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Macro Social InterventionJournal

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Social Work

MACRO SOCIAL INTERVENTION

Macro social work intervention:

Social cognition theory applied to the lives of African-American girls to prevent the development of obesity

Macro social work intervention:

Social cognition theory applied to the lives of African-American girls to prevent the development of obesity

While the type II diabetes and obesity epidemic sweeping the nation has been much-discussed in the media, its racial component has only been gingerly addressed. According to a blunt article in the Journal of American Medicine, African-Americans are at far greater risk for developing diabetes and obesity, due to a constellation of genetic, lifestyle, and diet-related factors (Ford 1998, p.361). African-Americans are more likely to lack access to appropriate healthcare management services; access to healthy food; and safe exercise facilities, in comparison to their white counterparts. Without proper weight management, the risk of individuals developing diabetic blindness due to retinopathy, kidney failure, neuropathy, and peripheral vascular disease increases astronomically, as does the chance of developing heart disease, high blood pressure, and high cholesterol. However, while social cognition theory suggests that negative social behaviors can be reinforced through observation of peers and impacted by other environmental factors, so can positive behaviors. Social support is deemed key to ensuring that individuals maintain healthy, rather than unhealthy lifestyle practices (Ford 1998, p.362).

The 2003 Ethnicity and Disease article "An after-school obesity prevention program for African-American girls: The Minnesota GEMS pilot study" by Story (et al.) examines the positive role of community-based health interventions, based on social cognition theory. The program discussed in the article was designed for African-American girls to prevent the development of obesity and its subsequent health complications. Obesity is not conceptualized as an individual illness and a failure of personal willpower by the study designers -- instead obesity is seen as a failure of social support networks. "The intervention was based on social cognitive theory and targeted key constructs from the following 3 domains" 1) environmental factors such as peer support and role modeling; 2) personal values, including self-efficacy and 3) behavioral factors such as goal-setting and reinforcement (Story, 2003, S1-55 )

Social support to aid health improvement can be informal or formal. Also, formal program interventions can reinforce existing networks of informal social support such as the family. Given the significance of social support in the lives of many African-Americans, it is important to examine the relationship between social support and the prevention of obesity. According to the Journal of American Medicine social cognition theory stresses the role of: "interpersonal transactions and includes emotional support, instrumental support, and informational support. Emotional support includes expressions of liking, admiration, respect, or love. Instrumental support, the use of relationships as the means to achieve a goal, often refers to providing money, labor, or time or modifying the physical environment for others, while informational support refers to providing advice, suggestions, directives, or information" (Ford 1998, p.361).

The Girl's Health Enrichment Multi-site Studies (GEMS) a National Heart, Lung, and Blood Institute-sponsored multicenter research program, was created to develop and test 4 intervention programs that were designed to prevent excess weight gain in fifty-four 8- to 10-year-old African-American girls. "The majority of households" in the study "were low-income, with 54% of parents reporting incomes of less than $30,000 per year. Approximately 44% of homes were female-headed households" (Story, 2003, S1-59). Each of 4 field centers independently developed and tested their own interventions, but all were based on common eligibility criteria and the same physical and social before-and-after measurements. Girls randomized into the intervention groups participated in a 12-week after- school programs such as "Girlfriends for KEEPS" (Story et al., 2003, S1-55). The program was based upon physical activity, educating girls in healthy eating and teaching them age-appropriate food preparation models. There was also a focus on educating the girls' families, to create a more positive and less obesegenic environment at home.

Girls were educated about the value of drinking water rather than soda, and encouraged to brainstorm and then follow a program of physically-related activities, rather than watching television (Story et al., 2003, S1-56). Meeting regularly to discuss such activities fostered an environment where positive social behaviors related to weight management were reinforced. In low-income communities, a lack of access to affordable healthy food creates… [END OF PREVIEW]

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