Mediating roles of psychological factors and physical and social environments between socioeconomic status and dietary behaviors among African Americans with overweight or obesity.

The study aim was to examine the relationship between socioeconomic status (SES) and dietary behaviors through psychological and environmental mediators among African Americans with overweight or obesity. We conducted a cross-sectional study in 225 African American men and women. Data were analyzed using structural equation modeling with bootstrapping procedures. In the multiple mediation model, SES had a significant indirect effect on dietary behaviors through psychological and environmental factors (β = -.27; p = .01; 95% confidence interval [CI] = -0.59--0.10), but it had no significant direct effect on dietary behaviors (β = .06; p = .70; 95% CI = -0.21-0.39). SES had significant direct effects on psychological (β = .52; p = .01; 95% CI = 0.31-0.77) and environmental factors (β = -.40; p = .03; 95% CI = -0.53--0.25). Psychological (β = -.31; p = .02; 95% CI = -0.68--0.04) and environmental factors (β = .26; p = .01; 95% CI = 0.04-0.47) also showed significant direct effects on dietary behaviors. Thus, psychological and environmental factors mediated the relationship between SES and dietary behaviors in African Americans with overweight or obesity. Interventions that enhance psychological and environmental factors such as self-efficacy, perceived barriers to healthy eating, health perceptions, and physical and social environments may improve dietary behaviors among socioeconomically disadvantaged African Americans.