Identifying Contextual and Emotional Factors to Explore Weight Disparities between Obese Black and White Women

BACKGROUND: Obese black women enrolled in weight loss interventions experience 50% less weight reduction than obese white women. This suggests that current weight loss strategies may increase health disparities. OBJECTIVE: We evaluated the feasibility of identifying daily contextual factors that may influence obesity. METHODS: In-home interviews with 16 obese (body mass index ≥ 30) black and white urban poor women were performed. For 14 days, ecological momentary assessment (EMA) was used to capture emotion and social interactions every other day, and day reconstruction method surveys were used the following day to reconstruct the context of the prior day’s EMA. RESULTS: Factors included percentage of participants without weight scales (43.8%) or fitness equipment (68.8%) in the home and exposed to food at work (55.6%). The most frequently reported location, activity, and emotion were home (19.4 ± 8.53), working (7.1 ± 8.80), and happy (6.9 ± 10.03), respectively. CONCLUSION: Identifying individual contexts may lead to valuable insights about obesogenic behaviors and new interventions to improve weight management.