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Rationale and Objective: Black men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South., Methods: We conducted individual telephone interviews with 23 Black men (mean age 50 ± 14 years) with overweight or obesity living in rural South Carolina communities in 2020 and 2021. Interviews were audio recorded, professionally transcribed, and coded by two men's health researchers who achieved an intercoder reliability of 70%. Content analysis using QSR NVivo 12 was used to generate themes using deductive and inductive approaches., Results: Physical health and health behaviors were perceived as key determinants of overall health. Family, friends, and other social contacts often provided positive social support that increased motivation but also hindered motivation by engaging in behaviors men were trying to avoid. Younger participants had stronger views of rural environments not supporting healthy lifestyles, which compounded personal challenges such as time constraints and lack of motivation. Comfort was discussed as a critical program consideration, and gender concordance among program participants and facilitators was perceived as promoting comfort. Participants noted preferences and benefits of in-person, group programs emphasizing physical activity, and younger participants more strongly endorsed programs that incorporated sports and competition., Conclusions: Findings from this study provide important evidence to inform the development of weight management interventions for Black men in the rural US South. Based on these findings, an innovative, competitive "football-themed" weight management program promoting peer support and integrating competitive physical activities is being evaluated for younger Black men in the rural South., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: To examine interest, resources, and preferences for weight loss programs among primary care patients with obesity., Methods: Primary care patients having a BMI ≥30 kg/m 2 were recruited in the summer and fall of 2018. Eligible patients were invited to complete an anonymous survey assessing sociodemographic factors, interest in weight loss, resources, and preferences for weight loss programs. Descriptive statistics were used for analysis., Results: A total of 77 patients completed the anonymous survey. Nearly 90% of patients were interested in participating in a weight loss program and reported having a smartphone. Approximately 80% had high-speed internet and a device with videoconferencing capabilities, whereas only 40% had a tablet or laptop computer. On average, patients preferred weight loss programs delivered in-person and led by a nutritionist or personal trainer. Patients' top three preferences for weight loss content included goal setting, staying motivated, and finding ways to be more active., Conclusions: Although primary care patients with obesity were interested in weight loss programs, availability of resources and preferred program characteristics varied., Practice Implications: This study provides insight on patient interest, resources, and preferences for weight loss programs that may help guide the development of future programs., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: To compare anthropometric measures of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and sagittal abdominal diameter (SAD) as predictors of blood pressure in college students., Participants: Students (N = 116) were recruited from November 2012 to May 2014 at an urban university and rural community colleges., Methods: Students underwent a brief physical examination during which anthropometric measures were obtained and blood pressure was measured. Covariates were measured using self-reported questionnaires. Hierarchical multiple linear regressions were used for the data analysis., Results: All anthropometric measures were predictive of systolic (SBP) and diastolic blood pressure (DBP). WC was the strongest predictor of SBP (β = .582, p < .01) explaining an additional 3-4% of the variance than BMI, WHtR, or SAD. The measures were similar in predicting DBP. WC predicted SBP independent of BMI., Conclusions: Clinicians should consider using WC to assess the risk for hypertension in college students.

Introduction: The prevalence of obesity is greater among adults living in rural compared to urban areas of the USA. Greater obesity risk among rural adults persists after adjusting for obesity-related behaviors and sociodemographic factors. With the rural-urban obesity disparity greatest among younger adults, it is important to examine the complexity of factors that may increase the risk for excess body weight in this population so that effective preventive interventions can be implemented. College students residing in economically deprived rural areas such as rural Appalachia may be particularly at risk for excess body weight from exposure to both rural and college obesogenic environments. The purpose of this study was to determine if living in economically distressed rural Appalachia is independently associated with excess body weight among college students., Methods: College students aged 18-25 years who were lifetime residents of either rural Eastern Appalachian Kentucky ( n= 55) or urban Central Kentucky ( n= 54) participated in this cross-sectional study. Students completed questionnaires on sociodemographics, depressive symptoms, and health behaviors including smoking, fruit and vegetable intake, and physical activity. Height and weight were obtained during a brief health examination to calculate body-mass index (BMI). Excess body weight was defined as being overweight or obese with a BMI of 25 kg/m2 or greater. Binary logistic regression was used to determine if living in economically distressed rural Appalachia was independently associated with excess body weight., Results: The prevalence of excess body weight was higher in the rural Appalachian group than the urban group (50% vs 24%, p< 0.001). Depressive symptom scores and smoking prevalence were also greater in the rural Appalachian group. There were no differences in fruit and vegetable intake and vigorous physical activity between the groups. Residing in economically distressed rural Appalachia was associated with more than a six-fold increased risk of overweight or obesity, controlling for sociodemographics, depressive symptoms, and health behaviors (odds ratio=6.36, 95%CI=1.97-20.48, p= 0.002)., Conclusions: Living in economically distressed rural Appalachia was associated with excess body weight in college students independent of sociodemographic factors, depressive symptoms, and obesity-related behaviors. Further research is needed to determine other characteristics of this region that are associated with excess body weight so that effective programs to reduce obesity risk can be implemented.