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Obes Res. 2001 Jan;9(1):59-67.

Stages of change and weight loss among rural African American women.

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Department of Health Evaluation Sciences, University of Virginia Health System, Charlottesville, Virginia 22908, USA.



Obesity is a prevalent public health problem in the United States, especially for rural African American women, and causes increased morbidity and mortality. The purpose of this analysis was to determine whether the transtheoretical stages of change model was generalizable to weight loss intention among overweight and obese rural African American women and to identify important predictors of the stages of change.


The study was conducted in two rural counties in central Virginia. A population-based sample of 200 women under the age of 40 completed questionnaires concerning weight loss behavior and beliefs about weight. Ordinal logistic regression was used to predict stage of change.


A total of 142 of the 200 women (71%) were overweight or obese (body mass index of > or =25) and were classified into a stage of change. Overall, 30% of respondents were in the precontemplation stage, 15% in the contemplation stage, 48% in the preparation stage, 4% in the action stage, and 3% in the maintenance stage. Education, what friends think about weight, body mass index, and a scale of the positive aspects of weight loss were significant predictors of the stage of change (p < 0.05).


Several predictors of stage were the same as those found in studies of other health behaviors, and this research provides support for applying a stages of change model for weight loss intention among rural African American women. Two predictors in particular, significance of what friends think about weight and a scale of the positive aspects of weight loss, have implications for health education initiatives and social support in weight loss interventions.

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