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Predictors of Depressive Symptoms and Obesity in African-American Women Transitioning from Welfare to Work. Mayola Rowser PhDc, DNP, FNP-BC, PMHNP. Background. Rates of depression and obesity increasing in the U.S. Rates are higher among welfare recipients

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Predictors of Depressive Symptoms and Obesity in African-American Women Transitioning from Welfare to Work

Mayola Rowser PhDc, DNP, FNP-BC, PMHNP


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Background African-American Women Transitioning from Welfare to Work

Rates of depression and obesity increasing in the U.S.

Rates are higher among welfare recipients

39% of recipients are African-American women

African American women have more health problems

than women of other races


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Background African-American Women Transitioning from Welfare to Work

  • Depression and obesity associated with many chronic diseases

  • Employment outcomes negatively impacted

  • Depression and obesity associated with increased health care costs

  • Few studies on depression and obesity among African-American women leaving welfare


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Conceptual Framework African-American Women Transitioning from Welfare to Work

  • Adaptation of Dr. Rice’s Health Assessment Status model

  • Rice’s model influenced by the Health Promotion model

  • Components of the model for the current study include

    • health risk behaviors

    • personal risk factors

    • perceived health status

    • situational influences


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Conceptual Model African-American Women Transitioning from Welfare to Work

  • Health Risk Behaviors

  • Physical inactivity

  • Poor nutrition

  • Smoking

  • Alcohol consumption

Perceived Health Status

Depressive Symptoms

Obesity

  • Personal Risk Factors

  • Demographic

  • Age

  • Education

    Biological

  • Body mass index

Situational Influences

Transition from welfare to work


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Significance African-American Women Transitioning from Welfare to Work

  • Welfare benefits are time limited

  • Recipients forced to find jobs

  • 90% of recipients have one or more barriers to work

  • Depression and obesity are barriers to sustained employment


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Research Questions African-American Women Transitioning from Welfare to Work

1. What is the prevalence of depressive symptoms in

African-American women transitioning from welfare to work?

2. What is the prevalence of obesity in African-American women

transitioning from welfare to work?

3. What is the association between depressive symptoms and

obesity in African-American women transitioning from welfare to

work?


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Research Questions African-American Women Transitioning from Welfare to Work

4. What is the prevalence of health risk behaviors

in African-American women transitioning from

welfare to work?

5. To what extent do health risk behaviors, personal risk factors, and perceived health status predict depressive symptoms ?

6. To what extent do health risk behaviors, personal risk factors, and perceived health status predict obesity?


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Methodology African-American Women Transitioning from Welfare to Work

Design

  • Retrospective cross-sectional, descriptive, correlation study

    Sample and Setting

  • Convenience sample of 162 welfare recipients

  • UTHSC Health Works Program participants

  • Data obtained from health assessments


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Criteria African-American Women Transitioning from Welfare to Work

  • African-American women

  • 18 years of age or older

  • Able to speak and read English

  • Enrolled in the UTHSC Health Works Program


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Instruments African-American Women Transitioning from Welfare to Work

  • The Healthier People Network Health Risk Appraisal

  • The Health Self Report

  • The Center for Epidemiologic Studies Depression Scale (CES-D)


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Data Analysis African-American Women Transitioning from Welfare to Work

Statistical Package for Social Sciences (SPSS)

  • Descriptive Statistics

  • Pearson Correlation

  • Stepwise Multiple Regression

  • Logistic Regression


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Sample Characteristics African-American Women Transitioning from Welfare to Work

  • N = 162

  • Ages ranged from 18 – 55

  • Mean age 28.87

  • 32% completed high school

  • 24% reported “some college”

  • 37% rated their health poor-fair



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Prevalence of Obesity in African-American Women Transitioning from Welfare to Work


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Association between Depressive Symptoms and Obesity in African-American Women Transitioning from Welfare to Work


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Correlation Analysis between Sample Characteristics and Depressive Symptoms and Obesity

† Physical activity (n=157)

*p≤.05

**p≤.01




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Predictors of Obesity in African-American Women Transitioning from Welfare to Work


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Predictors of Obesity in African-American Women Transitioning from Welfare to Work


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Conclusions Transitioning from Welfare to Work

  • High levels of education among the women

  • Age correlated with obesity

  • No correlation between depressive symptoms and obesity

  • Perceived health correlated with depressive symptoms and obesity


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Limitations Transitioning from Welfare to Work

  • Instrumentation

  • Convenience sample

  • Cross sectional design


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Strengths Transitioning from Welfare to Work

  • Limited studies conducted on African-American women on welfare

  • Few studies on depressive symptoms and obesity in African-American women preparing for work

  • Predictors of depressive symptoms and obesity examined


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Practice and Policy Implications Transitioning from Welfare to Work

  • Recognition of depressive symptoms among African-American women

  • Unmet need for mental health services

  • Awareness of sociocultural influence on perceptions of weight

  • Funding for programs to address barriers to work


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Implications for Future Research Transitioning from Welfare to Work

  • Prospective studies needed to determine causal relationships

  • Qualitative studies to address perceptions of health

  • Risk reduction interventions


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Questions Transitioning from Welfare to Work


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Thank you!!! Transitioning from Welfare to Work


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