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. Author manuscript; available in PMC: 2024 Dec 1.
Published in final edited form as: J Acad Nutr Diet. 2023 Jul 16;123(12):1763–1771. doi: 10.1016/j.jand.2023.07.003

“It’s gonna be okay” – A qualitative exploration of the COVID-19 pandemic’s effects on African American participants during a dietary intervention study

John A Bernhart 1,2, Mary Quattlebaum 3, Sarah Eustis 5, Nkechi Okpara 1, Mary J Wilson 4, Claudia Sentman 1, Gabrielle M Turner-McGrievy 1
PMCID: PMC10789910  NIHMSID: NIHMS1918041  PMID: 37437808

Abstract

Background:

African American adults are at increased risk for chronic diseases. Limited research exists regarding how the COVID-19 pandemic affected African American adults in behavioral interventions.

Objective:

This study assessed how the early months of the COVID-19 pandemic, prior to vaccine availability and widespread testing, affected stress, nutrition, and exercise behaviors of African American adults participating in a dietary intervention study.

Design:

This was a qualitative interview study conducted with participants from both diet groups as part of the ongoing Nutritious Eating with Soul (NEW Soul) study. NEW Soul is a two-year, randomized dietary intervention study with participants randomized to follow a vegan (intervention) or low-fat omnivorous diet (control), with both diets focused on soul food.

Participants/setting:

Participants (n=20) came from two cohorts of the larger intervention study in South Carolina and were purposefully recruited based on high and low attendance at intervention sessions. Participants in the first cohort were near the end of the intervention, and participants in the second cohort were near the mid-point. The interviews were conducted from June to July 2020.

Main outcome measures:

Outcomes included participants’ experiences related to stress, nutrition, and exercise behaviors during the early months of the COVID-19 pandemic.

Analysis:

Interviews were recorded and transcribed verbatim. Interview transcripts were coded by two coders using NVivo. Interviews were coded through content analysis using a constant comparative method.

Results:

Participants discussed three themes in relation to health behaviors: (1) increased stress, (2) change in routines, and (3) advice to follow health goals.

Conclusions:

Findings provide perspectives for designing interventions for African American adults establishing new routines to overcome setbacks and changes in routines created by the COVID-19 pandemic.

Keywords: stress, nutrition, exercise, health disparities, African Americans

Introduction

Obesity and cardiovascular disease disproportionately affect African American (AA) adults compared to other race and ethnicity groups.1,2 In the United States (U.S), people living in the American South have higher rates of chronic disease and poorer health compared to other regions of the U.S.3 The American South has been referred to as the stroke belt due to high mortality caused by stroke and other chronic diseases that could be mitigated through lifestyle behaviors such as healthy eating and physical activity.4 Beginning and maintaining healthy eating and physical activity behavior changes is disproportionately difficult among AA adults as this population faces barriers of a lack of knowledge and self-efficacy5 and low social support for health behavior changes.6 In addition, environmental racism contributes to increased stress and chronic disease in AA adults, further impacting health disparities.7,8 Similar to other health disparities, COVID-19 mortality is higher in AA adults compared to other race and ethnicity groups.9,10 Research informed by community input when designing and delivering behavioral interventions among AA adults is needed.

Although adherence to research protocol in the implementation of interventions is the gold standard, events can occur that may disrupt intervention delivery and participant outcomes. For example, natural disasters may lead to the closing of facilities where health interventions may be delivered, thereby inhibiting access to health programs. In addition, natural disasters negatively affect community members’ social, emotional, and physical health.11,12 Disasters such as hurricanes increase stress levels13 and disparities in food access among AA populations.14,15 Therefore, researchers, practitioners, and clinicians need to have the ability to adapt and continue to reach the community when access is limited.

The COVID-19 pandemic that began in March 2020 was a highly disruptive event with consequences that impacted participants’ engagement in research.16 The COVID-19 pandemic led to the shutdown of businesses, places of education, and houses of worship across the U.S. disrupting routines and behaviors. In addition, stay-at-home orders required people to work remotely and isolate from friends, co-workers, and family members, leading to high levels of stress.17 In addition, many individuals experienced changes in nutrition related to increased snacking,18 decreased frequency of eating meals inside restaurants,19 and decreased physical activity.20

The Nutritious Eating with Soul (NEW Soul) study began in 2018 and recruited AA adults living in the southeastern U.S. to participate in a two-year dietary lifestyle intervention focused on soul food.21 Prior to the COVID-19 pandemic, participants attended in-person group classes to receive education and support for following their assigned diet (i.e., vegan or low-fat omnivorous). The COVID-19 pandemic caused a shift from in-person to online intervention delivery. Because the NEW Soul study was actively assessing and intervening with participants prior to the onset of the COVID-19 pandemic and related restrictions and lockdowns, it presented a unique opportunity to examine how the early months of the pandemic affected stress, nutrition, and exercise behaviors. The purpose of this qualitative study was to explore how the early months of the COVID-19 pandemic affected AA adults’ stress, nutrition, and exercise behaviors while participating in a dietary intervention study.

Methods

Study Design

Semi-structured interviews were conducted to understand participant views on how the pandemic affected their stress, nutrition, and exercise behaviors. Participants in this study came from the larger NEW Soul study, described elsewhere.21 In brief, the study recruited AA adults living in the Midlands region of South Carolina and was delivered in Columbia, SC, from 2018-2021 across two cohorts each lasting two years. Participants in the first cohort began in May 2018 and completed in August 2020. Participants in the second cohort began in June 2019 and completed in June 2021. AA adults were randomized to a vegan or low-fat (<30% fat) omnivorous diet and attended classes to learn about nutrition, observe and participate in cooking demonstrations, and engage in discussions and activities to facilitate adherence to their assigned diet. Study assessments occurred at baseline, 6-months, 12-months, and 24-months. All participants provided written informed consent and the University of South Carolina Institutional Review Board approved the study.

On March 16, 2020, the University where the research was being conducted as well as schools and businesses in the local area closed due to the COVID-19 pandemic. At this time, the intervention transitioned from in-person to synchronous, online classes. The components of the online classes followed the in-person structure (i.e., nutrition content, cooking demonstration, and discussion and activities). The frequency of online classes for each cohort remained consistent with the in-person meeting schedule. At the time of this study, the first cohort was meeting bi-weekly and the second cohort was meeting weekly. The research team provided two additional activities to increase interaction and engagement with participants during these closures: semi-structured interviews (the basis for the current study) and electronic Bluetooth scales to monitor their body weight.22 These additions were approved by the University of South Carolina Institutional Review Board.

Recruitment

All participants (n=150) were eligible, and the recruitment goal was 20 interviews. A purposive sampling technique was used based on the percentage of attendance at in-person intervention sessions leading up to the switch to online classes. Participants were grouped into high attendance if they attended more than 80% of classes since January 1, 2020, and low attendance if they attended less than 30% of classes since January 1, 2020. January 1, 2020, was selected as a cutoff to capture more recent intervention engagement as an indication for potential engagement after the switch in intervention delivery modality. An equal number of participants from high and low attendance categories was sought because perspectives regarding behavior change may differ depending on intervention engagement.23

All interviews (n=20) were completed via Zoom or phone due to social distancing restrictions at the time of the study. Announcements were made during classes for eligible participants to check their email regularly for invitations to complete interviews. Because there were more eligible participants than the recruitment goal (n=20) and to address the practicality scheduling a reasonable number of interviews each week, participants were contacted via email in small batches of four to six participants. As acceptances or declines were received, another batch of eligible participants was contacted, continually seeking an equal number of participants from high and low attendance categories. In total, 28 participants were invited to the qualitative study. Eight participants were non-responsive to multiple inquiries (at least 3 invitations were sent before being marked as unresponsive).

Data Collection

At the beginning of the NEW Soul study, participants completed an online survey using Survey Gizmo (Survey Gizmo is currently known as Alchemer). In this survey, participants self-reported their age, sex, marital status, education level, race/ethnicity, employment status, and number of individuals living in the household younger than 18 years, between 18 and 65 years, and older than 65 years.

A semi-structured interview guide (Figure 1) was created by the first author and reviewed by the study team, including researchers with qualitative research experience and familiarity with the study population’s culture. The first author piloted the interview guide with two individuals of similar age and sociodemographic characteristics as the study population to ensure clarity and cultural appropriateness of the questions. Participants were asked questions regarding stress, nutrition, and exercise behaviors prior to and after the onset of the COVID-19 pandemic (i.e., March 15, 2020). Participants were also asked to share suggestions and advice about managing changes in stress, diet, and exercise behaviors to get through the pandemic.

Figure 1.

Figure 1.

Figure 1.

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Questions from an interview guided used to explore Africans Americans’ perspectives on how COVID-19 pandanic affected stress, nutrition, and exercise behavious.

Verbal consent was obtained prior to starting each interview. Most interviews (n=18) were conducted via Zoom with the remaining interviews (n=2) conducted by phone. Each interview was conducted by a female graduate research assistant staff member (MQ or NO) who had training and experience with qualitative data collection specific to the study population. A research assistant attended each interview as a notetaker. Interviews were conducted from June to July 2020 and ranged in length from 33 minutes to 101 minutes (mean±standard deviation = 52±17 minutes). Interviews were video (Zoom) or audio (Zoom and phone) recorded. Participants received a $25 Amazon e-gift card upon completion of the interview.

Data analysis

The baseline demographic characteristics of participants completing interviews were summarized using descriptive statistics. Interview memos were reviewed and weekly research team meetings were held to discuss saturation of data and to determine if 20 interviews were sufficient. While previous research has noted that saturation can be reached in 12 interviews,24 the research team reached the goal of 20 completed interviews and discussed if more were necessary. The interviewers (MQ and NO) determined no additional new perspectives were being shared, making 20 interviews the final sample.

All interviews were professionally transcribed verbatim and NVivo was used to facilitate coding of the transcripts and analysis of themes.25 A preliminary code book was developed including parent codes of stress, nutrition, and exercise before and after the onset of the COVID-19 pandemic. Additional subcodes were added iteratively during the analysis to capture specific instances related to stress, nutrition, and exercise. Interviews were coded through content analysis using a constant comparative method.26 Two research team members (MQ and SE) coded one transcript together. A meeting was held between the first author and coders to discuss differences and reach consensus. Then, the two research team members analyzed two additional transcripts independently, followed by another meeting with the first author to assess consensus. The remaining 17 interviews were coded independently by one coder (SE). Weekly meetings were held to discuss potential new codes. Once all interviews were coded, the analyzed transcripts were separated by high and low attendance participants to explore potential differences in responses.

Results

A total of 20 participants participated in this study, 9 in the low attendance category (denoted as “low” in quotations that follow) and 11 in the high attendance category (denoted as “high” in the quotations that follow). Baseline demographic characteristics of participants in this study are displayed in Table 1.

Table 1.

Demographic Characteristics at Baseline of African American NEW Soul Study Participants Completing Interviews (n=20) during the Early Months of the COVID-19 Pandemic

Full Sample
(n=20)		 High attendancea
(n=11)		 Low attendancea
(n=9)
Characteristic
n %b n %b n %b
Age (years) Median (range) 49.5 (30-65) 50 (45-65) 42 (30-59)
Sex
 Men 3 15 2 18 1 11
 Women 17 85 9 82 8 89
Diet group
 Vegan (intervention) 9 45 6 55 4 44
 Omnivorous (control) 11 55 5 45 5 56
Education
 High school or equivalent 1 5 0 0 1 11
 Some college 3 15 2 18 1 11
 College 6 30 3 27 3 33
 Advanced degree 10 50 6 55 4 44
Employment
 Employed for wages 16 80 8 73 8 89
 Home maker 1 5 0 0 1 11
 Retired 3 15 3 27 0 0
Child (<18 years old) living in household
 0 9 45 5 45 4 44
 1 6 30 2 18 4 44
 2+ 1 5 1 10 0 0
 Missing 4 20 3 27 1 11
Adult (18-64 years old) living in household c
 0 2 10 1 10 1 11
 1 8 40 6 55 2 22
 2+ 7 35 2 18 5 56
 Missing 3 15 2 18 1 11
Older adult (65+ years old) living in household
 0 11 55 4 36 7 78
 1 3 15 2 18 1 11
 2+ 0 0 0 0 0 0
 Missing 6 30 5 45 1 11
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a

High and low attendance refers to participant attendance from January 1, 2020 until March 15, 2020. High represents >80% attendance, and low represents <30% attendance during that time period.

b

Due to rounding, percentages may exceed or not sum to 100.

c

Does not include the participant in the study

Interviews revealed themes of increased stress, change in routines, and advice to follow health goals through the difficulties incurred by the COVID-19 pandemic. In most of the responses, participants in high and low attendance categories reported similar experiences. Context for each participant’s quote is provided with an identification number, age at the beginning of the NEW Soul study, sex, and high or low.

Increased Stress.

Many participants described how the pandemic increased stress regarding work, concern for family, and lack of attention towards nutrition.

Work.

Participants described stress at work in terms of not having the ability to see and interact with co-workers, shifting to virtual meetings, and growing uncertainty about doing things differently and the unknown. For example, one participant noted that “…knowing that I can’t go back in the office…working from home and not being able to like see people and talk to people, and, you know, just interact.” The same participant later shared “my stress level is probably a little higher…it’s been very stressful setting up virtual interviews…I thought working from home would be great. I think it’s okay.” (ID: 233, female, 50 years old, high) Another participant shared “We were all nervous….like, are they [employer] going to find something for us to do? And we kept having meetings, like, two and three times a day, so that was stressful because you didn’t know what they were going to talk about or what was going to come up.” (ID: 234, 42 years old, female, high) Another participant stated how the closures at work “puts extra stress on us at our job…because now we have to do things different…it’s just the unknown.” (ID: 276, 48 years old, female, high) Not all participants experienced increased stress at work. For example, one participant shared, “Sometimes work might be a little hectic, but it's nothing where I feel overly stressed or panicked about or anxious about.” (ID: 295, 46 years old, female, low)

Concern for family.

Participants expressed stress regarding caring for family members and unknowingly bringing COVID-19 into their home. For example, one participant expressed a concern about caring for her child sharing “it was really hard because my son, he’s in school, and so we had to move to the homeschooling thing…and figure out daycare.” She continued to share concerns about bringing COVID-19 into her home describing an event when “I recently went to a small gathering…and I found out later that one of the ladies that was there got sick…and so I’m nervous thinking like I was literally sitting next to her.” (ID: 110, 30 years old, female, low) Another participant noted a similar concern about how COVID-19 may be unknowingly brought into the home stating “not knowing if you‘re putting your family at risk…’cause you’re out there like that.” (ID: 276, 48 years old, female, high)

Lack of attention towards nutrition.

Participants noted how the increased stress contributed to a lack of attention towards nutrition. For example, one participant shared that “I kinda like went from thinking about, planning it and all that to…we’re just gonna eat whatever we want to eat…we weren’t really getting vegetables like we needed.” (ID: 291, 49 years old, female, high) Another participant expressed a similar sentiment stating, “I eat because I’m not even paying attention anymore to what I’m eating” and “I guess I eat my stress.” (ID: 155, 53 years old, female, low) Further, another participant shared, “COVID had a horrible effect on my diet, because I am an emotional eater…I tend to eat and it's not good stuff. It's, ‘Oh, let me eat some candy or let me eat some cookies.’” (ID: 235, 42 years old, female, low) Lastly, one participant recognized the negative changes stating, “I had never considered myself a stress eater.” (ID: 234, 42 years old, female, high)

Change in routines.

During the early months of the COVID-19 pandemic, many people were adapting to changes in routines mainly due to closures at work and school. For example, one participant shared how the extra time at home for her family impacted sleep routines stating, “it’s like I’ve been staying up till three o’clock in the morning.” (ID: 235, 42 years old, female, low) These changes in routine impacted participants’ nutrition (preparation and scheduling), and exercise negatively and positively.

Nutrition – preparation and scheduling.

Participants recognized that the increased time spent at home affected their routines for preparing food and scheduling times to eat when it came to meals and snacks. One participant shared that her meals were spaced out and timed better when she was working prior to the COVID-19 pandemic. She shared, “before COVID, I was on a better schedule knowing what time I’m having lunch and breakfast…now that I’m home all day, it’s like I don’t have a set schedule.” (ID: 304, 55 years old, female, low) One participant admitted since the COVID-19 pandemic’s effect on closures, “I would like to change some of the things I’m cooking…‘cause I am definitely like sabotaging myself.” (ID: 178, 59 years old, male, low) Other participants described changes in snacking due to the change in routine. For example, one participant noted that “When I was at work, I had a real nice routine…and it was just like that. I control what I ate. Here now, I’m around the house more. I might go in a closet and grab something to snack on.” The same participant continued to share that “I had my snacks planned before…and now it’s like…I just walk in the kitchen and go grab some.” (ID: 178, 59 years old, male, low) Another participant exclaimed, “oh gosh, I’m all over the place!…[and] put a cap on eat[ing] all day until you go to sleep.” (ID: 243, 35 years old, female, low) One participant noted that “If you’re inside…you see a commercial and food comes up…you snack more.” (ID: 210, 65 years old, male, high) Other participants shared struggles of “I did see myself kind of snacking on more processed foods, which I was trying to stay away from, but they were comforting.” (ID: 244, 45 years old, female, high) Another participant stated a struggle that “[w]e’ve been doing probably more snacking than before too.” (ID: 100, 37 years old, female, low) Lastly, another participant admitted to “eating [and] snacking more.” (ID: 178, 59 years old, male, low)

However, some participants recognized the increased time spent at home had a positive effect in how they chose to cook and prepare more healthful meals at home. For example, one participant shared, “I had to cook more. At one time, I was just cooking on the weekends before COVID.” (ID: 178, 59 years old, male, low) Another stated that “It’s better that I’m able to cook more. It’s nice to have control over what’s going in my mouth.” (ID: 305, 62 years old, female, high) Lastly, another participant shared, “I’m cooking just about every day now ‘cause we don’t eat out.” (ID: 224, 61 years old, female, high) Even though many restaurants remained open for takeout, one participant acknowledged a decrease in the frequency of eating out and an increase in “trying to cook more.” (ID: 234, 50 years old, female, high) In addition, one participant realized that “I’m probably eating better now because I’m not eating out.” (ID: 100, 37 years old, female, low)

Exercise.

Participants struggled giving attention to exercise routines due to other concerns about the COVID-19 pandemic and closures of exercise facilities. For example, one shared “I wasn’t really doing as much physical activity because focusing on the pandemic and worrying about what was going on…I just kind of put the physical activity on the back burner and…making sure that we had everything that we needed.” (ID: 291, 49, female, high) Another participant noted, “I don’t like to walk…I don’t have my Zumba or anything like that, so I don’t work out as nearly as much as I used to.” (ID: 276, 48 years old, female, high)

Similar to nutrition, some participants recognized that the increased time spent at home had a positive effect on their exercise. Other participants shared stories of increasing their exercise levels even though their preferred means of exercises were unavailable (e.g., closed exercise facilities or cancelled group exercise classes). One participant shared, “Since May 1st…I’ve done 15,000 steps every day except for one day…being home, and not going as many places, I’m able to exercise more…it’s kind of helped me to kind of slow down and focus.” (ID: 151, 57 years old, female, high) In addition, one participant noted “I would exercise more just because I was bored. And so I actually bought an exercise bike…it’s made me find ways to be creative of exercising at home. It’s provided me with a lot of time to exercise.” (ID: 110, 30 years old, female, low) Lastly, one participant acknowledged seeing more of her neighbors and their families outside walking. Therefore, she emphasized “to definitely put a routine in place of physical activity…and [then] deciding on a time as a family to be active together.” (ID: 234, 50 years old, female, high)

Advice to follow health goals.

Despite setbacks, participants shared positive advice for themselves and others about not being so hard on oneself and staying on track to follow health goals. One participant shared, “I’m not doing so bad…stop being so hard on yourself…just think of the big picture. What is the goal? And know your why. Like, why is this important?” (ID: 295, 46 years old, female, low) Another participant stated, “[D]on’t be too hard on yourself…You couldn’t fit it in yesterday? You can fit it in today…Every day is a new day, new opportunity.” (ID: 110, 30 years old, female, low) One participant shared, “we put a lot of pressures on ourselves sometimes to be okay.” (ID: 155, 53 years old, female, low) Another participant recommended that others “[R]ecognize that it will pass. It’s no reason to be fearful because when you operate in a fearful state, you make poor decisions.” (ID: 295, 46 years old, female, low) Another participant shared encouragement that “we put a lot of pressures on ourselves sometimes to be okay. But I wasn’t okay. But I hadn’t given myself permission yet to not be okay.” The same participant continued to share to not “allow yourself to be overwhelmed by the enormity of it. Accept that it’s okay that things are gonna change…it’s gonna be okay.” (ID: 155, 53 years old, female, low) Lastly, one participant shared that “this is an opportunity for everybody. What you do with the opportunities is up to you. Everybody has the opportunity to come out of this different than they came into it.” (ID: 305, 62 years old, female, high)

Discussion

The NEW Soul study had a unique opportunity to assess a population of AA adults participating in a dietary intervention study during the early months of the COVID-19 pandemic. The purpose of this qualitative study was to explore how the pandemic affected stress, nutrition, and exercise behaviors of AA adults participating in the study. Even though the intervention continued to emphasize healthy eating and physical activity in the online sessions, participants still expressed difficulties regarding their healthy eating and physical activity due to the COVID-19 pandemic. Themes consisted of increased stress, change in routines, and advice to follow health goals. Subthemes of increased stress consisted of work, concern for family, and lack of attention towards nutrition, and subthemes of change in routines consisted of nutrition (preparation and scheduling) and exercise. Participants also shared advice to follow health goals through the COVID-19 pandemic.

Many participants described how the COVID-19 pandemic increased their stress levels, which aligns with previous research.17 Participants described concerns over work and family and also how stress negatively impacted their attitudes towards nutrition. Though participants in the current study did not mention food insecurity as a stressor, research has shown that increased reports of food insecurity caused by the COVID-19 pandemic may have contributed to poorer nutrition habits, particularly among AA adults.27,28 Even though the COVID-19 pandemic is no longer considered a global health emergency, many businesses and organizations have continued to recognize the importance of providing stress management and resiliency services for employees.29,30 In addition, researchers should continue to identify community partners such as faith-based organizations31 or counseling services to help reach AA adults impacted by the COVID-19 pandemic.

Changes in routine were widespread as people spent large amounts of time at home during the early months of the COVID-19 pandemic. Thus, it was expected that this change would also change participants’ routines related to health behaviors. The changes in routine caused participants to eat at irregular scheduled times and increase snacking, which aligns with another study conducted among adults.32 In addition, participants shared that they were engaging in less exercise, aligning with a previous study.33

However, some participants identified that the change in routine was helpful and made positive use of the time to engage in healthful behaviors. Previous research confirms that some people were able to improve health habits during the pandemic.34 In the current study, some participants shared they had increased their frequency of cooking at home and controlling the food they ate compared to eating out at restaurants. Therefore, future programs should continue to highlight cooking at home strategies that incorporate quick and affordable healthful foods.

In addition, some participants shared how they increased their physical activity by spending more time walking. Therefore, as many individuals continue to progress towards a new normal post-pandemic, researchers, practitioners, and clinicians may wish to emphasize strategies for goal setting and establishing new routines around exercise rather than trying to reinstate pre-pandemic habits. Researchers may also wish to promote interventions through a post-pandemic weight loss lens since weight gain was a common issue regardless of pre-pandemic weight status.35 Finally, participants highlighted advice to follow health goals. Therefore, researchers should continue incorporate accountability through social support and reflection for successful behavior change in interventions.

This study had limitations. First, qualitative research is subject to response bias where some participants may respond in a way to please the researchers. Second, the study team did not implement another follow-up point in time to re-interview participants as the COVID-19 pandemic continued to be an ongoing issue after this study was conducted. Therefore, participant experiences and behaviors likely evolved under a new normal as the pandemic continued.

Despite these limitations, this study had two notable strengths. First, the study successfully recruited AA adults to participate in virtual semi-structured interviews. Given restrictions on in-person social interactions at the time of the study, this study’s successful completion of interviews and collecting data demonstrates the potential for virtual qualitative data collection in other studies. Second, this study design, nested within the larger ongoing intervention study, allowed for the exploration of the experiences of AA adults during the early months of the COVID-19 pandemic prior to the availability of vaccines, widespread testing, and loosening of restrictions. It remains important for researchers and practitioners to continue recruiting and engaging with populations underrepresented in nutrition research and lifestyle interventions.

Conclusions

The circumstances surrounding the COVID-19 pandemic presented a unique opportunity to explore the impact of a highly disruptive event on the health of AA adults participating in a dietary intervention study. Interviews with participants revealed that some participants experienced challenges regarding increased stress and positive and negative changes in nutrition and exercise routines. Participants shared resilient perspectives and encouragement to persevere during the pandemic. Future research should continue to prioritize helping AA adults establish healthful routines around managing stress and overcoming setbacks for healthy nutrition and exercise lifestyles to improve health and decrease health disparities.

Research Snapshot:

Research Question:

How did the early months of the COVID-19 pandemic affect stress, nutrition, and exercise behaviors of African American adults participating in a dietary intervention study?

Key Findings:

This qualitative study was conducted among African American adults participating in a dietary intervention study in the summer of 2020 after the onset of the COVID-19 pandemic. Participants shared experiences regarding increased stress, change in routines, and advice to follow health goals during the pandemic. This study’s findings provide unique perspectives regarding health behaviors among African American adults during the early months of the COVID-19 pandemic. Findings may be useful for designing interventions for African American adults post-COVID-19 pandemic to improve health.

Funding/financial disclosures:

This study was funded by the National, Heart, Lung, and Blood Institute of the National Institutes of Health under award number R01HL135220. The content is the sole responsibility of the authors and does not necessary represent the official views of the National Institutes of Health. The study was also supported by the Office of Research at the University of South Carolina under award number 115700-20-54014.

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

The study is registered at www.clinicaltrials.gov NCT03354377

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