Summary Non‐Hispanic Black women have the highest rates of overweight/obesity of any group in the United States. To date, few interventions have worked to reduce overweight/obesity in this population. This study investigated the views of Black women with overweight and obesity treated in a primary care setting regarding desired and undesired verbal and non‐verbal behaviours by providers in provider‐patient clinical encounters focused on losing weight, maintaining weight loss, and/or obesity. Two focus groups and an individual interview (n = 15) were conducted. Qualitative data analysis yielded five distinct themes, with 11 codes (listed in parenthesis): (a) desired weight‐focused discussions (codes: Discussing weight loss with patients and discussing weight‐loss maintenance with patients), (b) desired weight‐focused support (codes: Supporting patients experiencing weight loss and supporting patients experiencing weight gain), (c) undesired weight‐focused discussions (codes: Things to avoid during weight loss discussions and things to avoid during weight gain discussions), (d) desired attitudes and behaviours during weight‐focused discussions (codes: Show caring and understanding and encourage behaviour change for weight loss), and (e) building physician‐patient rapport (codes: Enable patients to feel respected by doctors, enable patients to feel comfortable with doctors and enable patients to trust their doctors). The qualitative approach employed in this study generates a deep understanding not only of the experiences of Black women patients but also of potential strategies that physicians could employ to succeed in their discussions with patients regarding healthy weight achievement and maintenance.

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Black older adults experience poorer health and health-related outcomes than their non-Hispanic White counterparts. Novel, tailored strategies to promote health and prevent adverse health-related outcomes that are aligned with the preferences and values of Black older adults are needed given the limited effectiveness of “one-size-fits-all” approaches. The present study evaluated the impact of a 9-week, community-based participatory research-informed program called the Health-Smart Holistic Health Program for Seniors that aimed to improve health and prevent adverse outcomes among Black older adults by targeting body mass index (BMI), loneliness, food insecurity, and physical and psychological health-related quality of life. Participants ( N = 139) were community dwelling, economically disadvantaged Black older adults living in an underserved area. Results indicated that from pre-intervention to post-intervention there were (a) significant decreases in BMI, loneliness, and food insecurity and (b) significant increases in the participating seniors’ psychological and physical health-related quality of life. Most of these changes were maintained at a 3-month post-intervention follow-up. These results have implications for similar efforts attempting to prevent adverse health outcomes among Black older adults, a high-risk and understudied group. Such efforts should be tailored and should address factors at multiple levels.

The prevalence of obesity is higher among Black women (56.6%) compared to Hispanic women (50%) and non-Hispanic White women (42%). Notably, interventions to reduce obesity typically result in initial weight loss that is not maintained. This study tested (a) the effectiveness of a 6-month Health-Smart Weight Loss (HSWL) Program for Black women patients with obesity implemented by community health workers (CHWs) within primary care clinics and (b) the comparative effectiveness of two 12month physician-implemented weight loss maintenance programs-a Patient-Centred Culturally Sensitive Weight Loss Maintenance Program (PCCS-WLM Program) and a Standard Behavioural Weight Loss Maintenance Program (SB-WLM Program). Black women patients (N = 683) with obesity from 20 community primary care clinics participated in the HSWL Program and were then randomized to either maintenance program. The HSWL Program led to significant weight loss (i.e., 2.7 pounds, 1.22 kg, p < .01, À1.1%) among the participants. Participants in both the PCCS-WLM Program and the SB-WLM Program maintained their weight loss; however, at month 18, participants in the PCCS-WLM Program had a significantly lower weight than those in the SB-WLM (i.e., 231.9 vs. 239.4 pounds or 105.19 vs. 108.59 kg). This study suggests that (a) the HSWL Program can produce significant weight loss among Black women patients with obesity when implemented in primary care clinics by CHWs, and (b) primary care physicians can be trained to successfully promote weight loss maintenance among their Black women patients.

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