand their own experiences will help promote positive change by providing information needed to build culturally-informed interventions that educate and encourage culturally-specific health behaviors that are conducive to the realities and experiences of this unique population. In this chapter, I explain the problem and purpose of this study.

I provide a brief explanation of the methods and theoretical 3 framework, as well as the nature, scope, assumptions, limitations, delimitations, and significance of this study. Background The phenomenon of the increased risks and prevalence of obesity and chronic disease in African Americans, compared to other ethnicities in the United States (U.