African Americans and obesity: implications for clinical nurse specialist practice.
OBJECTIVE
The purpose of this article is to examine the connection between genes, culture, and environment in the development of obesity and its impact on the health of African Americans. This information will be utilized to facilitate the design of weight management programs for African Americans.


BACKGROUND
Literature review of the connection between the above variables revealed a disproportionate amount of health risks associated with excess weight in African Americans. Several nonfatal consequences of obesity were noted to impact quality of life but improved significantly with small reductions in body weight. However, factors that affect weight in a culturally relevant context were seldom addressed and few intervention programs were specifically designed to treat minorities with obesity issues.


METHODS
This article describes the role that genetic, cultural, and environmental factors play in energy regulation. Factors that impact lifestyle changes, self-esteem, public awareness, participation, and community involvement are highlighted.


RESULTS
Providing healing environments that are culturally acceptable can empower individuals to commit to goals as well as influence others who are resistant to change. Public awareness tools designed by clinical nurse specialists (CNSs) that appeal to ethnic values can facilitate cooperation and enhance successful outcomes.


CONCLUSIONS
Despite genetic susceptibility to obesity, research on the African diaspora emphasized that obesity tends to be expressed in environmental conditions that are markedly different from ancestral origin. (Kruger A, Kruger HS, MacIntyre U, et al. S Afr J Sci. 2000;96:505-513. Available at: www.nrf.ac.za/sajs/absepooj.stm. Accessed April 11, 2004.) Black adults therefore have much to gain from weight management strategies that address the complexity of the disorder and are sensitive to cultural issues.


CONCLUSIONS
CNSs with advanced knowledge of the impact of obesity on health and wellness are in a unique position to utilize research-based data in the design of weight management programs for diverse populations. In practice, cultural variables that significantly impact the complex issues of weight control should be addressed in the study and treatment of obesity in black populations. By researching what is available to the community, CNSs can evaluate programs that may require adaptation to encourage greater participation.
Walker-Sterling
Angela
A
D'Youville College, Buffalo, NY, USA. angelaws@hotmail.com
D001741:Black or African American / Q000208:ethnology / Q000235:genetics; D001294:Attitude to Health / Q000208:ethnology; D018752:Diet, Fat-Restricted; D015444:Exercise; D005247:Feeding Behavior / Q000208:ethnology; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008019:Life Style; D009042:Motivation; D009720:Nurse Clinicians / Q000458:organization & administration*; D024802:Nurse's Role; D009765:Obesity / Q000208:ethnology / Q000235:genetics / Q000517:prevention & control; D010353:Patient Education as Topic; D011209:Power, Psychological; D016730:Program Development; D011788:Quality of Life; D012307:Risk Factors; D012649:Self Concept; D016746:Transcultural Nursing / Q000458:organization & administration; D014481:United States / Q000453:epidemiology