Lessons Learned from the Design and Implementation of a Health Promotion Intervention for African American Women

The purpose of this dissertation is to explore how intervention design can be enhanced to influence the health of African American women through examining the processes and methods related to health behavior theory, cultural adaptation, and participatory approaches. Data from African American women who participated in the Better Me Within (BMW)Trial, as well as, formative data from focus groups with African American women were used to investigate these intervention planning approaches through the following aims: Aim 1 addressed the question how do theoretical constructs of behavior change help to explain health outcomes in the BMW trial? This was quantitatively explored by examining theoretical constructs with outcomes of weight, diet and physical activity. Aim 2 explored the perspectives of African American women through qualitative analysis of focus groups for cultural and contextual elements that may influence the approach to intervention design, increase knowledge about cultural adaptations, and contribute methods to enhance weight management. Aim 3 critically examined how the community-based participatory research (CBPR) approach with African American faith communities in the BMW Trial aligned with the CBPR conceptual model through a case study. Understanding how processes, operations, and decisions in intervention design contribute to health improvements is imperative for ensuring programs are relevant and effective in specific populations. One size does not fit all. The current state of health inequities and chronic conditions in African American women require thoughtful intervention strategies that center community knowledge, culture, and context. This dissertation seeks to arrive at intervention strategies that are relevant to African American women, and influence how public health professionals approach intervention development for meaningful, community-identified health improvements.