Date

9-17-2026

Department

School of Health Sciences

Degree

Doctor of Philosophy in Health Sciences (PhD)

Chair

Linnaya Graf

Keywords

barriers, facilitators, health literacy, overweight, obesity, Black Americans, Health Belief Model (HBM), Information Motivation Behavior Skills (IMB) Model, and theoretical frameworks.

Disciplines

Nutrition | Public Health

Abstract

The purpose of this qualitative mini ethnography adapted from traditional ethnography with limited time and scope, was to explore and understand perceptions of barriers and facilitators to health literacy among Black Americans with overweight and obesity in three South Carolina counties. Population data showed that approximately 40.3% of U.S. adults are obese. Moreover, Non-Hispanic Black communities are disproportionately affected by overweight and obesity despite efforts to combat the weight-related health risk. Still, limited health literacy should be the focus of public health strategies like teach-back and plain language communication, to address overweight and obesity prevalence and disparities. The study was guided by the health belief model (HBM) and the information-motivation-behavior skills (IMB) as both theoretical frameworks explain different but complimentary aspects of health behavior: HBM explains perceptions that drive behavior intention, while IMB explains the cognitive and skill-based factors required to change behavior intention to action. Research participants were recruited by purposive sampling. Each participant completed an audio-recorded semi-structured interview. Thematic saturation was achieved through data collection and analysis of 10 audio-recorded semi-structured interviews. Four primary themes emerged as reported perceptions of barriers and facilitators to health literacy: (1) perceptions of weight status or health condition, (2) perceptions of knowledge and understanding of the association between weight status and health condition, (3) healthcare providers’ communication, and (4) cultural traditions and family values and beliefs of health and disease. Overall, the findings suggested that understanding reported perceptions of barriers and facilitators to health literacy can inform health care practice and policies.

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