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Research In Health Disparities

The College Health and Wellness Study

Overweight and obesity is epidemic in the United States, particularly among minority populations. This epidemic contributes to the development of chronic conditions that occur later in life such as type 2 diabetes and hypertension. The center conducted a cross-sectional survey among students graduating from a historically black college or university (HBCU) in the Mid-Atlantic region. The participants were 392 predominantly African-American seniors who graduated in the spring of 2003. Data were collected using a self-administered paper-and-pencil questionnaire which focused on weight, weight management activities, weight history and health status indicators.

Principal Investigators:
Yvonne Bronner, PhD; MSU
Tiffany L. Gary, PhD; JHSPH

Obesity is a significant problem in the U.S.; national data has pinpointed a 61% increase in prevalence from 1991-2000 (Mokdad, 2001). African-American (AA) women are particularly affected. In fact, recent data from the 1999-2000 National Health and Nutrition Examination Survey (NHANES) suggests that the prevalence of obesity is 46 % in AA women aged 20-39, compared to 24% of white women (Flegal, 2002). Furthermore the percentage of AA women aged 20 or older who are at least overweight is over 75%. Obesity has been identified as a precursor to many chronic diseases and is probably the strongest risk factor for type 2 diabetes. It is also well known that compared to their white counterparts, African Americans are disproportionately affected by the burden of type 2 diabetes, regardless of sex (Carter, 1996). Therefore, it is crucial to examine weight-related factors in African Americans early in life in order to prevent chronic disease that may develop in the middle years.

We have conducted a study among young adults (primarily African American) who are graduates of The Morgan State University in 2003 with the following specific aims:

  1. To conduct a cross-sectional study, with a primary emphasis on overweight, obesity, and other weight-related factors
  2. To follow-up individuals over time, in a prospective cohort study, to evaluate changes in weight and other factors

Research Questions

view questionnaire

Main Question:
This study will attempt to explore the following main research question among young African-American adults:

  1. What factors are associated with overweight and obesity in this population and do these factors predict weight gain over time?

Secondary Questions:
This study population will provide unique data for a number of secondary research questions including:

  1. What are the perceptions of health care providers and health care systems and how do these perceptions change with age and increased utilization of health services?
  2. What are the drug and alcohol practices during college and do those practices change after exposure to the workforce environment

Methods

Setting and Participants:

Participants will primarily consist of young (~age 22) African-American adults who are graduates of The Morgan State University in 2003. The entire graduating class will be eligible to participate, regardless of obesity status. It is estimated that between 800 and 950 undergraduate students will graduate in 2003. A brief description of Morgan State University follows below:

Design:

Initially, a cross-sectional survey will be conducted as part of the exit interview (or other planned activity for seniors) for college graduates of Morgan State. Participants will attend one clinic visit in which height, weight, blood pressure, and other clinical measures will be obtained. Subsequently, participants will be followed-up over time (at 3-5 year intervals) to track weight and other factors of interest. At this point, self-reported weight and height will be obtained and web-based methods will be employed to ensure that the survey is easily accessible for participants.

Measures:

Weight-Related Factors

  • Trying to lose weight/doctor recommending losing weight
  • Weight loss attempts
  • Participation in weight loss programs
  • Body Image (Stunkard scale)
  • Pregnancy and pregnancy-related weight gain (in women)
  • Diet patterns
  • Exercise patterns
  • Weight history
  • Weight history of family

Demographic and Socioeconomic Status

  • Parents/Guardians' Educational Attainment
  • Parents/Guardians' Occupation
  • Income (separate from their parents)/wealth
  • Insurance Status
  • Race/Ethnicity
    • Caribbean (British or French)
    • African
    • Latino
    • Brazil
  • College Major
  • GPA
  • Career Objectives
    • Immediate
    • Five Years From Now
  • Marital Status
  • Parental Status

Interaction with the Health Care System

  • Health care utilization
  • Perceptions of health care providers and the health care system
  • Satisfaction with health care

Drug/Alcohol Use

Mental Health

  • Depression (CES-D, Prime-MD, GHQ, SF-12/SF-36)
  • Anxiety

Stress/Racism

  • Perceived racism scale
  • MRWG reactions to race module (CDC developed)

Clinical Measures

  • Weight
  • Height
  • Waist/Hip
  • Body fat
  • Blood pressure

Health Status

  • GHQ, SF-12/SF-36

Significance

This study will provide unique data in this relatively unexplored population. Exploring factors that may contribute to obesity and weight gain over time will help to develop interventions to reduce the excess burden of chronic disease in African Americans.