title: Health literacy issues surrounding weight management among African American women: a mixed methods study.
abstract: BACKGROUND
  Individuals with limited health literacy (LHL) have poorer health outcomes and have difficulty understanding and complying with recommendations to maintain a healthy lifestyle. The present study examined the association between health literacy (HL) and sources of dieting information, the weight-loss methods used and the information needed to manage weight among African American women.
  
  
  METHODS
  This mixed method study included seven focus groups and a survey of 413 African American women. Binary logistic regression analyses were performed to examine the association between HL category and sources of dieting information, weight-loss methods and information needed to lose weight. Thematic analysis was used to analyse focus group data.
  
  
  RESULTS
  Women with LHL were significantly more likely to have a higher body mass index (BMI) than those with AHL (P < 0.05). Compared to respondents with LHL, those with adequate health literacy (AHL) are more likely to rely on information obtained from the Internet (P < 0.001), although they are less likely to rely on information obtained from the television (P < 0.05). They also are significantly more likely to participate in physical activity to lose weight (P ≤ 0.002). In addition, women with AHL were significantly less likely to want information on portion control (P = 0.002). Major qualitative themes were the importance of television and the Internet as major sources of health information, the use of healthy and unhealthy weight-loss methods, and being overwhelmed by the plethora of dieting information.
  
  
  CONCLUSIONS
  HL may affect BMI among AA women, where they access dieting information and the types of information needed to manage their weight.
authors.affiliation: Department of Health Science Education, University of Florida, Gainesville, FL, USA.
authors.forename: D C S
authors.initials: DC
authors.lastname: James
authors.forename: C
authors.initials: C
authors.lastname: Harville
authors.forename: O
authors.initials: O
authors.lastname: Efunbumi
authors.forename: M Y
authors.initials: MY
authors.lastname: Martin
mesh_terms: D000328:Adult; D001741:Black or African American; D015992:Body Mass Index; D032882:Comprehension; D003625:Data Collection; D015444:Exercise; D005260:Female; D017144:Focus Groups; D006262:Health; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D057226:Information Seeking Behavior; D008019:Life Style; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010349:Patient Compliance; D015431:Weight Loss; D055815:Young Adult
keywords: African Americans; health literacy; obesity; weight management