Body Image 11 (2014) 307–317

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Nobody’s perfect: A qualitative examination of African American maternal caregivers’ and their adolescent girls’ perceptions of body image Michell Pope ∗ , Rosalie Corona, Faye Z. Belgrave Department of Psychology, Virginia Commonwealth University, 810 West Franklin Street, PO Box 23284, Richmond, VA 23284, USA

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Article history: Received 12 September 2013 Received in revised form 22 April 2014 Accepted 24 April 2014 Keywords: Body image African American girls Parent–adolescent communication Peers Media

Using semi-structured interviews, we explored African American maternal caregivers’ and their adolescent girls’ (N = 25 dyads) perceptions about the adolescent’s body using Grounded Theory. Caregivers and adolescent girls (Mage = 13.42) were asked what the adolescent girls liked most/least about their bodies and how peers and media may affect adolescent girls’ perceptions. While some adolescent girls reported overall body satisfaction, others described features they would like to change. Belief in God, body acceptance, and appreciation for average/moderate features helped the adolescent girls maintain their positive body image. The body-related messages that adolescent girls received from caregivers and peers included compliments, pressure to lose weight, teasing, and advice. Adolescent girls also reported being either influenced by or skeptical of the images presented in the media. Programs that promote caregiver–adolescent communication about body perceptions and that build on the adolescent girls’ media skepticism may prove useful for their health-related attitudes and behaviors. © 2014 Elsevier Ltd. All rights reserved.

Introduction The high rate of body dissatisfaction among African American adolescent girls continues to be a public health concern. For example, Banitt, Kaur, Pulvers, Nollen, Ireland, and Fitzgibbon (2006) found that 55% of African American adolescent girls (10–19 years old) expressed a desire to have a thinner body. Likewise, 75% of preadolescent African American girls (ages 6–9) reported that they were dissatisfied with their current body size (Katz, Gordon-Larsen, Bentley, Kelsey, Shields, & Ammerman, 2004). Thus, even though African American girls’ body dissatisfaction may be lower than adolescent girls from other racial/ethnic groups (Duke, 2000; Roberts, Cash, Feingold, & Johnson, 2006), they do experience body dissatisfaction. It has been suggested that lower rates of body dissatisfaction in the African American community are the result of cultural differences in beauty standards. For example, aspects of the African American culture and family (e.g., larger body ideals, emphasis

∗ Corresponding author. Present address: Virginia Commonwealth University, 810 West Franklin Street, PO Box 23284, Richmond, VA 23284, USA. Tel.: +1 00448043379093. E-mail address: [email protected] (M. Pope). http://dx.doi.org/10.1016/j.bodyim.2014.04.005 1740-1445/© 2014 Elsevier Ltd. All rights reserved.

on ethnic identity, racial socialization, African American males’ preference for larger/thicker body types) are associated with African American adolescent girls’ self-esteem (BeauboeufLafontant, 2003; Granberg, Simons, & Simons, 2009; Hesse-Biber, Howling, Leavy, & Lovejoy, 2004), which in turn protects or buffers them from internalizing the thin ideal and developing body dissatisfaction (Rubin, Fitts, & Becker, 2003; Sabik, Cole, & Ward, 2010). Parker et al. (1995) suggest that African American adolescent girls tend to have a more multi-faceted and flexible view of beauty and body ideals; specifically, they place more emphasis on “making what they have work” (p. 110), and less focus on body weight and size. Body concerns developed during early adolescence can have a lasting impact on body image perceptions into adulthood (Smolak, 2011; Wertheim, Paxton, & Blaney, 2009). As behaviors associated with negative body image are maintained, they may become more difficult, or resistant to change (Keel, Dorer, Franko, Jackson, & Herzog, 2005; Wertheim & Paxton, 2011). Given the high prevalence of negative body perceptions and attitudes among adolescent girls (e.g., Grabe & Hyde, 2006; Wertheim et al., 2009), and the associated negative behaviors (e.g., lowered self-esteem, disordered eating) and possible long-term effects (Ohring, Graber, & BrooksGunn, 2002; Wertheim et al., 2009), more research is needed on factors that may influence the development of adolescent girls’

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body image perceptions, especially among racial/ethnic minority girls such as African Americans (Granberg et al., 2009; Katz et al., 2004). African American adolescent girls also tend to evaluate their self-worth on factors that are not typically associated with beauty such as attitude, personality, hygiene/grooming habits, uniqueness, and style (Duke, 2000; Hesse-Biber et al., 2004; Overstreet & Quinn, 2012; Sabik et al., 2010). Aspects of appearance such as hair and skin color have also been recognized as important non-weight related features of African American adolescent girls’ body image perceptions. Within the African American community, adolescent girls and women with more European features, light skin, and long straight hair are considered more attractive/desirable than adolescent girls and women with darker skin tones, and coarse thick hair (Bellinger, 2007; Hesse-Biber et al., 2004; Okazawa-Rey, Robinson, & Ward, 1987; Stephens & Few, 2007). Although these non-weight and attitudinal characteristics are important to African American adolescent girls’ and women’s body perceptions, studies examining body satisfaction often fail to measure these aspects of body image. This omission is not surprising since much of the prior work has been conducted primarily with European American adolescents girls and women. As a result of this homogenous sampling, few measures have been developed to assess non-weight related aspects of body image in African American adolescent girls (Jefferson & Stake, 2009; Roberts et al., 2006). The few studies that have examined non-weight related body image attributes have mostly used African American college-aged or adult samples. For example, Jefferson and Stake (2009) found that 84% of African American women (versus 32% of European women) reported being satisfied with their skin tone. Among the 16% of African American women who were dissatisfied, 92% indicated that they would like to have a lighter skin tone. Moreover, African American women viewed their hair as more important than other features including their eyes, lips, and nose. Despite these findings, little is known about whether African American girls also attend to hair and skin tone as part of their body image perceptions. African American girls look to their maternal caregivers (e.g., mothers, grandmothers) and use them as a standard by which to measure their own beauty and beauty ideals (Duke, 2000; Milkie, 1999) including skin color (Wilder & Cain, 2011). These maternal messages about beauty standards and cultural ideals in turn can be positively or negatively associated with adolescent girls’ body image perceptions (Hesse-Biber et al., 2004; Stephens & Phillips, 2005). For example, Neumark-Sztainer and colleagues (2010) found that in a racially/ethnically diverse sample of adolescent girls, parent weight talk, weight teasing, and parental dieting were common in families. Moreover, messages conveyed by parents and family members were strongly associated with adolescent girls’ higher body mass index (BMI), body dissatisfaction, unhealthy and extreme weight control behaviors, and binge eating. In fact, girls whose mothers encouraged them to diet were five times more likely to engage in extreme weight control behaviors than girls whose mothers did not. In one of the few studies examining African American families’ body image communication, Katz et al. (2004) used both qualitative (semi-structured interviews) and quantitative (body image silhouettes) methods to examine African American pre-adolescent girls’ (ages 6–9) and their maternal caregivers’ body image perceptions/ideals. They found that maternal caregivers served as important role models (positively and negatively) for adolescent girls’ body image and their health-related attitudes and behaviors. African American adolescent girls also learn about cultural/societal norms and behavioral expectations about body perceptions and beauty via popular media. Various studies (both cross sectional and meta-analyses) have shown the risks associated with extensive media exposure and adolescent girls’ negative body

perceptions or dissatisfaction (Botta, 2000; Grabe, Ward, & Hyde, 2008; Hargreaves & Tiggemann, 2003a, 2003b). Media messages linking physical attractiveness with success, popularity, or happiness (Griffin & Langlois, 2006, Hargreaves & Tiggemann, 2003a, 2003b; Irving, DuPen, & Berel, 1998), and the importance girls place on these characteristics, likely influence girls’ body image and create an environment in which only physical characteristics are valued (Wertheim & Paxton, 2011). Two theoretical perspectives, social comparison theory and cultivation theory, explain the role of the media as socialization agents. Social comparison theory (Festinger, 1954) can be used to argue that adolescent girls evaluate themselves by comparing their bodies with the bodies of others. Adolescent girls may experience feelings of dissatisfaction when comparing their bodies with others’ bodies, particularly those that are unrealistic or unattainable (Knauss, Paxton, & Alsaker, 2007; Thompson & Stice, 2001). As the number of African American women in the media increases, African American adolescent girls may begin to use these images for social comparison (Peterson, Wingood, DiClemente, Harrington, & Davies, 2007). African American adolescents are exposed to and consume more daily media than any other racial/ethnic group (nearly 4.5 h per day more than European Americans adolescents; Kaiser Foundation, 2010), suggesting that cultivation theory is also relevant. Given the high rates of media use among African American adolescents and the association between media exposure and poor body image, it is important to explore African American adolescent girls’ perceptions of how media affect how they feel about their body. Peer groups also act as socializing agents directly (e.g., weight teasing) and indirectly (e.g., modeling unhealthy behaviors) and can be negatively associated with their friends’ body image perceptions (Cash & Smolak, 2011). Blodgett-Salafia and Gondoli (2011) found that both maternal and peer messages predicted 5th–8th grade girls’ dieting behaviors and eating disorder symptoms. Likewise, a study with a tri-ethnic sample (African American, Latino American, and European American) of college-aged women (and men) found a positive relationship between peer dieting, peer teasing, and young adults’ body dissatisfaction (Gillen & Lefkowitz, 2009). Given social comparison processes, it is not surprising that adolescent girls in the same peer groups tend to exhibit similar levels of body esteem, body dissatisfaction, unhealthy eating behaviors (e.g., binge eating, dieting), and dieting behaviors (Paxton, Schutz, Wertheim, & Muir, 1999; Wertheim et al., 2009). Finally, other factors can also play a role in African American girls’ body image perceptions, attitudes, and risk behaviors. These factors include (a) individual and family level factors (e.g., socioeconomic status [SES], education level); (b) structural and community level factors (e.g., living in food deserts with reduced access to fresh fruits and vegetables, fewer options for physical activity, neighborhood violence); as well as (c) psychosocial stressors (e.g., family conflict, financial stress, perceived inequality; Flynn & Fitzgibbon, 1996; Joshu, Boehmer, Brownson, & Ewing, 2008; Wang & Chen, 2011). For example, girls and adults of lower SES are more likely to eat sugary, high calorie foods, less healthful foods, and have a higher BMI/be considered overweight (yet perceive themselves as healthy/underweight), than individuals from mid- to higher-SES groups (Drewnowski & Specter, 2004; Fiscella & Williams, 2004; Flynn & Fitzgibbon, 1996). The Current Study The overall goal of this study was to identify whether African American maternal caregivers and their adolescent girls believe that family, media, and peers affect African American adolescent girls’ body image perceptions. First, we examined dyads’ perceptions about how adolescent girls felt about their bodies, including non-weight related aspects salient in African American culture such

M. Pope et al. / Body Image 11 (2014) 307–317

as hair and skin tone. Second, we identified the types of messages that caregivers communicate to their adolescent girls about body image. Finally, we examined caregivers/adolescent girls’ views on whether media and peers may influence adolescent girls’ body image perceptions. We were specifically interested in developing a better understanding of the types of messages about physical attractiveness the girls received, as well as how these messages may influence girls’ feelings about their body and their eating, dieting, or grooming behaviors. Given the link between community level factors and body image, we targeted maternal caregiver–adolescent girl dyads living in an urban area in the Southeastern United States where there are high rates of community violence, poverty, and less healthy food alternatives. We used qualitative methods to obtain a deeper understanding of the types of messages significant others convey, but also girls’ interpretations of these messages (whether or not messages are helpful or harmful). This type of narrative information is not something easily obtained using quantitative methods (NeumarkSztainer, Bauer, Friend, Hannan, Story, & Berge, 2010). We used Grounded Theory (Strauss & Corbin, 1990) because it allows researchers to gain the dyads’ perspectives which is important given that multiple realities exist (McCarthy, Holland, & Gillies, 2003), and that caregivers and girls may have very different experiences, recollections, and interpretations of their communication (Cooley, Toray, Wang, & Valdez, 2008).

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Apparatus. Two Sony digital, flash voice recorders were used to capture and save both caregiver and adolescent responses. The interview recordings were downloaded onto a secure laptop and the recordings were then deleted from the recorders. Procedure After receiving IRB approval, dyads were recruited from a metropolitan area in the southeastern United States through flyers posted at various youth-serving organizations and through snowball sampling techniques. Most dyads (n = 18) were told about the study by friends and therefore contacted the project coordinator to participate. Seven dyads were recruited at community events. Flyers included information about the eligibility criteria (i.e., self-identify as African American, adolescent girls were between 11 and 14 years of age), the purpose of the study to examine caregiver–adolescent communication, a number to call if interested, and information about the incentives. Interviews were scheduled at times and locations convenient for the participants (i.e., participant’s home, n = 3 dyads; local community center, n = 13 dyads; researcher’s office, n = 9 dyads). Maternal caregivers and adolescent girls were interviewed at the same time but in different rooms. All interviews were digitally recorded and the entire study procedure lasted approximately 1–2 h. After completion of the study, each participant received $25 to compensate them for their time and effort.

Method Data Analysis Participants Twenty-five African American maternal caregiver–adolescent girl dyads participated in the study (only one adolescent girl per household was eligible to participate). Adolescent girls were between the ages of 11 and 14 years (Mage = 13.42, SD = 1.17). The majority of maternal caregivers (88%) were the adolescents’ biological mothers, and the remaining were grandmothers (12%). Caregivers ranged in age from 30 to 65 years (Mage = 42.91, SD = 8.16). Slightly more than half (52%) of maternal caregivers reported their marital status as single, divorced, or legally separated (versus 48% who were married). Twenty-four percent of maternal caregivers reported

Nobody's perfect: a qualitative examination of African American maternal caregivers' and their adolescent girls' perceptions of body image.

Using semi-structured interviews, we explored African American maternal caregivers' and their adolescent girls' (N=25 dyads) perceptions about the ado...
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