Program Design for Obesity in non-Hispanic Black Adult Populations
Overview of Obesity
Obesity is a complex chronic disease which is highly prevalent in the U.S. The 2024 CDC report shows that approximately 2 in 5 American adults have obesity. From 2017 to March 2020, the prevalence of obesity among U.S. adults was 41.9%. Also, the prevalence of severe obesity among the same population was 9.2% in the same period. This CDC report showed that the prevalence of obesity increased to 41.9% in 2017 – March 2020 from 30.5% in 1999-2000 (CDC, 2021). Being obese exposes adults to other severe chronic conditions, including heart disease, type 2 diabetes, and an increased risk of cancer. For example, approximately 58% of obese American adults have high blood pressure, which is the leading risk factor for heart conditions. Also, approximately 23% of obese U.S. adults have type 2 diabetes. Research shows that some population groups are more affected by obesity than others, including non-Hispanic Black adults, where approximately 49.6% have obesity (CDC, 2024). This program design focuses on improving obesity management among non-Hispanic Black adults, where the chronic disease is most prevalent among the U.S. population groups.
Geographic Region and Population Characteristics
In 2021, non-Hispanic Black Americans comprised approximately 40.1 million people, representing 12.1% of the U.S. population. This indicates that non-Hispanic Black Americans are diverse, with most residing in the South. In the U.S., this population group is largely found in ten states, including Alabama, Georgia, Virginia, Arkansas, Maryland, Louisiana, Mississippi, South Carolina, Delaware, and North Carolina. The non-Hispanic Black American population group is characterized by a range of factors, cutting across educational attainment, economics, health, insurance coverage, and socioeconomic classes. Compared to non-Hispanic Whites, non-Hispanic Blacks experience disparities in access to quality health, quality education, and insurance coverage. Given the non-Hispanics’ lower socioeconomic status, they experience health disparities and are thus unable to access quality health (Choupani, 2024). There are also cultural dietary practices that expose non-Hispanic Blacks to higher risks of obesity. As a result, the prevalence of obesity in non-Hispanic Blacks is higher than in non-Hispanic Whites.
Epidemiological Patterns of Obesity
The epidemiological patterns of obesity can be understood using the characteristics of person, place and time. Under the person pattern, non-Hispanic Black people are at the highest risk of becoming obese. This disease affects more women (38.51%) than men (17.61%). Approximately 49.6% of non-Hispanic Blacks have obesity against 38% of non-Hispanic whites (CDC, 2024). The underlying risk factors that explain the disparities in obesity prevalence among non-Hispanic black Americans and other Hispanic population groups include higher unemployment rates, higher consumption of poor quality foods, lower socioeconomic class and education attainment, targeted marketing of unhealthy/jug foods, inadequate access to physical activity zones, and poor access to quality care. For place, obesity is common in metropolitan areas where non-Hispanic black people are densely populated. For example, cities like Baltimore, New Orleans, New York, Texas, and Baton Rouge. With respect to time, the prevalence of obesity has been on the rise over the decades (Potter et al., 2024). Recent data from CDC report shows that cases of obesity are on the rise, especially for non-Hispanic Black adults. For example, from 1999 – 2000 to 2017 – 2018, the prevalence of obesity increased from 4.7% to 9.2% respectively. Today, obesity affects nearly 2 in 5 U.S. adults (41.9%) (CDC, 2024). This trend shows that with continued dietary changes and physical inactivity, the prevalence of obesity continues to increase.
Health Outcomes to Improve for the Population
The leading factors explaining the cause and epidemiology of obesity in adults are higher food insecurity levels, access to poor-quality foods, and limited physical activity. For this population, the targeted population health outcome to improve in this obesity prevention program would be:
- Adopting lifelong healthy lifestyle modifications among non-Hispanic Black adults with obesity.
Uncontrolled obesity exposes this population group to other health risks, including type 2 diabetes, heart failure, hypertension, liver disease, and certain cancers (Tamayo et al., 20201. This justifies the need to implement an obesity prevention program that adopts lifelong healthy lifestyle changes for this population group.
Current Evidence Supporting the Importance of Improving this Health Outcome
Clinicians are obligated to develop appropriate treatment plans for patients diagnosed with obesity and overweight. In adult people, being obese significantly increases the risk of heart disease, high blood pressure, stroke, some cancers, and other chronic conditions (Potter et al., 2024). These cardiovascular diseases increase the risks for substantial disability and fatal. This indicates that obesity interferes with population health, from contributing to cardiovascular chronic diseases to interfering with breathing, social interactions, mood, and sexual function, to being fatal. Evidence-based research by Wang et al. (2020) shows that adopting lifelong healthy lifestyle changes is an effective program for obesity prevention among adult populations. Thus, programs targeting lifelong healthy lifestyle changes have proved to be efficacious in reducing calories, which is pivotal in obesity prevention and control.
Evidence-Based Program for this Population
The evidence-based program being developed for non-Hispanic Black adults with obesity is Intensive Behavioral Modification Therapy. This program is designed to modify the unwanted negative behaviors of physical inactivity and poor diet. The proposed program will utilize an integrative approach by combining individual therapy, group therapy, and community outreach. Through the Intensive Behavioral Modification Therapy program, the target population group will learn ways of modifying their exercise and physical habits. The program will address lifelong healthy lifestyle change interventions like healthy eating habits, improved physical activity, and reducing the number of calories they consume each day (Ozoor et al., 2023). Also, the program will equip non-Hispanic Black adults with strategies to choose healthier foods, limit consumption of unhealthy foods, and access places of physical activity. By closely working with a counselor in either individual or group therapy, the program will help the population lose weight and learn ways to track their eating, improve physical activity, create a physical exercise plan, and achieve the set behavior modification goals.
Data Collection and Analysis
In this program, both primary and secondary data would be collected. Primary data will be gathered through a quasi-experimental pre- and post-test population trial. This will help compare the primary prevention programs in intervention with those in catchment zones (Wadden et al., 2020). Under secondary data, the program will employ a randomized controlled trial (RCT) to help compare the secondary prevention adult obesity programs within the primary prevention area. Primary prevention encompasses therapeutic efforts targeting the whole adult population to prevent the incidence and prevalence of obesity. The program’s secondary prevention would include weight reduction strategies to prevent lifelong obesity progression and its associated comorbidities. Data on participants’ calories consumption/level, level of physical activity, and dietary habits will be gathered. Also, the participants’ qualitative data about barriers to obesity prevention and control and their satisfaction levels with the program will be collected (Ozoor et al., 2023). Thus, the mixed research method will be used. Primary data will provide insightful information into the program’s effectiveness, while secondary data will provide information on the healthcare trends and resources used in obesity prevention, control, and treatment.
Program Objectives
This obese prevention and control program (Intensive Behavioral Modification Therapy) includes both short- and long-term SMART objectives.
Short-Term Goals
- Encourage enrolled participants to attend at least 75% of the program’s scheduled group and individual therapy sessions within the first 4 months.
- Help at least 70% of the participants achieve a 10% improvement in their knowledge of physical activity and healthy eating as measured by pre- and post-test assessments.
Long-Term Goals
- To help obese adults reduce their body mass index (BMI) by 10% within one year and maintain this BMI for at least 6 months.
- To work with obese adults and ensure that 40% of the participants report at least a 30% improvement in dietary control and a 25% increase in physical activity by the end of two years in the program, as measured by individual physical activity logs.
Key Stakeholders
The key stakeholders to engage in this behavioral modification therapy program include local health departments, dietitians, counselors, food banks, fitness trainers and centres, e.g., Gyms and gym instructors, social service providers, and local government authorities. All these stakeholders will collaborate with the program author to provide information about obese adult people (Ozoor et al., 2023). For example, healthcare providers like dietitians can provide clinical expertise and information, making it easy to tailor the program in ways that address obese people’s healthcare needs appropriately (Ozoor et al., 2023). Also, Gym trainers may provide physical activity resources and facilitate guided physical exercises to help achieve the program’s short- and long-term goals.
Program Planning Model
The chosen funding model for this program is the PRECEDE-PROCEED planning model (PPM). This is a widely applied program planning model in health promotion. In this obese prevention and control program for non-Hispanic Black adults, PPM will facilitate efficient assessment of population health needs and guide in the design, implementation, and evaluation of the proposed health promotion interventions (Curley, 2020). Also, PPM will inform the development and deployment of population-based health strategies by comprehensively identifying health needs and assessing outcomes. Thus, the PRECEDE-PROCEED model will facilitate (1) planning, (2) implementation, and (3) evaluation of the proposed program, i.e., Intensive Behavioral Modification Therapy. Planning would involve conducting a population needs assessment to design tailored and appropriate interventions (Friis & Sellers, 2021). Implementation will involve launching the proposed program with tailored interventions such as physical activity programs and healthy eating. Evaluation will involve the assessment of the behavior modification therapy’s effectiveness in improving the population’s health outcomes.
Cultural and Ethical Considerations
The intensive behavioral modification therapy program is specifically designed for non-Hispanic Black adults with obesity. This implies that there are important ethical and cultural considerations to consider when designing the program (Tamayo et al., 2021). The ethical factors to consider include informed consent, protecting obese adult people against further harm to their health, need to maintain confidentiality, and promoting diversity, equity, and inclusion (DEI) in the program’s activities. For example, it is important to seek consent and ensure informed consent with obese adults before involving them in the program. Only participants who give consent should enrol to the program. Also, maintaining participants’ confidentiality in terms of health records and information is mandatory (Friis & Sellers, 2021). Besides, those enrolled on the behavioral change therapy program must be protected against further harm. On the other hand, the cultural factors to consider in the program’s design include cultural respect and sensitivity, health beliefs, population’s dietary preferences, and community norms (Choupani, 2024). The cultural elements held by non-Hispanic Black people, such as food culture, dietary habits, and health beliefs must be considered when designing the program.
Program Funding
Funding determines the success or failure of the program. The sources of funding for this program would include NGOs like the American Public Health Association (APHA) and the American Obesity Foundation (AOF), federal health grants, state health grants, and local businesses. Before seeking the funding, a comprehensive budget would be prepared, listing the anticipated expenses that must be funded to promote the program’s effective delivery. The budget would then be presented to the representatives of the community-based NGOs dedicated to preventing obesity and its related conditions, federal and state grants, and local businesses for consideration (Ozoor et al., 2023). Securing sufficient funding would ensure that the program’s short- and long-term goals are achieved, helping prevent and control the prevalence of obesity among non-Hispanic Black adults.
Program Marketing Strategies
This program’s marketing strategies would include social media outreach, local media campaigns, use of pamphlets, partnerships with federal, state, and local organizations, and community activities. Given that the targeted population is adults, appropriate social media marketing would be used, i.e., messaging (Curley, 2020). Also, other social media outreach channels like Facebook, which are heavily used by adults, would be considered in the marketing strategy. Besides, local media campaigns, like roadshows, will be organized and run into the community to create awareness of the need to enrol for a program that encourages physical activity and guidance on food diet for obese people. In addition, community outreach activities, including free guidance and counseling about behavioral change to improve health would be provided to engage with the targeted population (Curley, 2020). Pamphlets advertising and promoting free health consultation services, Gym locations, and gym instructor services will also be distributed to the publics’ residing within the affected areas.
Conclusion
This program has been developed for non-Hispanic Black adults living with obesity. Research has shown that obesity is highly prevalent in non-Hispanic Blacks, currently at 49.6% for adult people. The epidemiologic causes of obesity include higher food insecurity levels, limited physical activity, and access to poor-quality foods. If left uncontrolled, obesity exposes adult people to other cardiovascular health risks, including type 2 diabetes, heart disease, and cancer. The program’s desired health outcome for this population is to adopt lifelong healthy lifestyle modifications which include healthy eating habits, improved physical activity, and reducing the number of calories consumed. To prevent and control obesity among non-Hispanic Black adults, the appropriate evidence-based program is intensive behavioral modification therapy. This program will equip the non-Hispanic Black adults with strategies to choose healthier foods, limit consumption of unhealthy foods, and improve their access to places of physical activity.
References
Centres for Disease Control and Prevention (2024). High Obesity Program: Adult Obesity Facts. Retrieved from: https://shorturl.at/eCfUr
Choupani, F. (2024). Abstract P343: Diet Behaviors, Income, and Body Composition among Diverse Adult Populations in the United States. Circulation, 149(Suppl_1), AP343. https://doi.org/10.1161/circ.149.suppl_1.P343
Curley, A. L. C. (Ed.). (2020). Population-based nursing: Concepts and competencies for advanced practice (3rd Ed.). Springer.
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