Correlates of African American Breast Cancer Survivors' Intentions to Prevent Weight Gain: Elicitation Study Results and Questionnaire Development

Abstract

Background: Disparities exist in mortality rates in African American breast cancer survivors (AABCS), partly due to modifiable lifestyle behaviors. Gaps remain in developing effective tools to assess AABCS' motivations to prevent weight gain. Conceptual Framework: This research study used the Theory of Planned Behavior (TPB) to guide development of the elicitation study and the AABCS-Weight Gain Prevention Intention Questionnaire (AABCS-WGPIQ). Purpose: Aim One was to use the elicitation approach of the TPB to identify, define and describe AABCS' salient behavioral (advantages/disadvantages), normative (social influence) and control (facilitators/barriers) beliefs related to the prevention of post diagnosis weight gain. Aim Two was to develop and pilot test a questionnaire based on qualitative data to quantify the magnitude of influences of attitudes, subjective norms and perceived behavioral controls related to intentions to prevent weight gain in AABCS. Methods: Guided by the TPB, this cross-sectional, descriptive study used an internet based qualitative elicitation questionnaire to identify salient beliefs of 27 AABCS regarding their motivations to prevent weight gain and inform development of the quantitative AABCS-WGPIQ. Initial psychometric testing of the questionnaire included content and face validity and temporal stability assessment of belief constructs, using the test-retest approach. Findings: Aim One: Motivators to preventing weight gain among AABCS included improving health and well-being (advantages), social support from family and friends (approvals), external support systems, and personal accountability (facilitators). Time and effort required preventing weight gain (disadvantages), lack of social support (disapprovals), and time constraints, lack of accountability, unhealthy eating and health issues (barriers) negatively influenced AABCS' decisions to prevent weight gain. Future interventions aiming to increase motivation to prevent weight gain in AABCS should emphasize positive benefits of preventing weight gain, include social support systems, focus on skill building for time management, planning and goal setting, managing health issues and incorporate weight loss management strategies. Aim Two: The AABCS-WGPIQ has acceptable content validity, face validity and temporal stability of belief constructs. The AABCS-WGPIQ has the potential to be a valid instrument for assessing correlates of weight gain prevention in AABCS. Future research with larger groups of AABCS should include assessing internal consistency and construct validity.