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Williams LB, Abu Farsakh B, Karle ER, Almogheer ZS, Coughlin S, Kim Yeary KH. How effective are church-based weight-loss interventions among Black adults? A systematic review. Obesity (Silver Spring) 2024. [PMID: 39199014 DOI: 10.1002/oby.24115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/18/2024] [Accepted: 06/10/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE Churches are frequently used to reach Black adults to effect weight loss. However, there has been no recent review, to our knowledge, inclusive of solely Black adults in church settings. We sought to comprehensively examine the methodological approaches and weight-loss outcomes of church-based weight-loss lifestyle interventions conducted among Black adults to provide insights on literature gaps and offer suggestions for future research. METHODS Google Scholar, PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for trials conducted in churches that reported weight outcomes at any time point. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guided manuscript development. RESULTS A total of 15 studies (N = 2285) from 2007 to 2023 met inclusion criteria, and 33% were high-quality randomized trials. The majority were pilot studies (60%) conducted in the Southern United States. Most reported significant postintervention weight loss. The follow-up time points varied from 2 to 12 months. Methodological approaches included the following: cultural adaptations (93%); theory-guided (93%); delivered by community health workers (80%); and delivered in person in a group format (100%). Only one study offered individual-level attention beyond texts/emails. Most participants were well-educated female individuals. CONCLUSIONS Weight-loss interventions among Black church settings effect statistically significant weight loss, albeit in a small way. Limitations include pilot studies and small samples. More rigorously designed studies are warranted.
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Affiliation(s)
| | | | - Erika R Karle
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | | | - Steven Coughlin
- College of Allied Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Karen H Kim Yeary
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Ng BP, Ely E, Papali'i M, Cannon MJ. Delivering the National Diabetes Prevention Program: Assessment of Retention, Physical Activity, and Weight Loss Outcomes by Participant Characteristics and Delivery Modes. J Diabetes Res 2024; 2024:8461704. [PMID: 39165352 PMCID: PMC11335425 DOI: 10.1155/2024/8461704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/13/2024] [Accepted: 07/19/2024] [Indexed: 08/22/2024] Open
Abstract
Type 2 diabetes disproportionately affects older adults, persons from racial and ethnic minority groups, and persons of low socioeconomic status. It can be prevented or delayed through evidence-based interventions such as the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). This analysis is aimed at evaluating the outcomes (i.e., retention, physical activity, and weight loss) associated with participation in the National DPP LCP by participant characteristics and delivery mode (i.e., in-person, online, distance learning, and combination) using the 2012-2018 Diabetes Prevention Recognition Program (DPRP) data. Across all delivery modes, there were generally no substantial differences in retention between male and female participants, but male participants tended to have higher physical activity and weight loss (e.g., average weight loss for in-person delivery: 5.0% for males and 4.3% for females). Older participants had better retention rates than younger participants in all delivery modes and mostly higher physical activity and weight loss except for distance learning delivery (e.g., average weight loss for in-person delivery: 5.1% for those aged 65+ and 3.3% for those aged 18-34). Among the seven racial and ethnic groups studied, retention was generally highest for non-Hispanic/Latino (NH)-White participants and lowest for Hispanic/Latino participants. Physical activity varied by racial and ethnic groups and delivery mode. NH-White participants generally had the most weight loss except for distance learning delivery, and NH-Black/African American participants had the least (e.g., average weight loss for in-person delivery: 5.1% for NH-White participants, 3.3% for both NH-Black/African American and NH-American Indian/Alaska Native participants, and other racial and ethnic minority groups ranged from 3.4% to 4.9%). Monitoring and identifying disparities across demographics and delivery modes, particularly across multiple racial and ethnic groups, provides information that can be used to improve the implementation of the National DPP LCP by tailoring the intervention to reduce disparities.
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Affiliation(s)
- Boon Peng Ng
- College of Nursing and DisabilityAging and Technology ClusterUniversity of Central Florida, Orlando, Florida, USA
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Ely
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle Papali'i
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael J. Cannon
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
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Berkley-Patton J, Thompson CB, Templeton T, Finocchario-Kessler S, Williams E, Wainright C, Materia FT, Dennis L, Catley D, Burgin T, Derose KP, Bradley-Ewing A, Geyer A, Ellison SR, Allsworth JE. Have a Little Faith: Overcoming Pandemic-Related Challenges to Designing and Implementing a COVID-19 Testing Trial in African American Churches. Am J Public Health 2024; 114:S366-S371. [PMID: 38776493 PMCID: PMC11111378 DOI: 10.2105/ajph.2024.307607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Jannette Berkley-Patton
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Carole Bowe Thompson
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Turquoise Templeton
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Sarah Finocchario-Kessler
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Eric Williams
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Cassandra Wainright
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Frank T Materia
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Lesha Dennis
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Delwyn Catley
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Tacia Burgin
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Kathryn P Derose
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Andrea Bradley-Ewing
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Alex Geyer
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Stefanie R Ellison
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
| | - Jenifer E Allsworth
- Jannette Berkley-Patton, Carole Bowe Thompson, Turquoise Templeton, Tacia Burgin, Alex Geyer, Stefanie R. Ellison, and Jenifer E. Allsworth are with the School of Medicine, University of Missouri, Kansas City. Sarah Finocchario-Kessler is with the Department of Family Medicine and Community Health, Kansas University Medical Center, Kansas City, MO. Eric Williams is with Calvary Community Outreach Network, Kansas City, MO. Cassandra Wainright is with Heaven Sent Outreach Ministries, Kansas City, MO. Frank T. Materia and Andrea Bradley-Ewing are with Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO. Lesha Dennis is with the Office of Population Health Science, Kansas City MO Health Department. Delwyn Catley is with the Center for Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, MO. Kathryn P. Derose is with the Department of Health Promotion & Policy, University of Massachusetts Amherst
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Strayhorn SM, Carter A, Harmon BE, Hébert JR. An Examination of Culturally Relevant Health Messages in African-American Churches. JOURNAL OF RELIGION AND HEALTH 2023; 62:2547-2562. [PMID: 35994186 PMCID: PMC9943804 DOI: 10.1007/s10943-022-01638-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 05/07/2023]
Abstract
This quantitative study examined the presence of culturally relevant health messages for African-Americans based on a preexisting dataset from 21 African-American churches in South Carolina (USA). Content analysis served as the primary methodological approach to code printed media messages based on their cultural relevance among African-Americans (Cohen's kappa = .74). Within the dataset (n = 2166), 477 (22%) items were identified as culturally relevant. A low prevalence of culturally relevant messages was found across the three message topics, two media types, and one media source. Due to the limited presence of culturally relevant messages, researchers should collaborate with African-American churches to design health promotion messages.
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Affiliation(s)
- Shaila M Strayhorn
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, 601 S. College Road, Wilmington, NC, 28403, USA
| | - Andrew Carter
- Department of Public Health and Recreation, San José State University, One Washington Square, San José, CA, 95192, USA
| | - Brook E Harmon
- Department of Nutrition and Health Care Management, Beaver College of Health Sciences, Appalachian State University, 1179 State Farm Rd, Boone, NC, 28607, USA.
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Statewide Cancer Prevention and Control Program, University of South Carolina, 242 Discovery 1, Columbia, SC, 29208, USA
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Promoting Physical Activity Among Immigrant Asian Americans: Results from Four Community Health Worker Studies. J Immigr Minor Health 2023; 25:291-305. [PMID: 36273386 DOI: 10.1007/s10903-022-01411-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 03/07/2023]
Abstract
Racial/ethnic minorities have demonstrated lower rates of physical activity (PA) than non-Hispanic Whites. This study examined outcomes in PA measures after participation in a community health worker (CHW) intervention. We performed a secondary data analysis from four randomized controlled trials utilizing CHWs (n = 842) in New York City (Bangladeshi-diabetes management, Filipino-hypertension management, and Korean and Asian Indian-diabetes prevention). Outcomes included total weekly PA, PA self-efficacy, PA barriers, and PA social interaction. Each measure was examined at baseline and study endpoint. Generalized estimating equation models were fitted to assess the repeated measures over time, while accounting for study group and socio-demographic factors. Moderate PA, recommended PA, and self-efficacy increased significantly among treatment group participants. PA social interaction increased significantly among Filipinos and Asian Indians. In adjusted regression analysis, time x group interaction was significant for all PA outcomes except for PA barriers. Culturally-adapted lifestyle interventions may potentially improve PA-related outcomes in Asian immigrant communities. Trial registration at ClinicalTrials.gov includes: NCT03530579 (RICE Project), NCT02041598 (DREAM Project), and NCT03100812 (AsPIRE).
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Hartmann-Boyce J, Theodoulou A, Oke JL, Butler AR, Bastounis A, Dunnigan A, Byadya R, Cobiac LJ, Scarborough P, Hobbs FR, Sniehotta FF, Jebb SA, Aveyard P. Long-Term Effect of Weight Regain Following Behavioral Weight Management Programs on Cardiometabolic Disease Incidence and Risk: Systematic Review and Meta-Analysis. Circ Cardiovasc Qual Outcomes 2023; 16:e009348. [PMID: 36974678 PMCID: PMC10106109 DOI: 10.1161/circoutcomes.122.009348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/13/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly regained. We assessed the impact of weight regain after BWMPs on cardiovascular risk factors, diabetes, and cardiovascular disease. METHODS Trial registries, 11 databases, and forward-citation searching (latest search, December 19) were used to identify articles published in English, from any geographical region. Randomized trials of BWMPs in adults with overweight/obesity reporting cardiometabolic outcomes at ≥12 months at and after program end were included. Differences between more intensive interventions and comparator groups were synthesized using mixed-effects, meta-regression, and time-to-event models to assess the impact of weight regain on cardiovascular disease incidence and risk. RESULTS One hundred twenty-four trials reporting on ≥1 cardiometabolic outcomes with a median follow-up of 28 (range, 11-360) months after program end were included. Median baseline participant body mass index was 33 kg/m2; median age was 51 years. Eight and 15 study arms (7889 and 4202 participants, respectively) examined the incidence of cardiovascular disease and type 2 diabetes, respectively, with imprecise evidence of a lower incidence for at least 5 years. Weight regain in BWMPs relative to comparators reduced these differences. One and 5 years after program end, total cholesterol/HDL (high-density lipoprotein) ratio was 1.5 points lower at both times (82 studies; 19 003 participants), systolic blood pressure was 1.5 mm mercury and 0.4 mm lower (84 studies; 30 836 participants), and HbA1c (%) 0.38 lower at both times (94 studies; 28 083 participants). Of the included studies, 22% were judged at high risk of bias; removing these did not meaningfully change results. CONCLUSIONS Despite weight regain, BWMPs reduce cardiometabolic risk factors with effects lasting at least 5 years after program end and dwindling with weight regain. Evidence that they reduce the incidence of cardiovascular disease or diabetes is less certain. Few studies followed participants for ≥5 years. REGISTRATION URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42018105744.
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Affiliation(s)
- Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
| | - Annika Theodoulou
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
| | - Jason L. Oke
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, United Kingdom (J.L.O.)
| | - Ailsa R. Butler
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
| | - Anastasios Bastounis
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom (A.B.)
| | - Anna Dunnigan
- Oxford University Hospitals NHS Foundation Trust, United Kingdom (A.D.)
- Royal Free London NHS Foundation Trust, United Kingdom (A.D.)
| | - Rimu Byadya
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
- United Nations World Food Programme, Cox’s Bazar, Bangladesh, India (R.B.)
| | - Linda J. Cobiac
- Nuffield Department of Population Health, Centre on Population Approaches for Non-Communicable Disease Prevention (L.J.C.), University of Oxford, United Kingdom
| | - Peter Scarborough
- Nuffield Department of Population Health, Oxford Biomedical Research Centre (P.S.), University of Oxford, United Kingdom
| | - F.D. Richard Hobbs
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
| | - Falko F. Sniehotta
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, United Kingdom (F.F.S.)
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences (J.H.-B., A.T., A.R.B., A.B., R.B., F.D.R.H., S.A.J., P.A.), University of Oxford, United Kingdom
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Sanusi A, Elsey H, Golder S, Sanusi O, Oluyase A. Cardiovascular health promotion: A systematic review involving effectiveness of faith-based institutions in facilitating maintenance of normal blood pressure. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001496. [PMID: 36962921 PMCID: PMC10022319 DOI: 10.1371/journal.pgph.0001496] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/17/2022] [Indexed: 01/21/2023]
Abstract
Globally, faith institutions have a range of beneficial social utility, but a lack of understanding remains regarding their role in cardiovascular health promotion, particularly for hypertension. Our objective was assessment of modalities, mechanisms and effectiveness of hypertension health promotion and education delivered through faith institutions. A result-based convergent mixed methods review was conducted with 24 databases including MEDLINE, Embase and grey literature sources searched on 30 March 2021, results independently screened by three researchers, and data extracted based on behaviour change theories. Quality assessment tools were selected by study design, from Cochrane risk of bias, ROBINS I and E, and The Joanna Briggs Institute's Qualitative Assessment and Review Instrument tools. Twenty-four publications contributed data. Faith institution roles include cardiovascular health/disease teaching with direct lifestyle linking, and teaching/ encouragement of personal psychological control. Also included were facilitation of: exercise/physical activity as part of normal lifestyle, nutrition change for cardiovascular health, cardiovascular health measurements, and opportunistic blood pressure checks. These demand relationships of trust with local leadership, contextualisation to local sociocultural realities, volitional participation but prior consent by faith / community leaders. Limited evidence for effectiveness: significant mean SBP reduction of 2.98 mmHg (95%CI -4.39 to -1.57), non-significant mean DBP increase of 0.14 mmHg (95%CI -2.74 to +3.01) three months after interventions; and significant mean SBP reduction of 0.65 mmHg (95%CI -0.91 to -0.39), non-significant mean DBP reduction of 0.53 mmHg (95%CI -1.86 to 0.80) twelve months after interventions. Body weight, waist circumference and multiple outcomes beneficially reduced for cardiovascular health: significant mean weight reduction 0.83kg (95% CI -1.19 to -0.46), and non-significant mean waist circumference reduction 1.48cm (95% CI -3.96 to +1.00). In addressing the global hypertension epidemic the cardiovascular health promotion roles of faith institutions probably hold unrealised potential. Deliberate cultural awareness, intervention contextualisation, immersive involvement of faith leaders and alignment with religious practice characterise their deployment as healthcare assets.
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Affiliation(s)
- Abayomi Sanusi
- Department of Health Sciences, University of York, York, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
| | - Su Golder
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Adejoke Oluyase
- Cicely Saunders Institute of Palliative Care & Rehabilitation, King's College London, London, United Kingdom
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8
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Bringing Treatment to the Patients: Community-Based Tobacco-Dependence Treatment and Interventions. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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9
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Williams LB, Moser DK, Gustafson A, Waters TM, Rayens MK, Karle ER, Kriska AM. Reaching high-risk Black adults for diabetes prevention programming during a pandemic: The design of Fit & Faithful a randomized controlled community trial. Contemp Clin Trials 2022; 123:106973. [PMID: 36334705 PMCID: PMC10155857 DOI: 10.1016/j.cct.2022.106973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 10/14/2022] [Accepted: 10/20/2022] [Indexed: 11/08/2022]
Abstract
Obesity is a key risk factor for Type 2 diabetes (T2D). Alarmingly, 87% of US adults have overweight or obesity, with non-Hispanic black adults having higher obesity and T2D prevalence than non-Hispanic white. The Diabetes Prevention Program (DPP) demonstrated the clinical benefits of lifestyle intervention (LI). While the DPP LI is effective, some participants don't achieve clinically significant weight loss in the current group-based translation paradigm. Black adults have the lowest adjusted weight loss (3.2%) among all racial/ethnic groups. Early intervention nonresponse defined as ≤1% weight loss at intervention week 4 is linked to lower probability of achieving weight loss goals. This paper describes the design and methods of a cluster randomized controlled trial among black weight loss nonresponders nested in 20 community sites (primarily churches). Descriptions of the adaptations made to transition the program to virtual format during the COVID-19 pandemic are also included. Trained community health workers deliver a group-based, 6-month long DPP over 18 sessions via Zoom. Additionally, nonresponders in the enhanced group receive weekly telephone support to provide individual-level intervention to help overcome weight loss barriers. Outcomes include weight, physical activity level, blood pressure, and dietary behaviors; these are compared between nonresponders in the enhanced intervention group and nonresponders in the active control group. Cost, mediators, and moderators are explored. If found to efficacious, these enhanced strategies could be standardized as a supplement for use with DPP nonresponders.
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Affiliation(s)
- Lovoria B Williams
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States.
| | - Debra K Moser
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States
| | - Alison Gustafson
- University of Kentucky, College of Agriculture, Department of Dietetics and Human Nutrition, 206g Funkhouser, Lexington, KY 40536, United States
| | - Teresa M Waters
- University of Kentucky, College of Public Health Department of Health Management and Policy, 111 Washington Avenue, Lexington, KY 40536, United States
| | - Mary Kay Rayens
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States; University of Kentucky, College of Public Health Department of Health Management and Policy, 111 Washington Avenue, Lexington, KY 40536, United States
| | - Erika R Karle
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States
| | - Andrea M Kriska
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, 130 Desoto Street, Pittsburgh, PA 15261, United States
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10
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Saju R, Castellon-Lopez Y, Turk N, Moin T, Mangione CM, Norris KC, Vu A, Maranon R, Fu J, Cheng F, Duru OK. Differences in Weight Loss by Race and Ethnicity in the PRIDE Trial: a Qualitative Analysis of Participant Perspectives. J Gen Intern Med 2022; 37:3715-3722. [PMID: 35469358 PMCID: PMC9037581 DOI: 10.1007/s11606-022-07521-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many Diabetes Prevention Program (DPP) translation efforts have been less effective for underresourced populations. In the cluster-randomized Prediabetes Informed Decision and Education (PRIDE) trial, which evaluated a shared decision-making (SDM) intervention for diabetes prevention, Hispanic and non-Hispanic Black participants lost less weight than non-Hispanic White participants at 12-month follow-up. OBJECTIVE To explore perspectives about weight loss from PRIDE participants of different racial and ethnic groups. PARTICIPANTS Sample of participants with prediabetes who were randomized to the PRIDE intervention arm (n=24). APPROACH We conducted semi-structured interviews within three groups stratified by DPP participation and % weight loss at 12 months: (DPP+/WL+, enrolled in DPP and lost >5% weight; DPP+/WL-, enrolled in DPP and lost <3% weight; DPP-/WL-, did not enroll in DPP and lost <3% weight). Each group was further subdivided on race and ethnicity (non-Hispanic Black (NHB), non-Hispanic White (NHW), Hispanic). Interviews were conducted on Zoom and transcripts were coded and analyzed with Dedoose. KEY RESULTS Compared to NHW participants, Hispanic and NHB participants more often endorsed weight loss barriers of limited time to make lifestyle changes due to long work and commute hours, inconvenient DPP class locations and offerings, and limited disposable income for extra weight loss activities. Conversely, facilitators of weight loss regardless of race and ethnicity included retirement or having flexible work schedules; being able to identify convenient DPP classes; having a strong, positive support system; and purchasing supplementary resources to support lifestyle change (e.g., gym memberships, one-on-one activity classes). CONCLUSIONS We found that NHB and Hispanic SDM participants report certain barriers to weight loss more commonly than NHW participants, particularly barriers related to limited disposable income and/or time constraints. Our findings suggest that increased lifestyle change support and flexible program delivery options may be needed to ensure equity in DPP reach, participant engagement, and outcomes.
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Affiliation(s)
- Rintu Saju
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Yelba Castellon-Lopez
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Family Medicine, University of California, Los Angeles, CA, USA
| | - Norman Turk
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Tannaz Moin
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
- VA Greater Los Angeles Health System and HSR&D Center for Study of Healthcare Innovation, Implementation & Policy, University of California, Los Angeles, CA, USA
- Division of Endocrinology, Diabetes & Metabolism, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Carol M Mangione
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Keith C Norris
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Amanda Vu
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Richard Maranon
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Jeffery Fu
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Felicia Cheng
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - O Kenrik Duru
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA.
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11
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Garcia JF, Peters AL, Raymond JK, Fogel J, Orrange S. Equity in Medical Care for People Living With Diabetes. Diabetes Spectr 2022; 35:266-275. [PMID: 36082008 PMCID: PMC9396720 DOI: 10.2337/dsi22-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Disparities and inequities exist for individuals with diabetes in marginalized communities of color, especially among people with low socioeconomic status. Although these barriers are apparent, only a few care models have been designed for and examined in racially and ethnically diverse individuals. This article reviews models that have been developed and examined in a variety of different populations and focuses on how to implement elements from these programs in clinical practice. Health equity-promoting ideas and approaches that can be applied throughout the life span (children to seniors) are also included. As diabetes health care providers, researchers, educators, policymakers, and advocates, we must now combine our efforts and focus on historically excluded populations to bridge the gap to essential diabetes care.
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The Role of Black Pastors in Disseminating COVID-19 Vaccination Information to Black Communities in South Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158926. [PMID: 35897301 PMCID: PMC9332625 DOI: 10.3390/ijerph19158926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
COVID-19 vaccination rates have increased since distribution began in December 2020. However, in some states, such as South Carolina, getting people to take the vaccine has been challenging; as of spring 2022, slightly less than 60% of the total population is fully vaccinated. Vaccine hesitancy among Black Americans may be explained by several factors, including lack of confidence in the medical establishment and vaccines in particular. Faith-based leaders, such as pastors, can make a difference. This study explores the communication strategies that pastors in predominantly Black churches use to increase COVID-19 vaccination rates among churchgoers and the surrounding community. We conducted semi-structured interviews with 10 pastors in South Carolina. The main themes that emerged are: (1) using various communication channels to ensure access; (2) representing a trusted source of information; (3) offering a role model for vaccination—leading by example; and (4) strengthening the commitment to health. As the need for COVID-19 vaccination continues, including booster vaccines, pastors can provide accurate information and community outreach to promote the health of Black communities.
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Marin DB, Karol AB, Sharma V, Wetmore J, Costello Z, Henry B, Robinson M, Thompson L, Peña I, Jandorf L. M.I.C.A.H. Project HEAL: Sustainability of a Faith-Based Community Health Advisor Training Program in Urban Underserved Communities in the USA. JOURNAL OF RELIGION AND HEALTH 2022; 61:2527-2538. [PMID: 34751869 DOI: 10.1007/s10943-021-01453-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
Faith-based organizations (FBOs) can play an important role in improving health outcomes. Lay community health advisors (CHAs) are integral to these efforts. This paper assesses the sustainability of a CHA training program for congregants in African-American and Latino FBOs and subsequent implementation of educational workshops. The program is unique in that a health care chaplain in an academic medical center was central to the program's development and implementation. Forty-eight CHAs in 11 FBOs were trained to teach workshops on cardiovascular health, mental health, diabetes, and smoking cessation. Two thousand four hundred and forty-four participants attended 70 workshops. This program has the potential to be a model to educate individuals and to address health inequities in underserved communities. Health care chaplains in other medical centers may use this as a model for enhancing community engagement and education.
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Affiliation(s)
- Deborah B Marin
- Center for Spirituality and Health, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
| | - Alex B Karol
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Vansh Sharma
- Center for Spirituality and Health, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - John Wetmore
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Brittney Henry
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Mimsie Robinson
- Bethel Gospel Assembly, 2-26 East 120th Street, New York, NY, 10035, USA
| | - Linda Thompson
- Health Ministry Leader, Abyssinian Baptist Church, 132 Odell Clark Place, New York, NY, 10030, USA
| | - Israel Peña
- Department of Psychology, Boricua College, Bronx, NY, 10451, USA
- The FLOW Kingdom Ministries, 901 East Tremont Avenue, Bronx, NY, 10460, USA
| | - Lina Jandorf
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
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14
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Shaw AR, Perales-Puchalt J, Valdivieso-Mora E, McGee JL, Vaduvathiriyan P, Vidoni ED. Effectiveness of non-pharmaceutical interventions on cognitive function among non-demented African American and Latino older adults in the USA: a scoping review. ETHNICITY & HEALTH 2022; 27:929-945. [PMID: 33021816 PMCID: PMC8021606 DOI: 10.1080/13557858.2020.1828292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE African Americans and Latinos/Hispanics have a higher prevalence of dementia compared to non-Latino Whites. This scoping review aims to synthesize non-pharmaceutical interventions to delay or slow age-related cognitive decline among cognitively healthy African American and Latino older adults. DESIGN A literature search for articles published between January 2000 and May 2019 was performed using the databases PubMed, CINAHL, PsycINFO and Web of Science. Relevant cited references and grey literature were also reviewed. Four independent reviewers evaluated 1,181 abstracts, and full-article screening was subsequently performed for 145 articles. The scoping review consisted of eight studies, which were evaluated according to the peer-reviewed original manuscript, non-pharmaceutical intervention, cognitive function as an outcome, separate reporting of results for African American and Latinos, minimum age of 40, and conducted in the US. A total of 8 studies were considered eligible and were analyzed in the present scoping review. RESULTS Eight studies were identified. Four studies focused on African Americans and four focused on Latinos. Through the analysis, results indicated cognitive training-focused interventions were effective in improving memory, executive function, reasoning, visuospatial, psychological function, and speed among African Americans. Exercise interventions were effective in improving cognition among Latinos. CONCLUSION This scoping review identified effective non-pharmaceutical interventions among African American and Latinos. Effective interventions focused on cognitive training alone for African Americans and exercise combined with group educational sessions for Latinos. Future research should explore developing culturally appropriate non-pharmaceutical interventions to reduce disparities and to enhance cognition among older African American and Latinos.
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Affiliation(s)
- Ashley R. Shaw
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, United States
| | - Jaime Perales-Puchalt
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, United States
| | | | - Jerrihlyn L. McGee
- School of Nursing, University of Kansas Medical Center, Kansas City, United States
| | | | - Eric D. Vidoni
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, United States
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15
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A Mixed-Methods Formative Evaluation of a Dementia-Friendly Congregation Program for Black Churches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084498. [PMID: 35457369 PMCID: PMC9028238 DOI: 10.3390/ijerph19084498] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023]
Abstract
Black churches have traditionally been a haven for Black American families; however, many churches do not currently have programs to support families living with dementia. Alter™ was established to assist faith communities in meeting the needs of these families and becoming a viable resource to promote their health and wellness. Alter™ achieves this aim through a three-pronged approach: (1) conducting educational sessions, (2) modifying Black churches to be dementia-inclusive spaces, and (3) providing ongoing support. The principal goal of Alter™ is to offer guidance to churches in adapting their community to reflect a supportive environment for families affected by dementia. Alter™ uses a partnership checklist to encourage activities that incorporate dementia education opportunities, environmental modifications, and dementia resources and support. This paper reports on a formative mixed-methods evaluation of church partners enrolled in Alter™. Church partner ambassadors within the faith communities participated in the evaluation survey (n = 8) and two focus groups (n = 11). Ambassadors are appointed by church leadership to lead the implementation of program activities. Data were collected concerning the levels of helpfulness, difficulty, usefulness, or utility of checklist activities and modifications and the ease of program implementation. The evaluation also assessed the COVID-19 pandemic’s impact on each church’s ability to implement activities and modifications. The survey results revealed that most required partnership activities and modifications were found to be at least moderately helpful. Some of the items (themes) that differed across church partners included barriers to implementing activities, the support provided and needed, and the use of program funding. This evaluation provides key insights to consider in developing and refining community-based, dementia-friendly communities (including faith communities). As implementation science expands and improves, the need to evaluate the implementation of programs continues to be highlighted. Our formative evaluation shed light on key areas in which modifications to our original programming would lead to program improvement and sustainability. Additionally, implementing the modifications identified in our evaluation will facilitate the achievement of the mission of Alter™ to improve the well-being of older adults affected by dementia and their families. Other programs would reap substantial benefits from engaging in similar formative evaluation efforts.
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16
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Kriska AM, Devaraj SM, Kramer K, Napoleone JM, Rockette-Wagner B, Eaglehouse Y, Arena VC, Miller RG. The Likely Underestimated Impact of Lifestyle Intervention: Diabetes Prevention Program Translation Examples. Am J Prev Med 2022; 62:e248-e254. [PMID: 35031174 PMCID: PMC9059238 DOI: 10.1016/j.amepre.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/20/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Lifestyle interventions promoting weight loss and physical activity are important elements of prevention efforts with the evaluation of program impact typically limited to weight loss. Unfortunately, diabetes/cardiovascular disease risk factors and activity are infrequently reported and inconsistent in findings when examined. This inconsistency may partially be due to a lack of consideration for ceiling effects because of broad risk profile inclusion criteria in community translation efforts. To demonstrate this, change in each individual cardiometabolic risk factor limited to those who, at baseline, had a clinically defined abnormal value for that risk factor was examined in 2 cohorts using identical community translations of the Diabetes Prevention Program lifestyle intervention. METHODS For both studies (2010-2014, 2014-2019), adults with prediabetes and/or metabolic syndrome were recruited through community centers. Outcome measures collected at baseline and 6 months included BMI, activity, blood pressure, lipids, and fasting glucose. Data analyses examined pre-post change in each variable after 6 months of intervention and change within randomized groups at 6 months. RESULTS Change results were examined for the entire cohort and separately for participants with baseline values outside the recommended range for that risk factor. Whether assessing the pre-post intervention change or change within the randomized groups at 6 months, often the risk factor-specific approach demonstrated a greater effect size for that variable and sometimes newly reached statistical significance. CONCLUSIONS When examining the effectiveness of community translation efforts, consideration of the individual's baseline profile with risk factor-specific analysis is suggested to understand the full extent of the impact of the intervention.
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Affiliation(s)
- Andrea M Kriska
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Susan M Devaraj
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kaye Kramer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Spark 360, Pittsburgh, Pennsylvania
| | - Jenna M Napoleone
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bonny Rockette-Wagner
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yvonne Eaglehouse
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Vincent C Arena
- and the Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rachel G Miller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
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Smith ML, Bergeron CD, Sherman LD, Goidel K, Merianos AL. Contextualizing the Chronic Care Model among Non-Hispanic Black and Hispanic Men with Chronic Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3655. [PMID: 35329342 PMCID: PMC8951030 DOI: 10.3390/ijerph19063655] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023]
Abstract
Middle-aged and older men of color with chronic conditions have low utilization of preventive health services. In the context of the Chronic Care Model (CCM), the objective of this study was to identify perceptions about being informed, activated patients and having productive interactions in healthcare settings among non-Hispanic Black and Hispanic middle-aged and older men with chronic health conditions in the United States. Using an internet-based survey deployed nationally using a Qualtrics panel, data were collected from a sample of non-Hispanic Black and Hispanic men aged 40 years and older with one or more self-reported chronic conditions (n = 2028). Chi-square tests and one-way ANOVAs were used to describe this national sample by race/ethnicity and age group (40-64 years and ≥65 years). Results suggest that most health-related factors differed more on age than by race/ethnicity. Younger age groups reported less preventive care, greater barriers to self-care, mental health issues, and risky behavior. Findings from this study provide insight into the health status and healthcare utilization of racial/ethnic men with one or more chronic conditions. Results may help inform prevention and treatment interventions for middle-aged and older men of color.
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Affiliation(s)
- Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; (C.D.B.); (A.L.M.)
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA
| | - Caroline D. Bergeron
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; (C.D.B.); (A.L.M.)
- LIFE Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Ledric D. Sherman
- Department of Health and Kinesiology, College of Education, Texas A&M University, College Station, TX 77845, USA;
| | - Kirby Goidel
- Public Policy Research Institute, Texas A&M University, College Station, TX 77843, USA;
- Department of Communication, College of Liberal Arts, Texas A&M University, College Station, TX 77843, USA
| | - Ashley L. Merianos
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA; (C.D.B.); (A.L.M.)
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
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18
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Skinner AC, Xu H, Christison A, Neshteruk C, Cuda S, Santos M, Yee JK, Thomas L, King E, Kirk S. Patient Retention in Pediatric Weight Management Programs in the United States: Analyses of Data from the Pediatrics Obesity Weight Evaluation Registry. Child Obes 2022; 18:31-40. [PMID: 34415779 DOI: 10.1089/chi.2021.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: Meeting recommended provider contact hours in multicomponent pediatric weight management (PWM) programs is difficult when patient retention is low. Our objective was to examine associations between individual patient characteristics, program characteristics, and patient retention. Methods: Using the Pediatric Obesity Weight Evaluation Registry, a prospective longitudinal study of 32 PWM programs, we included children (≤18 years; n = 6502) enrolled for a full year. We examined associations between retention (any follow-up visit) and patient and program characteristics using multivariable models with site-clustering random effects. Results: Sixty-seven percent of children had at least one follow-up visit, whereas 12% had four or more visits. Compared with non-Hispanic white children, non-Hispanic black children were less likely to have a follow-up visit [adjusted odds ratio (aOR) = 0.79], whereas Hispanic children (any race) were more likely (aOR = 1.22). Children with Medicaid had similar retention to those with private insurance. Retention did not differ by age, gender, weight status, or comorbidities, nor by program characteristics. Conclusions: Few characteristics of PWM programs are clearly associated with retention, indicating that a variety of formats can support continued treatment and likely reflect the influence of unmeasured characteristics. Clearer ways to identify and overcome barriers for individual patients will be needed to improve retention in PWM.
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Affiliation(s)
- Asheley Cockrell Skinner
- Department of Population Health Sciences, Duke University, Durham, NC, USA.,Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Haolin Xu
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Amy Christison
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - Cody Neshteruk
- Department of Population Health Sciences, Duke University, Durham, NC, USA.,Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Suzanne Cuda
- Department of Pediatrics, Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, TX, USA
| | - Melissa Santos
- Pediatric Obesity Center, Connecticut Children's, Hartford, CT, USA
| | - Jennifer K Yee
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Laine Thomas
- Duke Clinical Research Institute, Duke University, Durham, NC, USA.,Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Eileen King
- Division of Biostatistics and Epidemiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Shelley Kirk
- Department of Pediatrics, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
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19
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Brown NR, Alick CL, Heaston AG, Monestime S, Powe N. The Black Church and Public Health: A Key Partnership for Theory Driven COVID-19 Recovery Efforts. J Prim Care Community Health 2022; 13:21501319221097672. [PMID: 35619243 PMCID: PMC9150224 DOI: 10.1177/21501319221097672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 epidemic has negatively impacted the Black community in the United States. Despite current disease mitigation efforts, work is still needed to ensure that Black individuals living in the United States understand their risks regarding COVID-19 infection whether vaccinated or unvaccinated. Thus, the current article posits that the Black church, in concert with public health practitioners, is a venue through which theoretically based health messages should be designed and disseminated regarding COVID-19 recovery efforts. The Health Belief Model and the Harm Reduction approach are posed as theoretical frameworks to facilitate the design of such messages.
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Affiliation(s)
| | - Candice L. Alick
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Shanada Monestime
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
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20
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Poon IO, Pounds K, Morris-Moultry A, Jemerson T. Effect of Pharmacist Home Visits on Weight Control in Overweight Elderly Hypertensive African American Patients: Managing Your Blood Pressure (My Bp) Program. JOURNAL OF ADVANCES IN MEDICAL AND PHARMACEUTICAL SCIENCES 2021; 23:43-50. [PMID: 34790878 PMCID: PMC8594906 DOI: 10.9734/jamps/2021/v23i730249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective was to investigate the effect of a home-based pharmacy intervention on body mass index (BMI) in a cohort of older hypertensive overweight African American (AA) patients. DESIGN A secondary analysis of data collected in a community-based intervention study. SETTING Community-based. PARTICIPANTS AA patients, ≥ 65 years old, residing independently, with hypertension diagnosis and BMI ≥ 25. INTERVENTIONS During a 6month period, patients received 1) two in-home pharmacist-led consultations on weight management, 2) bi-weekly telephone counseling, and 3) health education strategies. MAIN OUTCOME MEASURES BMIs at baseline and 6 months; stages of behavioral change in diet and exercise based on the Transtheoretical Model. RESULTS At baseline and 6-month follow-up, a total of 153 participants had BMI ≥ 25 and received a completed assessment of behavioral stages. Participants' mean age was 74.2 years. A reduction of BMI from 31.7 (obese) at baseline to 29.8 (overweight) at 6-months (p=0.0008) was observed. For every stage of improvement in diet, there was a reduction of 1.24 points in BMI (p=0.008). For every stage of progress in exercise, there was a reduction of 0.77 points in BMI (p=0.013). CONCLUSION Pharmacists-led in-home consultations coupled with telephone follow-ups and health education strategies may improve lifestyle and lower BMIs in this cohort. Further studies are needed to investigate these strategies on weight management in geriatric patients with chronic illnesses.
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Affiliation(s)
- Ivy O. Poon
- Texas Southern University, 3100 Cleburne Ave., Houston, TX 77004, USA
| | - Kimberly Pounds
- Texas Southern University, 3100 Cleburne Ave., Houston, TX 77004, USA
| | | | - Terrica Jemerson
- Texas Southern University, 3100 Cleburne Ave., Houston, TX 77004, USA
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21
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Devaraj SM, Napoleone JM, Miller RG, Rockette-Wagner B, Arena VC, Mitchell-Miland C, Saad MB, Kriska AM. The role of Sociodemographic factors on goal achievement in a community-based diabetes prevention program behavioral lifestyle intervention. BMC Public Health 2021; 21:1783. [PMID: 34600527 PMCID: PMC8487523 DOI: 10.1186/s12889-021-11844-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/29/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Diabetes Prevention Program (DPP) behavioral lifestyle intervention was effective among a diverse sample of adults with prediabetes. Demonstrated effectiveness in translated versions of the DPP lifestyle intervention (such as Group Lifestyle Balance, DPP-GLB) led to widescale usage with national program oversight and reimbursement. However, little is known about the success of these DPP-translation programs across subgroups of sociodemographic factors. This current effort investigated potential disparities in DPP-translation program primary goal achievement (physical activity and weight) by key sociodemographic factors. METHODS Data were combined from two 12-month community-based DPP-GLB trials among overweight/obese individuals with prediabetes and/or metabolic syndrome. We evaluated change in weight (kilograms and percent) and activity (MET-hrs/week) and goal achievement (yes/no; ≥5% weight loss and 150 min per week activity) after 6 and 12 months of intervention within and across subgroups of race/ethnicity (non-Hispanic white, non-Hispanic black), employment status, education, income, and gender. RESULTS Among 240 participants (85%) with complete data, most sociodemographic subgroups demonstrated significant weight loss. However, non-Hispanic white lost more weight at both 6 and 12 months compared to non-Hispanic black participants [median weight loss (IQR), 6 months: 5.7% (2.7-9.0) vs. 1.5% (1.2-7.5) p = .01 and 12 months: 4.8% (1.1-9.6) vs. 1.1% (- 2.0-3.7) p = .01, respectively]. In addition, a larger percentage of non-Hispanic white demonstrated a 5% weight loss at 6 and 12 months. Employment was significantly related to 12-month weight loss, with retired participants being the most successful. Men, participants with graduate degrees, and those with higher income were most likely to meet the activity goal at baseline and 12 months. Differences in physical activity goal achievement across gender, education, and income groups were significant at baseline, attenuated after 6 months, then re-emerged at 12 months. CONCLUSIONS The DPP-GLB was effective in promoting weight loss and helped to alleviate disparities in physical activity levels after 6 months. Despite overall program success, differences in weight loss achievement by race/ethnicity were found and disparities in activity re-emerged after 12 months of intervention. These results support the need for intervention modification providing more tailored approaches to marginalized groups to maximize the achievement and maintenance of DPP-GLB behavioral goals. TRIAL REGISTRATION NCT01050205 , NCT02467881 .
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Affiliation(s)
- Susan M Devaraj
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Jenna M Napoleone
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Rachel G Miller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Bonny Rockette-Wagner
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
| | - Vincent C Arena
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Chantele Mitchell-Miland
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Mohammed Bu Saad
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Andrea M Kriska
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 5135 Public Health, 130 De Soto Street, Pittsburgh, PA, 15261, USA
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22
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Culturally tailored lifestyle interventions for the prevention and management of type 2 diabetes in adults of Black African ancestry: a systematic review of tailoring methods and their effectiveness. Public Health Nutr 2021; 25:422-436. [PMID: 34435943 PMCID: PMC8883766 DOI: 10.1017/s1368980021003682] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: To evaluate the cultural tailoring methods used in type 2 diabetes (T2D), prevention and management interventions for populations of Black African ancestry and to examine their effectiveness on measures of glycaemia. Design: Three databases were searched in October 2020; eligible studies used a randomised controlled trial (RCT) design to evaluate the effectiveness of culturally tailored lifestyle interventions compared with usual care for the prevention or management of T2D in adults of Black African ancestry. Cultural tailoring methods were evaluated using the Facilitator-Location-Language-Messaging (FiLLM) framework, whereby facilitator refers to delivery by individuals from the target community, language focuses on using native language or language appropriate to literacy levels, location refers to delivery in meaningful settings, and messaging is tailoring with relevant content and modes of delivery. Results: Sixteen RCT were identified, all from USA. The mean age of participants was 55 years, majority female. Six of fifteen RCT reported significant improvements in glycated haemoglobin (HbA1c) at 6 and 8 months; one, in prediabetes, reported significantly improved fasting plasma glucose. Diabetes knowledge improvement (5/7 studies) was associated with HbA1c improvement. The majority tailored to location (12/16), facilitators (11/16), messaging (9/16) and language (6/16) domains of FiLLM. Those with ethnically matched facilitators and those which tailored to more than one domain showed the greatest HbA1C benefits. Conclusion: This evidence supports the effectiveness of culturally tailored lifestyle interventions for T2D management in populations of Black African ancestry, with further RCT needed to evaluate interventions for T2D prevention and for communities outside of the USA.
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23
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Yeary KHK, Alcaraz KI, Ashing KT, Chiu C, Christy SM, Felsted KF, Lu Q, Lumpkins CY, Masters KS, Newton RL, Park CL, Shen MJ, Silfee VJ, Yanez B, Yi J. Considering religion and spirituality in precision medicine. Transl Behav Med 2021; 10:195-203. [PMID: 31294809 DOI: 10.1093/tbm/ibz105] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The emerging era of precision medicine (PM) holds great promise for patient care by considering individual, environmental, and lifestyle factors to optimize treatment. Context is centrally important to PM, yet, to date, little attention has been given to the unique context of religion and spirituality (R/S) and their applicability to PM. R/S can support and reinforce health beliefs and behaviors that affect health outcomes. The purpose of this article is to discuss how R/S can be considered in PM at multiple levels of context and recommend strategies for integrating R/S in PM. We conducted a descriptive, integrative literature review of R/S at the individual, institutional, and societal levels, with the aim of focusing on R/S factors with a high level of salience to PM. We discuss the utility of considering R/S in the suitability and uptake of PM prevention and treatment strategies by providing specific examples of how R/S influences health beliefs and practices at each level. We also propose future directions in research and practice to foster greater understanding and integration of R/S to enhance the acceptability and patient responsiveness of PM research approaches and clinical practices. Elucidating the context of R/S and its value to PM can advance efforts toward a more whole-person and patient-centered approach to improve individual and population health.
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Affiliation(s)
| | | | | | - Chungyi Chiu
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | | | - Qian Lu
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Crystal Y Lumpkins
- School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | | | | | | | - Megan J Shen
- Weill Cornell Medical College, New York City, NY, USA
| | | | - Betina Yanez
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jean Yi
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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24
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Misra R, Shawley-Brzoska S, Khan R, Kirk BO, Wen S, Sambamoorthi U. Addressing Diabetes Distress in Self-Management Programs: Results of a Randomized Feasibility Study. JOURNAL OF APPALACHIAN HEALTH 2021; 3:68-85. [PMID: 35770030 PMCID: PMC9192112 DOI: 10.13023/jah.0303.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management. METHODS This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN (n=10 per group) completed baseline and 12-week assessments. Diabetes distress was measured by using a validated Diabetes Distress Survey (17-item Likert scale; four sub-scales of emotional burden, physician related burden, regimen related burden, and interpersonal distress). Baseline and post-intervention changes in diabetes distress were compared for both groups; reduction in distress in the intervention groups are depicted using waterfall plots. The mean age, HbA1c and BMI were 55 ± 9.6 years, 7.8 ± 2.24 and 36.4 ± 8.8, respectively. Diabetes distress (total; mean) was 1.84±0.71. RESULTS Participants reported higher diabetes distress related to emotional burden (2.1±0.94) and regimen-related distress (2.0 ± 0.74); physician-related distress was the lowest (1.18±0.64). In general, diabetes distress reduced among intervention participants and was especially significant among those with HbA1c ≤ 8% (r=0.28, p=0.4), and systolic/diastolic BP ≤140/80 mm Hg (r=0.045, P=0.18). IMPLICATIONS Findings suggest that lifestyle self-management programs have the potential to reduce diabetes distress.
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Affiliation(s)
| | | | - Raihan Khan
- College of Health and Behavioral Studies, James Madison University
| | | | - Sijin Wen
- School of Public Health, West Virginia University
| | - Usha Sambamoorthi
- Texas Center for Health Disparities, University of North Texas Health Sciences Center
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25
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Rogers CR, Matthews P, Brooks E, Le Duc N, Washington C, McKoy A, Edmonson A, Lange L, Fetters MD. Barriers to and Facilitators of Recruitment of Adult African American Men for Colorectal Cancer Research: An Instrumental Exploratory Case Study. JCO Oncol Pract 2021; 17:e686-e694. [PMID: 33974818 DOI: 10.1200/op.21.00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Racial and ethnic minorities remain underrepresented in research and clinical trials. Better understanding of the components of effective minority recruitment into research studies is critical to understanding and reducing health disparities. Research on recruitment strategies for cancer-specific research-including colorectal cancer (CRC)-among African American men is particularly limited. We present an instrumental exploratory case study examining successful and unsuccessful strategies for recruiting African American men into focus groups centered on identifying barriers to and facilitators of CRC screening completion. METHODS The parent qualitative study was designed to explore the social determinants of CRC screening uptake among African American men 45-75 years of age. Recruitment procedures made use of community-based participatory research strategies combined with built community relationships, including the use of trusted community members, culturally tailored marketing materials, and incentives. RESULTS Community involvement and culturally tailored marketing materials facilitated recruitment. Barriers to recruitment included limited access to public spaces, transportation difficulties, and medical mistrust leading to reluctance to participate. CONCLUSION The use of strategies such as prioritizing community relationship building, partnering with community leaders and gatekeepers, and using culturally tailored marketing materials can successfully overcome barriers to the recruitment of African American men into medical research studies. To improve participation and recruitment rates among racial and ethnic minorities in cancer-focused research studies, future researchers and clinical trial investigators should aim to broaden recruitment, strengthen community ties, offer incentives, and use multifaceted approaches to address specific deterrents such as medical mistrust and economic barriers.
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Affiliation(s)
- Charles R Rogers
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Phung Matthews
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Ellen Brooks
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Nathan Le Duc
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Chasity Washington
- Population Sciences Department, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Alicia McKoy
- Population Sciences Department, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Al Edmonson
- A Cut Above the Rest Barbershop, Columbus, OH
| | - LaJune Lange
- International Leadership Institute, Minneapolis, MN
| | - Michael D Fetters
- Mixed Methods Program and Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI
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26
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Onyishi CN, Ilechukwu LC, Victor-Aigbodion V, Eseadi C. Impact of spiritual beliefs and faith-based interventions on diabetes management. World J Diabetes 2021; 12:630-641. [PMID: 33995850 PMCID: PMC8107980 DOI: 10.4239/wjd.v12.i5.630] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | | | - Vera Victor-Aigbodion
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
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27
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Berkley-Patton J, Huffman MM, Thompson CB, Johnson N, Ervie K, Lindsey C, Reuchter V, Christensen K, Davis A, Burgin T. Increasing Reach of the Diabetes Prevention Program in African American Churches: Project FIT Lessons Learned in Using an Interprofessional Student Service-Learning Approach. MISSOURI MEDICINE 2021; 118:264-271. [PMID: 34149088 PMCID: PMC8210992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention proven to reduce/delay diabetes onset with diet change, physical activity, and modest weight loss. However, access to the program is limited in low-resource communities. Having health profession students facilitate DPP groups as a service learning course-credit opportunity may benefit their interprofessional training while also expanding DPP access in underserved communities. We sought to use student reflections to identify themes to assist with program evaluation and to inform program refinements. Students (N=95) from the University of Missouri-Kansas City (UMKC) medical, physician assistant, and pharmacy programs led DPP groups in urban Kansas City African American churches alongside church health liaisons as part of an interprofessional service-learning course. Students reported creating satisfying, ongoing relationships with participants; developing a deeper understanding of obstacles to weight loss; and learning the role of other health professionals in the care of patients. They also identified obstacles to successful program implementation, such as needing less time in training and having equal participation from students across their interprofessional teams. Students learned important lessons by leading the DPP, but interprofessional service-learning courses have multiple obstacles to successful delivery. Still, this approach has great potential to increase access to the DPP in African American communities and promote skill development in health profession students.
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Affiliation(s)
- Jannette Berkley-Patton
- Professor and the director of the Community Health Research Group, in the School of Medicine (SOM) Department of Biomedical and Health Informatics at the University of Missouri-Kansas City, Kansas City, Missouri (DMHI UMKC-KCMO)
| | - Miranda M Huffman
- Associate professor in the Department of Family and Community Medicine at Meharry Medical College in Nashville, Tennessee
| | | | - Nia Johnson
- Research associate previously in the Community Health Research Group, SOM DMHI UMKC-KCMO, and is currently a medical student in the School of Medicine at Saint Louis University, St. Louis, Missouri
| | - Katherine Ervie
- Program director of the physician assistant program in the SOM UMKC-KCMO
| | - Cameron Lindsey
- Interim chair and director of Co-Curriculum and Professor of Pharmacy Practice and Administration in the School of Pharmacy, UMKC-KCMO
| | - Valerie Reuchter
- Director of Experiential Learning and Clinical Associate Professor in the Division of Pharmacy Practice and Administration in the School of Pharmacy, UMKC-KCMO
| | | | | | - Tacia Burgin
- Doctoral student in the Psychology Department, UMKC-KCMO
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28
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Abstract
Latinos face healthcare access barriers and are highly religious. Church-based health interventions could help address these disparities. We conducted a systematic review of church-based health interventions among Latinos using multiple search terms and databases. The 21 articles reviewed represented 19 interventions. Only six were tested through full-scale randomized controlled trials and five had statistically significant improvements in health-related outcomes. Most (16) utilized groups classes, eight promoted screening or preventive services, and three provided these on-site. Few intervened at multiple levels (e.g., individual, group, and community) and only three utilized pastors' sermons to deliver health-related messages. Church-based health interventions among Latinos are nascent, with only a handful of full-scale trials. Various pilot studies demonstrating feasibility across diverse health conditions suggest model adaptability. Larger studies with objectively measured outcomes and interventions that address multiple levels and structural issues are needed to ensure improvements in Latinos' access and health.
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29
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Su D, Garg A, Wiens J, Meyer E, Cai G. Assessing Health Needs in African American Churches: A Mixed-Methods Study. JOURNAL OF RELIGION AND HEALTH 2021; 60:1179-1197. [PMID: 31595445 DOI: 10.1007/s10943-019-00924-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Among major racial and ethnic groups in the USA, African Americans are the most religious, and faith-based organizations play an important role in health promotion for African Americans. This study aimed to assess health needs in African American churches using a mixed-methods approach. Based on quantitative and qualitative data collected from eight African American churches in Nebraska in 2017, the most prevalent chronic conditions among participating African American church members (n = 388) included hypertension (60.8%), allergies (41.0%), arthritis (36.4%), high cholesterol (35.8%), and diabetes (28.1%). Significant predictors of fair or poor health were identified as male sex, unemployment, delayed utilization of health care in the past 12 months due to cost, lower frequency of church attendance, and feeling down, depressed, or hopeless in the past 2 weeks. Pastors from participating churches identified cost as one of the primary barriers to providing church-based health services. There were substantial unmet health needs in African American faith communities, especially in the areas of chronic disease prevention and management, and churches would need more support to realize their full potential in faith-based health promotion.
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Affiliation(s)
- Dejun Su
- Department of Health Promotion, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-4340, USA.
| | - Ashvita Garg
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jessica Wiens
- Department of Health Promotion, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-4340, USA
| | - Eric Meyer
- Department of Health Promotion, College of Public Health, 984340 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-4340, USA
| | - Grace Cai
- Trinity College of Arts and Sciences, Duke University, Durham, NC, USA
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30
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Blankinship LA, Rouse WA, Bernstein J, Kruk J, Aboul-Enein BH. A Narrative Review of Ethnic Minority Studies for Faith-Based Health Promotion Interventions with Special Reference to the Contemporary Christian Nurse. JOURNAL OF RELIGION AND HEALTH 2021; 60:1375-1387. [PMID: 33400145 DOI: 10.1007/s10943-020-01150-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
Heart disease, diabetes mellitus (DM) type 2, and obesity are three of the most prevalent diseases in the USA. Some obesity-related comorbidities are disproportionately higher within African-American and Hispanic communities. While governmental and local health programs offer educational opportunities encouraging long-term health behavior changes, the most accessible programs have been through faith-based communities. This narrative review investigates the outcomes of faith-based wellness programs on Latino and African-American populations with respect to general health and wellness, obesity management, DM type 2, and hypertension. Perceived authority of faith community nurses, faith leaders, and accountability and encouragement provided by faith communities are critical. Long-term behavior change is positively affected by elements faith-based organizations can provide: cultural appropriateness, community support, and self-efficacy.
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Affiliation(s)
- Lisa A Blankinship
- Department of Biology, University of North Alabama, 1 Harrison Plaza, Florence, AL, USA
| | - William A Rouse
- Anderson College of Nursing and Health Professions, University of North Alabama, Florence, AL, 35632, USA
| | - Joshua Bernstein
- College of Graduate Health Studies, A.T. Still University of Health Sciences, 800 W. Jefferson St., Kirksville, MO, 63501, USA
| | - Joanna Kruk
- Faculty of Physical Culture and Health Promotion, University of Szczecin, Al. Piastów 40b/6, 71-065, Szczecin, Poland
| | - Basil H Aboul-Enein
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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Haw JS, Shah M, Turbow S, Egeolu M, Umpierrez G. Diabetes Complications in Racial and Ethnic Minority Populations in the USA. Curr Diab Rep 2021; 21:2. [PMID: 33420878 PMCID: PMC7935471 DOI: 10.1007/s11892-020-01369-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Racial and ethnic minority populations have a higher burden of diabetes-related complications. There have been many epidemiologic studies to better define these racial/ethnic disparities in diabetes outcomes with additional studies offering interventions to mitigate them. This narrative review highlights the epidemiologic trends in diabetes complications specific to racial and ethnic minorities and underscores differences in microvascular and macrovascular complications of diabetes, health care utilization, and diabetes prevention efforts and also reviews interventions aimed to reduce racial/ethnic disparities and their limitations. RECENT FINDINGS While we have seen in general an overall improvement in complication rates for all people with diabetes, the disparities between Black and Hispanic compared to non-Hispanic White people with diabetes seem to persist. There is a continued need to better understand the underlying causes of and strategies to mitigate race/ethnicity disparities in diabetes complications in the USA.
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Affiliation(s)
- J Sonya Haw
- Division of Endocrinology, Metabolism & Lipids, School of Medicine, Emory University, 69 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA.
| | - Megha Shah
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, USA
| | - Sara Turbow
- Department of Family and Preventative Medicine, Emory University, Atlanta, GA, USA
- Division of General Internal Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | | | - Guillermo Umpierrez
- Division of Endocrinology, Metabolism & Lipids, School of Medicine, Emory University, 69 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA
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Berkley-Patton J, Bowe Thompson C, Bauer AG, Berman M, Bradley-Ewing A, Goggin K, Catley D, Allsworth JE. A Multilevel Diabetes and CVD Risk Reduction Intervention in African American Churches: Project Faith Influencing Transformation (FIT) Feasibility and Outcomes. J Racial Ethn Health Disparities 2020; 7:1160-1171. [PMID: 32329033 PMCID: PMC7581562 DOI: 10.1007/s40615-020-00740-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 12/30/2022]
Abstract
Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.
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Affiliation(s)
- Jannette Berkley-Patton
- Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Carole Bowe Thompson
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Alexandria G Bauer
- Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Marcie Berman
- The Institute for Community Research, Hartford, CT, USA
| | - Andrea Bradley-Ewing
- Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kathy Goggin
- Health Services and Outcomes Research, Children's Mercy Kansas City; Schools of Medicine and Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City; Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Jenifer E Allsworth
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
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Impact of Physical Activity and Weight Loss on Fat Mass, Glucose Metabolism, and Inflammation in Older African Americans with Osteoarthritis. Nutrients 2020; 12:nu12113299. [PMID: 33126555 PMCID: PMC7694088 DOI: 10.3390/nu12113299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/16/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Abstract
(1) Background: There are currently very few interventions performed within a community setting that compare the effects of physical activity (PA) versus PA plus weight loss on cancer and chronic disease risk in older African Americans. Therefore, we investigated the impact of an 8 week (24 session) PA intervention compared to a PA plus weight loss intervention on fat mass, glucose metabolism, and markers of inflammation in older, overweight and obese African Americans. (2) Methods: Subjects were randomized to a PA (n = 83) or PA plus weight loss (n = 72) intervention that met three times weekly for 8 weeks. At baseline and post-intervention, anthropometrics, body composition, systemic inflammation (high-sensitivity C-reactive protein, tumor necrosis factor-α, and interleukin 6), fasting glucose, insulin and homeostasis model assessment-insulin resistance (HOMA-IR) were determined. (3) Results: Subjects had a mean age of 67 years (SD = 5.3) and were mostly women (88%). The PA plus weight loss group lost more total and visceral fat than the PA group (−4.0% vs. +0.6% and −4.1% vs. +3.7%, respectively, p < 0.01 for both). Changes in inflammation and glucose metabolism were similar between groups post-intervention. Within the PA plus weight loss group only, serum insulin and HOMA-IR decreased significantly. (4) Conclusions: PA combined with weight loss can decrease total and visceral fat mass and improve insulin sensitivity, confirming that these cancer- and chronic disease-related risk factors are influenced by relatively modest lifestyle changes in the short term.
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Modell SM, Kardia SLR. Religion as a Health Promoter During the 2019/2020 COVID Outbreak: View from Detroit. JOURNAL OF RELIGION AND HEALTH 2020; 59:2243-2255. [PMID: 32548832 PMCID: PMC7297133 DOI: 10.1007/s10943-020-01052-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The 2019/2020 COVID outbreak has surfaced as a global pandemic. The news has carried stories of the heroic efforts of medical and other health practitioners, with public health officials charting the course of spread. In an urban center like Detroit, the generosity of everyday citizens and church organizations has also played an important role. This inspection of the pandemic from the view of Detroit will examine the epidemiology of the coronavirus, translation of professional practice into people's awareness of the chronic disease risk factors which are prevalent in Detroit, moral and ethical views on the distribution of resources, and three major ways that religious faith has helped to sustain people's health and welfare in the midst of the broad social challenges posed by this novel coronavirus.
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Affiliation(s)
- Stephen M. Modell
- Department of Epidemiology, University of Michigan School of Public Health, M5049, SPH II 1415 Washington Hts., Ann Arbor, MI 48109-2029 USA
| | - Sharon L. R. Kardia
- Department of Epidemiology, University of Michigan School of Public Health, M5049, SPH II 1415 Washington Hts., Ann Arbor, MI 48109-2029 USA
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Kitzman H, Mamun A, Dodgen L, Slater D, King G, King A, Slater JL, DeHaven M. Better Me Within Randomized Trial: Faith-Based Diabetes Prevention Program for Weight Loss in African American Women. Am J Health Promot 2020; 35:202-213. [PMID: 32945175 PMCID: PMC8177484 DOI: 10.1177/0890117120958545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Previous DPP translations in African American women have been suboptimal. This trial evaluated a community-based participatory research developed faith-based diabetes prevention program (DPP) to improve weight loss in African American women. DESIGN This cluster randomized trial allocated churches to faith-based (FDPP) or standard (SDPP) DPP interventions. Setting. African American churches. Subjects. Eleven churches with 221 African American women (aged 48.8 ± 11.2 years, BMI = 36.7 ± 8.4) received the FDPP (n = 6) or SDPP (n = 5) intervention. INTERVENTION FDPP incorporated 5 faith-based components, including pastor involvement, into the standard DPP curriculum. The SDPP used the standard DPP curriculum. Lay health leaders facilitated interventions at church sites. MEASURES Weight and biometrics were collected by blinded staff at baseline, 4- and 10-months. ANALYSIS A multilevel hierarchical regression model compared the FDPP and SDPP groups on outcomes. RESULTS FDPP and SDPP churches significantly lost weight at 10-months (overall -2.6%, p < .01). Women in FDPP churches who attended at least 15 sessions lost an additional 6.1 pounds at 4-months compared to SDPP corresponding to a 5.8% reduction at 10-months (p < .05). Both groups had significant improvements in health behaviors and biometrics. CONCLUSIONS Faith-based and standard DPP interventions led by lay health leaders successfully improved weight, health behaviors, and chronic disease risk. However, the faith-based DPP when fully implemented met the CDC's recommendation for weight loss for diabetes prevention in African American women.
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Affiliation(s)
- Heather Kitzman
- Baylor Scott & White Health and Wellness Center, 10616Baylor Scott & White Health, Dallas, TX, USA.,Robbins Institute for Health Policy & Leadership, Hankamer School of Business, Baylor University, Waco, TX, USA
| | - Abdullah Mamun
- Baylor Scott & White Health and Wellness Center, 10616Baylor Scott & White Health, Dallas, TX, USA
| | - Leilani Dodgen
- Baylor Scott & White Health and Wellness Center, 10616Baylor Scott & White Health, Dallas, TX, USA
| | - Donna Slater
- Better Me Within Community Advisory Board, New Millennium Bible Fellowship Praise Center, Dallas, TX, USA
| | - George King
- Better Me Within Community Advisory Board, New Millennium Bible Fellowship Praise Center, Dallas, TX, USA
| | - Alene King
- Better Me Within Community Advisory Board, New Millennium Bible Fellowship Praise Center, Dallas, TX, USA
| | - J Lee Slater
- Better Me Within Community Advisory Board, New Millennium Bible Fellowship Praise Center, Dallas, TX, USA
| | - Mark DeHaven
- Department of Public Health Science, 14727University of North Carolina, Charlotte, NC, USA
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Faith Community Nursing: Using Spiritual Interventions in Diabetes Prevention. J Christ Nurs 2020; 37:243-249. [PMID: 32898067 DOI: 10.1097/cnj.0000000000000752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
As the incidence of diabetes rises in the United States, education on diabetes prevention and management is paramount. Diabetes programs offered in churches or community settings have reported positive outcomes such as weight loss and improved glucose control. Delphi Survey technique was used to identify spiritual interventions used by faith-based and community-based coaches in leading Diabetes Prevention Program (DPP) courses. Results showed that faith-based coaches reported using prayer, active listening, and emotional support in their DPP course; giving hope, incorporating humor, and using spiritual/sacramental activities were rated as important or very important by most coaches and can be used by faith community nurses in their practice.
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Asamane EA, Greig CA, Thompson JL. The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults. BMC Nutr 2020; 6:36. [PMID: 32864152 PMCID: PMC7447572 DOI: 10.1186/s40795-020-00363-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/20/2020] [Indexed: 01/06/2023] Open
Abstract
Background There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months' follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Methods Multiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake. Results Complete data were collected at baseline (n = 100) and 8-months' follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z = -4.01, p < 0.001) and nutritional status (Z = -2.37, p = 0.018) declined over time. Higher SPPB scores at baseline (OR = 0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status. Conclusion The observed declines and inadequate nutrient intakes in the absence of weight loss in just 8 months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.
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Affiliation(s)
- Evans A Asamane
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,School Primary, Community and Social Care, Keele University, Keele, UK
| | - Carolyn A Greig
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Janice L Thompson
- School of Sports, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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Abbey EL, Keogh George SM. Our Bodies are Temples: Health Programming in Christian Church Communities. JOURNAL OF RELIGION AND HEALTH 2020; 59:1958-1981. [PMID: 31493214 DOI: 10.1007/s10943-019-00905-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This exploratory research considers the ways in which Christian churches provide health and wellness programming to their congregations and the surrounding community. We investigated one community in the Pacific Northwest region of the USA. Here we examined the types of health-related programs promoted by the church community, to whom these programs are directed, and the theological motivations for providing such services. We also analyzed the sociocultural dynamics of each congregation that may lead some churches to promote health and wellness more than others. Findings suggest that many churches focus primarily on providing services to the community at large, rather than promoting healthy living within their own communities.
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Affiliation(s)
- Elizabeth L Abbey
- Department of Health Sciences, Whitworth University, 300 W Hawthorne Rd., Spokane, WA, 99251, USA.
| | - Stacy M Keogh George
- Department of Sociology, Whitworth University, 300 W Hawthorne Rd., Spokane, WA, 99251, USA
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Harrison CR, Phimphasone-Brady P, DiOrio B, Raghuanath SG, Bright R, Ritchie ND, Sauder KA. Barriers and Facilitators of National Diabetes Prevention Program Engagement Among Women of Childbearing Age: A Qualitative Study. DIABETES EDUCATOR 2020; 46:279-288. [PMID: 32597384 DOI: 10.1177/0145721720920252] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose of this study was to understand barriers and facilitators to engagement in a diabetes prevention program for young women at an urban safety-net health care system. METHODS Individual semistructured interviews (N = 29) explored motivations, challenges, and successes regarding participation and suggestions for improvement among women aged 18 to 39 years who enrolled in the National Diabetes Prevention Program in the past 2 years. Participants were classified as nonattendees (n = 10), early-withdrawers (n = 9), or completers (n = 10). Interview transcriptions were analyzed using a grounded hermeneutic editing approach. RESULTS Qualitative analysis revealed 4 main themes (enrollment, attendance, experience, and suggestions) with multiple subthemes. Most women were motivated to enroll for health and family concerns. Early-withdrawers and nonattendees reported confusion about the program's aim and relevancy, logistical barriers, and lack of connection with fellow participants/coaches. Highly engaged women noted persistent motivation, perceived weight loss, and supportive program relationships. CONCLUSIONS Multiple barriers/facilitators for young women appear addressable in future adaptations. Additional research is needed to confirm these findings in other settings and explore implementation and effectiveness of adaptations, with a goal of reducing risks prior to conception.
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Affiliation(s)
- Caroline R Harrison
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | | | - Becky DiOrio
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Riley Bright
- Denver Health and Hospital Authority, Denver, Colorado
| | - Natalie D Ritchie
- Denver Health and Hospital Authority, Denver, Colorado.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado.,College of Nursing, University of Colorado, Aurora, Colorado
| | - Katherine A Sauder
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Aurora, Colorado
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40
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Flórez KR, Payán DD, Palar K, Williams MV, Katic B, Derose KP. Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review. Nutr Rev 2020; 78:304-322. [PMID: 31539069 PMCID: PMC8453621 DOI: 10.1093/nutrit/nuz046] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
CONTEXT Multilevel church-based interventions may help address racial/ethnic disparities in obesity in the United States since churches are often trusted institutions in vulnerable communities. These types of interventions affect at least two levels of socio-ecological influence which could mean an intervention that targets individual congregants as well as the congregation as a whole. However, the extent to which such interventions are developed using a collaborative partnership approach and are effective with diverse racial/ethnic populations is unclear, and these crucial features of well-designed community-based interventions. OBJECTIVE The present systematic literature review of church-based interventions was conducted to assess their efficacy for addressing obesity across different racial/ethnic groups (eg, African Americans, Latinos). DATA SOURCES AND EXTRACTION In total, 43 relevant articles were identified using systematic review methods developed by the Center for Disease Control and Prevention (CDC)'s Task Force on Community Preventive Services. The extent to which each intervention was developed using community-based participatory research principles, was tailored to the particular community in question, and involved the church in the study development and implementation were also assessed. DATA ANALYSIS Although 81% of the studies reported significant results for between- or within-group differences according to the study design, effect sizes were reported or could only be calculated in 56% of cases, and most were small. There was also a lack of diversity among samples (eg, few studies involved Latinos, men, young adults, or children), which limits knowledge about the ability of church-based interventions to reduce the burden of obesity more broadly among vulnerable communities of color. Further, few interventions were multilevel in nature, or incorporated strategies at the church or community level. CONCLUSIONS Church-based interventions to address obesity will have greater impact if they consider the diversity among populations burdened by this condition and develop programs that are tailored to these different populations (eg, men of color, Latinos). Programs could also benefit from employing multilevel approaches to move the field away from behavioral modifications at the individual level and into a more systems-based framework. However, effect sizes will likely remain small, especially since individuals only spend a limited amount of time in this particular setting.
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Affiliation(s)
- Karen R Flórez
- CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Denise D Payán
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, California, USA
- RAND Corporation, Santa Monica, California, USA
| | - Kartika Palar
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | - Bozena Katic
- CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
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Kivelä J, Wikström K, Virtanen E, Georgoulis M, Cardon G, Civeira F, Iotova V, Karuranga E, Ko W, Liatis S, Makrilakis K, Manios Y, Mateo-Gallego R, Nanasi A, Rurik I, Tankova T, Tsochev K, Van Stappen V, Lindström J. Obtaining evidence base for the development of Feel4Diabetes intervention to prevent type 2 diabetes - a narrative literature review. BMC Endocr Disord 2020; 20:140. [PMID: 32164690 PMCID: PMC7066732 DOI: 10.1186/s12902-019-0468-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/04/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Feel4Diabetes was a school and community based intervention aiming to promote healthy lifestyle and tackle obesity for the prevention of type 2 diabetes among families in 6 European countries. We conducted this literature review in order to guide the development of evidence-based implementation of the Feel4Diabetes intervention. We focused on type 2 diabetes prevention strategies, including all the phases from risk identification to implementation and maintenance. Special focus was given to prevention among vulnerable groups and people under 45 years. METHODS Scientific and grey literature published between January 2000 and January 2015 was searched for relevant studies using electronic databases. To present the literature review findings in a systematic way, we used the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. A complementary literature search from February 2015 to December 2018 was also conducted. RESULTS The initial review included 27 studies with a follow-up ≥12 months and 9 studies with a follow-up ≥6 months and with a participant mean age < 45 years. We found out that interventions should be targeted at people at risk to improve recruiting and intervention effectiveness. Screening questionnaires (primarily Finnish Diabetes Risk Score FINDRISC) and blood glucose measurement can both be used for screening; the method does not appear to affect intervention effectiveness. Screening and recruitment is time-consuming, especially when targeting lower socioeconomic status and age under 45 years. The intervention intensity is more important for effectiveness than the mode of delivery. Moderate changes in several lifestyle habits lead to good intervention results. A minimum of 3-year follow-up seemed to be required to show a reduction in diabetes risk in high-risk individuals. In participants < 45 years, the achieved results in outcomes were less pronounced. The complementary review included 12 studies, with similar results regarding intervention targets and delivery modes, as well as clinical significance. CONCLUSION This narrative review highlighted several important aspects that subsequently guided the development of the Feel4Diabetes high-risk intervention. Research on diabetes prevention interventions targeted at younger adults or vulnerable population groups is still relatively scarce. Feel4Diabetes is a good example of a project aiming to fill this research gap. TRIAL REGISTRATION clinicaltrials.gov NCT02393872, registered 20th March 2015.
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Affiliation(s)
- Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, PO BOX 27, 00300 Helsinki, Finland
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Katja Wikström
- Department of Public Health Solutions, National Institute for Health and Welfare, PO BOX 27, 00300 Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Eeva Virtanen
- Department of Public Health Solutions, National Institute for Health and Welfare, PO BOX 27, 00300 Helsinki, Finland
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Fernando Civeira
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | | | - Winne Ko
- International Diabetes Federation, Brussels, Belgium
| | - Stavros Liatis
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Rocío Mateo-Gallego
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Anna Nanasi
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University Sofia, Sofia, Bulgaria
| | - Kaloyan Tsochev
- Department of Paediatrics, Medical University Varna, Varna, Bulgaria
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Jaana Lindström
- Department of Public Health Solutions, National Institute for Health and Welfare, PO BOX 27, 00300 Helsinki, Finland
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McElfish PA, Ayers B, Riklon S, Selig JP, Yeary KHC, Carleton A, Wilmoth R, Laukon F, Gittelsohn J, Netwon M, Long CR. Study protocol for a multilevel diabetes prevention program for Marshallese Pacific Islanders in faith-based organizations. Contemp Clin Trials Commun 2020; 17:100528. [PMID: 32025587 PMCID: PMC6997497 DOI: 10.1016/j.conctc.2020.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/06/2020] [Accepted: 01/19/2020] [Indexed: 10/29/2022] Open
Affiliation(s)
- Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125, N. College Ave., Fayetteville, AR, 72703, USA
| | - Britni Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125, N. College Ave., Fayetteville, AR, 72703, USA
| | - Sheldon Riklon
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
| | - James P. Selig
- College of Public Health University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR, 72205, USA
| | - Karen Hye-cheon Yeary
- Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carton Streets, Buffalo, NY, 14263, USA
| | - Ayoola Carleton
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
| | - Ralph Wilmoth
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
| | - Faith Laukon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125, N. College Ave., Fayetteville, AR, 72703, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health 615 North Wolfe St, Baltimore, MD, 21205-2179, USA
| | - Morda Netwon
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
| | - Christopher R. Long
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR, 72703, USA
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Rodriguez Then FS, Jackson J, Ware C, Churchyard R, Hanseeuw B. Interdisciplinary and Transdisciplinary Perspectives: On the Road to a Holistic Approach to Dementia Prevention and Care. J Alzheimers Dis Rep 2020; 4:39-48. [PMID: 32206756 PMCID: PMC7081086 DOI: 10.3233/adr-180070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Dementia, of which the most frequent form is Alzheimer's disease, is a chronic and terminal condition with multi-factorial causes and numerous consequences on a patient's life. Combining perspectives from different disciplines seems necessary for unraveling dementia's entangled issues. Current dementia management is a multidisciplinary effort; however, integrating different disciplines as a holistic treatment process is often hindered due to different responsibilities, various conceptual approaches, and distinctive research methods. With this paper, we raise some of the challenges that need to be addressed in order to initiate an interdisciplinary or even transdisciplinary research agenda. We also outline recommendations on how to integrate multiple disciplinary perspectives in dementia care and research. We see opportunities for young investigators to draw from different fields of research in dementia as their research focus is still developing. By establishing common objectives with investigators from other fields, we can pursue the goal of improving treatment and care as a team-meaning accomplishing different tasks but sharing a common purpose. It is necessary to address the communication between fields that limits the understanding of connections between cognitive symptoms, biological processes, treatment, lifestyle, and care giving in order to reach the aim of developing a holistic, person-centered, patient-first approach. Associating biomedical research to field experience from care professionals and the study of human science will promote a more independent, social, and sustainable lifestyle for people with dementia.
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Affiliation(s)
- Francisca S Rodriguez Then
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology & Public Health, Greifswald, Germany.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA.,Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Jonathan Jackson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Caitlin Ware
- Department of Psychoanalytical Studies, Université de Paris, CRPMS, F-75013, Paris, France.,Institut National de la Santé et de la Recherche Médicale, (INSERM) Inserm UMR-S 1237, Normandie Univ, UNICAEN, GIP Cyceron, France
| | - Rebekah Churchyard
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Bernard Hanseeuw
- Cliniques Universitaires Saint-Luc, Department of Neurology, Brussels, Belgium.,Université Catholique de Louvain, Institute of Neurosciences, Brussels, Belgium.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, and the GordonCenter for Medical Imaging, Charlestown, MA, USA
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Castro-Juarez AA, Serna-Gutiérrez A, Dórame-López NA, Solano-Morales M, Gallegos-Aguilar AC, Díaz-Zavala RG, Alemán-Mateo H, Urquidez-Romero R, Campa-Quijada F, Valenzuela-Guzmán DM, Esparza-Romero J. Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study. J Diabetes Res 2020; 2020:6320402. [PMID: 33062713 PMCID: PMC7545430 DOI: 10.1155/2020/6320402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/24/2020] [Indexed: 12/02/2022] Open
Abstract
Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.
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Affiliation(s)
- Alejandro Arturo Castro-Juarez
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Araceli Serna-Gutiérrez
- Sociocultural Department, Technological Institute of Sonora, Cd. Obregon, Sonora 85137, Mexico
| | - Norma Alicia Dórame-López
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Mariela Solano-Morales
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Ana Cristina Gallegos-Aguilar
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Rolando Giovanni Díaz-Zavala
- Nutrition Health Promotion Center, Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Sonora 83000, Mexico
| | - Heliodoro Alemán-Mateo
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Rene Urquidez-Romero
- Department of Health Sciences, Nutrition Program, Autonomous University of Ciudad Juarez, Cd. Juarez, Chihuahua 32315, Mexico
| | - Fernanda Campa-Quijada
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Diana Marcela Valenzuela-Guzmán
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
| | - Julián Esparza-Romero
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD), A.C., Hermosillo, Sonora 83304, Mexico
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Perceptions and Practices of Diabetes Prevention Among African Americans Participating in a Faith-Based Community Health Program. J Community Health 2019; 44:694-703. [PMID: 31065854 DOI: 10.1007/s10900-019-00667-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Black churches are instrumental in reducing chronic diseases, yet there is a paucity of literature regarding the association of Black churches and pre-diabetes among African Americans. The purpose of this study was to examine the diabetes prevention perceptions and practices of African Americans with pre-diabetes who participated in a larger intervention study (the Hosea Project). Interviews and focus groups (n = 51) were conducted 2 months following the intervention. A thematic analysis was performed to identify six emergent themes: general understanding of pre-diabetes and diabetes, diabetes prevention knowledge, program benefits, program barriers, lack of participation from men, and behavioral changes after program participation. This study illustrates how Black churches should serve as an intervention setting to increase pre-diabetes health behavior and education. Tailored and culturally appropriate programs can be beneficial in helping African Americans implement strategies to prevent diabetes.
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Derose KP, Williams MV, Flórez KR, Ann Griffin B, Payán DD, Seelam R, Branch CA, Hawes-Dawson J, Mata MA, Whitley MD, Wong EC. Eat, Pray, Move: A Pilot Cluster Randomized Controlled Trial of a Multilevel Church-Based Intervention to Address Obesity Among African Americans and Latinos. Am J Health Promot 2019; 33:586-596. [PMID: 30474376 PMCID: PMC7171715 DOI: 10.1177/0890117118813333] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To implement a multilevel, church-based intervention with diverse disparity populations using community-based participatory research and evaluate feasibility, acceptability, and preliminary effectiveness in improving obesity-related outcomes. DESIGN Cluster randomized controlled trial (pilot). SETTING Two midsized (∼200 adults) African American baptist and 2 very large (∼2000) Latino Catholic churches in South Los Angeles, California. PARTICIPANTS Adult (18+ years) congregants (n = 268 enrolled at baseline, ranging from 45 to 99 per church). INTERVENTION Various components were implemented over 5 months and included 2 sermons by pastor, educational handouts, church vegetable and fruit gardens, cooking and nutrition classes, daily mobile messaging, community mapping of food and physical activity environments, and identification of congregational policy changes to increase healthy meals. MEASURES Outcomes included objectively measured body weight, body mass index (BMI), and systolic and diastolic blood pressure (BP), plus self-reported overall healthiness of diet and usual minutes spent in physical activity each week; control variables include sex, age, race-ethnicity, English proficiency, education, household income, and (for physical activity outcome) self-reported health status. ANALYSIS Multivariate linear regression models estimated the average effect size of the intervention, controlling for pair fixed effects, a main effect of the intervention, and baseline values of the outcomes. RESULTS Among those completing follow-up (68%), the intervention resulted in statistically significantly less weight gain and greater weight loss (-0.05 effect sizes; 95% confidence interval [CI] = -0.06 to -0.04), lower BMI (-0.08; 95% CI = -0.11 to -0.05), and healthier diet (-0.09; 95% CI = -0.17 to -0.00). There was no evidence of an intervention impact on BP or physical activity minutes per week. CONCLUSION Implementing a multilevel intervention across diverse congregations resulted in small improvements in obesity outcomes. A longer time line is needed to fully implement and assess effects of community and congregation environmental strategies and to allow for potential larger impacts of the intervention.
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Affiliation(s)
| | | | - Karen R. Flórez
- City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York City, NY, USA
| | | | - Denise D. Payán
- RAND Corporation, Santa Monica, CA, USA
- University of California, Merced, Merced, CA, USA
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HbA1c reduction and weight-loss outcomes: a systematic review and meta-analysis of community-based intervention trials among patients with type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0708-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Rhodes EC, Chandrasekar EK, Patel SA, Narayan KMV, Joshua TV, Williams LB, Marion L, Ali MK. Cost-effectiveness of a faith-based lifestyle intervention for diabetes prevention among African Americans: A within-trial analysis. Diabetes Res Clin Pract 2018; 146:85-92. [PMID: 30273708 PMCID: PMC6295256 DOI: 10.1016/j.diabres.2018.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/13/2018] [Accepted: 09/25/2018] [Indexed: 12/18/2022]
Abstract
AIMS We assessed costs and cost-effectiveness of implementing Fit Body and Soul (FBAS), a church-based 18-session lifestyle education intervention for African Americans. METHODS We calculated incremental cost-effectiveness ratios (ICER) using data from a cluster randomized controlled trial comparing FBAS with health education (HE) among 604 overweight participants in 20 churches. The ICER was the adjusted difference in costs to deliver FBAS versus HE over the difference in weight change (kilograms [kg]) at one-year follow-up. Costs included those incurred for participant identification and program implementation. We fitted linear mixed-effects regression models, accounting for clustering of participants within churches and for age, sex, and educational attainment. We repeated these analyses for secondary outcomes (waist circumference [cm], physical activity [MET], glucose, blood pressure, and quality of life). RESULTS Per-person intervention cost of FBAS was $50.39 more than HE ($442.22 vs. $391.83 per-person), and adjusted differences in weight change (1.9 kg [95% CI: 1.0 to 2.8]) and waist circumference (2.4 cm [95% CI: 1.3 to 3.4]) were both significant. FBAS did not result in statistically significant differences in physical activity, glucose, blood pressures, or quality of life. We estimated that compared to HE, FBAS costs an additional $26.52 per kg weight lost and $21.00 per cm reduction in waist circumference. CONCLUSIONS For a modest increase in cost, FBAS led to greater weight and waist reductions among African Americans in a church setting. ClinicalTrials.gov Identifier NCT01730196.
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Affiliation(s)
- Elizabeth C Rhodes
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Eeshwar K Chandrasekar
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, United States.
| | - Shivani A Patel
- Hubert Department of Global Health and Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
| | - K M Venkat Narayan
- Hubert Department of Global Health and Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
| | - Thomas V Joshua
- College of Nursing, Augusta University, 987 St. Sebastian Way, Augusta, GA 30912, United States.
| | - Lovoria B Williams
- College of Nursing, Augusta University, 987 St. Sebastian Way, Augusta, GA 30912, United States.
| | - Lucy Marion
- College of Nursing, Augusta University, 987 St. Sebastian Way, Augusta, GA 30912, United States.
| | - Mohammed K Ali
- Hubert Department of Global Health and Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, United States.
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Krukowski RA, Hare ME, Talcott GW, Gladney LA, Johnson KC, Richey PA, Kocak M, Keller PL, Hryshko-Mullen A, Klesges RC. Dissemination of the Look AHEAD Intensive Lifestyle Intervention in the United States Military: A Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:1558-1565. [PMID: 30277030 PMCID: PMC6173202 DOI: 10.1002/oby.22293] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/03/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study, "Fit Blue," was to compare a translation of the Look AHEAD (Action for Heath in Diabetes) intensive lifestyle intervention with a self-paced version of the same intervention among active duty military personnel. METHODS Active duty military personnel (N = 248; 49% male, 34% racial minority) with overweight or obesity were randomized to 12-month distance-based (i.e., phone and email) parallel programs, counselor-initiated (CI) condition or self-paced (SP) condition, from 2014 to 2016. Trained lay interventionists were retired military personnel or had extensive familiarity with the military. RESULTS The CI condition had greater weight loss at 4 months (CI: mean ± SD = -3.2 ± 3.4 kg; SP: -0.6 ± 2.9 kg; P < 0.0001) and at 12 months (CI: mean ± SD = -1.9 ± 4.1 kg; SP: -0.1 ± 3.8 kg; P < 0.001). Participants in the CI condition also had a greater percent weight loss at both 4 months (CI: 3.5% ± 3.8, SP: 0.6% ± 3.1; P < 0.0001) and 12 months (CI: 2.1% ± 4.7, SP: 0.0% ± 4.0; P < 0.001). In addition, a greater proportion of CI participants lost 5% or more at 4 months (CI: 29.8%, SP: 10.5%; P < 0.001) and at 12 months (CI: 29.5%, SP: 15.6%; P < 0.05). CONCLUSIONS The CI behavioral weight loss intervention translated from Look AHEAD was well received and is a promising approach for managing weight in an active duty military population.
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Affiliation(s)
- Rebecca A. Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Marion E. Hare
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Gerald W. Talcott
- University of Tennessee Health Science Center, Lackland AFB, TX, USA
- University of Virginia, Department of Public Health Sciences, School of Medicine, Charlottesville, VA, USA
| | - Leslie A. Gladney
- University of Tennessee Health Science Center, Lackland AFB, TX, USA
- University of Virginia, Department of Public Health Sciences, School of Medicine, Charlottesville, VA, USA
| | - Karen C. Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Phyllis A. Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mehmet Kocak
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Patrick L. Keller
- University of Virginia, Department of Public Health Sciences, School of Medicine, Charlottesville, VA, USA
| | - Ann Hryshko-Mullen
- Defense Institute for Medical Operations, Joint Base San Antonio-Lackland Air Force Base, San Antonio, TX, USA
| | - Robert C. Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
- Department of Mental Health, Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio–Lackland AFB, San Antonio, Texas, USA
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50
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Newton RL, Carter LA, Johnson W, Zhang D, Larrivee S, Kennedy BM, Harris M, Hsia DS. A Church-Based Weight Loss Intervention in African American Adults using Text Messages (LEAN Study): Cluster Randomized Controlled Trial. J Med Internet Res 2018; 20:e256. [PMID: 30143478 PMCID: PMC6128956 DOI: 10.2196/jmir.9816] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/17/2018] [Accepted: 06/18/2018] [Indexed: 12/23/2022] Open
Abstract
Background African American adults experience a high prevalence of obesity and its associated comorbidities, including diabetes. Church-based interventions have been shown to be effective in decreasing weight in this population. mHealth interventions can address two needs for obesity treatment in this community, including enhancing weight loss and providing wide dissemination. Objective This study aimed to assess the feasibility and efficacy of a church-based weight loss intervention that incorporates mHealth technology. Methods In this study, 8 churches (n=97) were randomly assigned to the intervention or delayed intervention condition (control group). We recruited participants through their respective church. Volunteer church members were trained by study staff to deliver the 10-session, 6-month intervention. Participants in the intervention group attended group sessions and received automated short message service (SMS) text messages designed to reinforce behavioral strategies. Conversely, participants in the delayed intervention condition received SMS text messages related to health conditions relevant for African American adults. We obtained measures of body composition, blood pressure, blood glucose, and cholesterol. Results We successfully recruited 97 African American adults, with a mean age of 56.0 (SE 10.3) years and a mean body mass index of 38.6 (SE 6.4) kg/m2 (89/97, 91.8% females), who attended the churches that were randomized to the intervention (n=68) or control (n=29) condition. Of these, 74.2% (72/97) of the participants (47/68, 69.1% intervention; 25/29, 86.2% delayed intervention) completed the 6-month assessment. The average intervention group attendance was 55%. There was a significant difference in weight loss (P=.04) between participants in the intervention (–1.5 (SE 0.5) kg) and control (0.11 (SE 0.6) kg) groups. Among participants in the intervention group, the correlation between the number of SMS text messages sent and the percent body fat loss was r=.3 with P=.04. The participants reported high satisfaction with the automated SMS text messages. Conclusions Automated SMS text messages were well-received by participants, suggesting that more enhanced mHealth technologies are a viable option for interventions targeting African American adults. Trial Registration ClinicalTrials.gov NCT02863887; https://clinicaltrials.gov/ct2/show/NCT02863887 (Archived by WebCite at http://www.webcitation.org/71JiYzizO)
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Affiliation(s)
- Robert L Newton
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Leah A Carter
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - William Johnson
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Dachuan Zhang
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Sandra Larrivee
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Betty M Kennedy
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Melissa Harris
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Daniel S Hsia
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
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