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African American Women, coronary heart disease (CHD), Jalowiec Coping Scale, Norbeck Social Support Questionnaire, obesity, overweight, perceived stress scale, weight class



  1. Strickland, Ora Lea PhD, RN, FAAN
  2. Giger, Joyce Newman EdD, APRN, BC, FAAN
  3. Nelson, Michelle A. MSN, RN, FNP
  4. Davis, Claudia M. MSN, OCN


The purpose of this study was to determine the nature of the relationships among stress, coping, social support, and weight class in premenopausal African American women as risk factors for coronary heart disease. Overweight and obesity are significant problems for African American women who are at an increased risk of weight-related diseases, such as diabetes, hypertension, cardiovascular disease, and cancer. Of these women, those who are premenopausal have a significantly higher coronary heart disease mortality rate than their white counterparts. There are gaps in current knowledge concerning the role that stress and other psychosocial factors play in weight control of premenopausal African American women. Data were obtained from 178 women with eligible data sets from a larger study of 236 subjects (Genetic Predictors of Coronary Heart Disease in Premenopausal African American Women). The measures for stress, coping, and social support included the Perceived Stress Scale, the Norbeck Social Support Questionnaire, and the Jalowiec Coping Scale. The weight class of the women was determined as: normal weight-body mass index (BMI) of 18.5-24.9 kg/m2, overweight-BMI of 25-29.9 kg/m2, or obese-BMI >=30kg/m2. Statistical analysis conducted included Spearman's rho, Chi-square, and regression analysis. Confrontive coping was shown to be used more often to a "high" degree in normal-weight African American women than in overweight and obese African American women ([chi]2 = 24.024; P = .0001). Confrontive coping was the only independent predictor of weight class in a regression model that included perceived stress, life events, social support, and optimistic, self-reliant, and evasive coping strategies. Therefore, African American women who use confrontive coping to a high degree were more likely to confront problems, such as weight control issues, than those who use this coping strategy to a low or medium degree.