title: "Does skinny mean healthy?" Perceived ideal, current, and healthy body sizes among African-American girls and their female caregivers.
abstract: OBJECTIVE
  To qualitatively and quantitatively examine body image ideals and perceived weight-related health among African-American girls and their female caregivers to inform intervention development for Girls Rule!, an obesity prevention pilot program.
  
  
  METHODS
  Formative study using qualitative data from semi-structured interviews and validated quantitative body image silhouette assessment among girls (N=47) and caregivers (N=44). The participants were a convenience sample of African-American church members from North Carolina. Differences were evaluated between perceived: 1) current and ideal body size; 2) current and unhealthy body size; and 3) ideal and unhealthy body size.
  
  
  RESULTS
  Thirty-seven percent of the girls and 77% of the caregivers were overweight or obese. Three body image themes emerged from the qualitative interviews: 1) being fat is unhealthy; 2) caregivers are role models (positive and negative) for body image ideals; and 3) smaller body size is important for wearing fashionable clothing. A series of 9 body silhouettes were used to assess perceptions of both girls and caregivers. Overall, both girls (2.9 +/- 1.4) and caregivers (4.4 +/- 1.4) ideal body size was significantly (P<.01) smaller than their current body size (3.7 +/- 1.3 girls; 6.3 +/- 2.2 caregivers). Both girls (3.7 +/- 1.4) and caregivers (6.7 +/- 2.0) indicated that their current body sizes were statistically significantly (P<.05) smaller that what they considered to be unhealthy (7.9 +/- 1.4 girls; 7.9 +/- 1.2 caregivers).
  
  
  CONCLUSIONS
  Results suggest that most of these African-American participants were not satisfied with their current body size and desired a smaller body. At the same time, both girls and caregivers failed to recognize the potential health consequences associated with their current body size. Critical issues for designing obesity prevention programs include positive role modeling within the family and addressing the association of body size with health risk.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, North Carolina, USA. katz-4@medctr.osu.edu
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
authors.forename: Penny
authors.initials: P
authors.lastname: Gordon-Larsen
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Bentley
authors.forename: Kristine
authors.initials: K
authors.lastname: Kelsey
authors.forename: Kenitra
authors.initials: K
authors.lastname: Shields
authors.forename: Alice
authors.initials: A
authors.lastname: Ammerman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D001828:Body Image; D049628:Body Size; D017028:Caregivers; D002648:Child; D005260:Female; D006801:Humans; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000208:ethnology / Q000517:prevention & control*; D010865:Pilot Projects