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Andersen CJ, Ragonesi N, Cintrón-Rivera L, Murray K, Cerrito B, Melville J, Mccabe M. Food Pantry Inventories Vary in Food Group Availability, Diversity, and Nutritional Composition Across City Districts: A Pilot Study. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2154629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Catherine J. Andersen
- Department of Biology, Fairfield University, Fairfield, CT, USA
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | | | | | - Kristina Murray
- Department of Biology, Fairfield University, Fairfield, CT, USA
| | - Brianna Cerrito
- Department of Biology, Fairfield University, Fairfield, CT, USA
| | - Jamie Melville
- Department of Biology, Fairfield University, Fairfield, CT, USA
| | - Michelle Mccabe
- Center for Food Equity and Economic Development, Bridgeport, CT, USA
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2
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Abstract
The global diabetes burden is staggering, and prevention efforts are needed to reduce the impact on individuals and populations. There is strong evidence from efficacy trials showing that lifestyle interventions promoting increased physical activity, improvements in diet, and/or weight loss significantly reduce diabetes incidence and improve cardiometabolic risk factors. Implementation research assessing the feasibility, effectiveness, and cost-effectiveness of delivering these proven programs at the community level has shown success, but more research is needed to overcome barriers to implementation in different settings globally. New avenues of research should be considered to combat this public health issue.
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Affiliation(s)
- Mary Beth Weber
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA.
| | - Saria Hassan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322, USA; Department of Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Rakale Quarells
- Cardiovascular Research Institute, Morehouse School of Medicine, 720 Westview Drive, SW NCPC-318, Atlanta, GA 30310, USA
| | - Megha Shah
- Department of Family and Preventive Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
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3
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Frerichs L, Bess K, Young TL, Hoover SM, Calancie L, Wynn M, McFarlin S, Cené CW, Dave G, Corbie-Smith G. A Cluster Randomized Trial of a Community-Based Intervention Among African-American Adults: Effects on Dietary and Physical Activity Outcomes. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:344-354. [PMID: 31925605 DOI: 10.1007/s11121-019-01067-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Evidence of the effectiveness of community-based lifestyle behavior change interventions among African-American adults is mixed. We implemented a behavioral lifestyle change intervention, Heart Matters, in two rural counties in North Carolina with African-American adults. Our aim was to evaluate the effect of Heart Matters on dietary and physical activity behaviors, self-efficacy, and social support. We used a cluster randomized controlled trial to compare Heart Matters to a delayed intervention control group after 6 months. A total of 143 African-American participants were recruited and 108 completed 6-month follow-up assessments (75.5%). We used mixed regression models to evaluate changes in outcomes from baseline to 6-month follow-up. The intervention had a significant positive effect on self-reported scores of encouragement of healthy eating, resulting in an increase in social support from family of 6.11 units (95% CI [1.99, 10.22]) (p < .01). However, intervention participants also had an increase in discouragement of healthy eating compared to controls of 5.59 units (95% CI [1.46, 9.73]) among family (p < .01). There were no significant differences in changes in dietary behaviors. Intervention participants had increased odds (OR = 2.86, 95% CI [1.18, 6.93]) of increased frequency of vigorous activity for at least 20 min per week compared to control participants (p < .05). Individual and group lifestyle behavior counseling can have a role in promoting physical activity levels among rural African-American adults, but more research is needed to identify the best strategies to bolster effectiveness and influence dietary change. Trial Registration: Clinical Trials, NCT02707432. Registered 13 March 2016.
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Affiliation(s)
- Leah Frerichs
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1102C McGavran-Greenberg Hall, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA.
| | - Kiana Bess
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Tiffany L Young
- The North Carolina Translational Research and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Lenell & Lillie Consulting, LLC, New Bern, NC, USA
| | - Stephanie M Hoover
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Larissa Calancie
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Mysha Wynn
- Project Momentum, Inc., Rocky Mount, USA
| | | | - Crystal W Cené
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Gaurav Dave
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Giselle Corbie-Smith
- Center for Health Equity Research, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Social Medicine and Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
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4
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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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5
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Hurt TR, Francis SL, Seawell AH, Krisco MP, Flynn MH, O'Connor MC, Rudolph CS, Hill A. Revising Diabetes Programming for Black Men and Their Families. Glob Qual Nurs Res 2020; 7:2333393620960183. [PMID: 33088849 PMCID: PMC7545759 DOI: 10.1177/2333393620960183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022] Open
Abstract
Type-2 diabetes has increased 160% for African American males in the United States. This two-part study's purpose was to apply social marketing theory to understand the Type-2 diabetes education needs of men in Iowa. Study One was a preference assessment of Type-2 diabetes education strategies. Four African American men participated in a series of four focus groups and indicated that they were interested in diabetes prevention programming with their families but not in having it labeled as diabetes education. Participating men would rather increase their physical activity as opposed to tracking their food intake. As a follow-up to this study, nine other African American males took part in Study Two, which used cooking demonstrations and recipe taste-testing with the men to examine their relationship to food in the context of managing their Type-2 diabetes. The findings of both studies, which provided insight into these African American men's lifestyle as related to their Type-2 diabetes, could be useful for nursing professionals who have a critical role in navigating cultural, gender, and family norms while developing care plans, offering patient education, and promoting quality of life.
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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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7
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Barbershop Management of Hypertension in the African American Population: Pitfalls and Opportunities for Extension to Other Underserved Communities. Curr Cardiol Rep 2020; 22:64. [DOI: 10.1007/s11886-020-01319-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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8
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Gittelsohn J, Anderson Steeves ET, Ho JJ, Shin A, Farner H, Summers A. A Church-Based Diabetes Risk Factor Prevention Program Improves Psychosocial Factors and Food-Related Behaviors. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2018.1564720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Joel Gittelsohn
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | | | - Jessica J Ho
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | - Ahyoung Shin
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | - Harmony Farner
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | - Amber Summers
- Center for Communication Programs, Johns Hopkins School of Public Health, USA
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9
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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: 12] [Impact Index Per Article: 3.0] [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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AuYoung M, Moin T, Richardson CR, Damschroder LJ. The Diabetes Prevention Program for Underserved Populations: A Brief Review of Strategies in the Real World. Diabetes Spectr 2019; 32:312-317. [PMID: 31798288 PMCID: PMC6858084 DOI: 10.2337/ds19-0007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
IN BRIEF This review highlights examples of the translation of the Diabetes Prevention Program (DPP) to underserved populations. Here, underserved populations are defined as groups whose members are at greater risk for health conditions such as diabetes but often face barriers accessing treatment. Strategies to develop and evaluate future DPP translations are discussed.
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Affiliation(s)
- Mona AuYoung
- Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA
| | - Tannaz Moin
- Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
- VA Health Services Research and Development Center for Healthcare Innovation, Implementation and Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
| | | | - Laura J. Damschroder
- VA Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI
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11
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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: 17] [Impact Index Per Article: 3.4] [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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12
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Conte KP, Held F, Pipitone O, Bowman S. The Feasibility of Recruiting and Training Lay Leaders During Real-World Program Delivery and Scale-up: The Case of Walk With Ease. Health Promot Pract 2019; 22:91-101. [PMID: 30971154 DOI: 10.1177/1524839919840004] [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: 11/17/2022]
Abstract
Introduction. To maximize limited resources, many health promotion programs are designed to be delivered by volunteer lay leaders. But this model poses challenges to implementation in real-world settings and barriers to successfully scaling-up programs. This study examines the current lay leader training model for Walk With Ease, a Centers for Disease Control and Prevention-funded evidence-based arthritis program delivered at-scale. Method. Recruited volunteers (n = 106) opted into free online or in-person training and agreed to deliver one Walk With Ease program within the following year-only 49%, however, did. Using logistic regression models and qualitative interviews, we explored predictors of volunteer delivery. Results. Volunteers had higher odds of delivering programs if they trained online (odds ratio [OR] = 9.04, 95% confidence interval [CI: 2.30, 48.36]), previously taught health programs (OR = 15.52, 95% CI [3.51, 103.55]) or trained in the second year of implementation (OR = 27.08, 95% CI [2.63, 415.78]). Qualitative findings underscored that successful volunteers were readied by their previous health education experience. Conclusions. While online training modes appear effective to prepare experienced volunteers, lay leaders required additional support. This calls into question whether lay-led delivery models are suitable for scaling-up programs with limited resources. Given the many lay-led health interventions for chronic disease self-management, investing in common training and infrastructures for lay leader development could advance the quality and sustainability of real-world program delivery.
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Affiliation(s)
| | - Fabian Held
- University of Sydney, Sydney, New South Wales, Australia
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13
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Nam S, Jung S, Whittemore R, Latkin C, Kershaw T, Redeker NS, Jeon S, Vlahov D. Social Network Structures in African American Churches: Implications for Health Promotion Programs. J Urban Health 2019; 96:300-310. [PMID: 30747370 PMCID: PMC6458228 DOI: 10.1007/s11524-018-00339-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The prevalence of obesity among African Americans is higher than among other racial/ethnic groups. African American churches hold a central role in promoting health in the community; yet, church-based interventions have had limited impact on obesity. While recent studies have described the influence of social networks on health behaviors, obesity interventions informed by social network analysis have been limited. We conducted a cross-sectional study with 281 African American men and women from three churches in northeast urban cities in the USA. Data were collected on sociodemographic and clinical factors and anthropometrics. Using a social network survey applying a name generator, we computed network level metrics. Exponential random graph models (ERGM) were performed to examine whether each structural property found in the empirical (observed) networks occurred more frequently than expected by chance by comparing the empirical networks to the randomly simulated networks. Overall, church friendship networks were sparse (low density). We also found that while friendship ties were more reciprocated between dyads in church networks, and there were more tendencies for clustering of friendships (significant positive transitive closure) than in random networks, other characteristics such as expansiveness (number of actors with a great number of friends) did not differ from what would be expected by chance in random networks. These data suggest that interventions with African American churches should not assume a unitary network through which a single intervention should be used.
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Affiliation(s)
- Soohyun Nam
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.
| | - Sunyoung Jung
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Robin Whittemore
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Carl Latkin
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Trace Kershaw
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Nancy S Redeker
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Sangchoon Jeon
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - David Vlahov
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
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14
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Schoenthaler AM, Lancaster KJ, Chaplin W, Butler M, Forsyth J, Ogedegbe G. Cluster Randomized Clinical Trial of FAITH (Faith-Based Approaches in the Treatment of Hypertension) in Blacks. Circ Cardiovasc Qual Outcomes 2018; 11:e004691. [DOI: 10.1161/circoutcomes.118.004691] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Antoinette M. Schoenthaler
- Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine (A.M.S., M.B., J.F., G.O.)
| | - Kristie J. Lancaster
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University (K.J.L.)
| | - William Chaplin
- Department of Psychology, St. John’s University College of Liberal Arts and Sciences, Queens, NY (W.C.)
| | - Mark Butler
- Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine (A.M.S., M.B., J.F., G.O.)
| | - Jessica Forsyth
- Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine (A.M.S., M.B., J.F., G.O.)
| | - Gbenga Ogedegbe
- Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine (A.M.S., M.B., J.F., G.O.)
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15
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Mitchell JB, Paschal AM, Parmelee PA, Murphy PZ. LIVE: A Community-Based Intervention to Reduce CVD Risk Factors in Rural Community-Dwelling African Americans. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2018.1486757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Morales-Alemán MM, Moore A, Scarinci IC. Development of a Participatory Capacity-Building Program for Congregational Health Leaders in African American Churches in the US South. Ethn Dis 2018; 28:11-18. [PMID: 29467561 PMCID: PMC5794442 DOI: 10.18865/ed.28.1.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
African Americans are disproportionately affected by diabetes and colorectal cancer. Although studies have shown the effectiveness of spiritually based health interventions delivered by community health workers to African Americans, few have described the development of the capacity-building component. This article describes this process. The development of the Healthy Congregations Healthy Communities Program (HCHC) was guided through a community-based participatory research lens and included: 1) establishment of a community coalition; 2) identification by coalition members of churches as the best venues for health promotion strategies among African Americans; 3) recruitment of churches; 4) development of a training manual; 5) recruitment and training of congregational health leaders (CHLs); and 6) "Passing of the torch" from the coalition to the CHLs who implemented the intervention in their congregations. We trained 35 CHLs to promote awareness about diabetes and colorectal cancer using a culturally relevant, spiritually based curriculum. Pre- and post-test paired t-tests showed significant increases in CHLs' knowledge of wellness (P<.001), colorectal cancer (P<.002), nutrition (P<.004), and lifestyle changes (P<.005). The community-academic partnership was successful in developing a culturally relevant, spiritually based capacity-building program for African American CHLs to implement health promotion strategies in their congregations and communities.
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Affiliation(s)
| | - Artisha Moore
- Division of Preventive Medicine, University of Alabama at Birmingham
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Galaviz KI, Narayan KMV, Lobelo F, Weber MB. Lifestyle and the Prevention of Type 2 Diabetes: A Status Report. Am J Lifestyle Med 2018; 12:4-20. [PMID: 30202378 PMCID: PMC6125024 DOI: 10.1177/1559827615619159] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 12/11/2022] Open
Abstract
Diabetes is a costly disease affecting 387 million individuals globally and 28 million in the United States. Its precursor, prediabetes, affects 316 and 86 million individuals globally and in the United States, respectively. People living with elevated blood glucose levels are at high risk for all-cause mortality and numerous cardiometabolic ailments. Fortunately, diabetes can be prevented or delayed by maintaining a healthy lifestyle and a healthy body weight. In this review, we summarize the literature around lifestyle diabetes prevention programs and provide recommendations for introducing prevention strategies in clinical practice. Overall, evidence supports the efficacy and effectiveness of lifestyle diabetes prevention interventions across clinical and community settings, delivery formats (eg, individual-, group-, or technology-based), and implementers (eg, clinicians, community members). Evidence-based diabetes prevention strategies that can be implemented in clinical practice include brief behavior change counseling, group-based education, community referrals, and health information technologies. These strategies represent opportunities where practitioners, communities, and health care systems can work together to provide individuals with education, support and opportunities to maintain healthy, diabetes-free lifestyles.
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Affiliation(s)
- Karla I. Galaviz
- Karla I. Galaviz, MSc, PhD, Emory Global Diabetes Research Center, Hubert Department of Global Health, Emory University, No. 1518 Clifton Rd, Atlanta, GA 30322; e-mail:
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Spears EC, Foster MJ, Bonner TJ. Diabetes Prevention for African-Americans: a Scoping Review. J Racial Ethn Health Disparities 2017; 5:947-965. [PMID: 29218497 DOI: 10.1007/s40615-017-0443-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is the most common form of diabetes and is preventable in many instances. African-Americans are disproportionately represented in T2DM statistics. The strategies in place to prevent disease development in this population warrant critical examination. METHODS A scoping review of literature was conducted to provide an overview of the largely inconsistent approach to African-American T2DM prevention research. Specific research questions included: (1) How are African-Americans treated in the existing T2DM literature? (1a) Are African-Americans primarily treated as a homogenous group in the literature? (1b) Has the literature addressed middle-class African-Americans? (2) Is the T2DM prevention literature focused on primary or secondary prevention? The review included articles published from 1985 to 2016, examining the methodology and approach toward African-Americans in each article. RESULTS The review yielded 653 unduplicated articles. Through title, abstract, and full-text screenings, 381 articles were excluded. Of the remaining articles only 37% were focused on the prevention of T2DM development, and only 22.7% described a participant education component. The majority of the studies were observational (n = 19). Only 53.5% included majority African-American participants. Samples ranged from 2 to 27,899 individuals, which were often treated as homogeneous groups in terms of income and/or education (62.3%). CONCLUSION The approach to T2DM prevention in African-Americans is largely inconsistent, which may be contributing to stagnation in this area of research.
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Affiliation(s)
- Erica C Spears
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
| | - Margaret J Foster
- Health Sciences Center, Texas A&M University, College Station, TX, USA
| | - Timethia J Bonner
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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Whitt-Glover MC, Goldmon MV, Gizlice Z, Sillice M, Hornbuckle L, Heil DP. Increasing Physical Activity in Black Women: Results from a Randomized Trial Conducted in Faith-Based Settings. Ethn Dis 2017; 27:411-420. [PMID: 29225442 PMCID: PMC5720951 DOI: 10.18865/ed.27.4.411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-integrated (FI) and a secular (SEC) intervention for increasing physical activity with a self-guided (SG) control group among African American women. Design/Setting/Participants L.A.D.I.E.S. was a cluster randomized, controlled trial. Churches (n=31) were randomized and women within each church (n=12 - 15) received the same intervention. Interventions FI and SEC participants received 24 group-based sessions, delivered over 10 months. SG participants received printed materials to review independently for 10 months. Participants were followed for 12-months post-intervention to assess long-term intervention impact. Main Outcome Measures Data on participant characteristics, physical activity, and intervention-related constructs were collected at baseline, 10 months, and 22 months. Results Intervention session attendance was greater for FI compared with SEC participants (15.7 + 5.7 vs 12.4 + 7.3 sessions, respectively, P<.01). After 10 months, FI and SEC participants significantly increased daily walking (+1,451 and +1,107 steps/day, respectively) compared with SG participants (-128 steps/day). Increases were maintained after 22 months in the FI group compared with the SG group (+1092 vs. +336 daily steps, P<.01). Between-group changes in accelerometer-assessed physical activity were not statistically significant at any time point. Conclusions The FI intervention is a feasible strategy for short- and long-term increases in physical activity among African American women. Additional dissemination and evaluation of the strategy could be useful for reducing chronic disease in this high-risk population.
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Affiliation(s)
| | | | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marie Sillice
- The Miriam Hospital and Alpert School of Medicine, Brown University, Providence, Rhode Island
| | | | - Daniel P. Heil
- Exercise Physiology, Montana State University, Bozeman, Montana
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Edwards J, Hosseinzadeh H. The impact of structured physical activity on glycaemic control in diabetes prevention programmes: A systematic review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2017. [DOI: 10.1177/2010105817739924] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Seven landmark randomised controlled trials, with some that began as early as the 1990s, observed the prediabetic state, namely, impaired glucose tolerance and impaired fasting glucose conditions, against the impact of lifestyle interventions such as physical activity, to prevent or delay the onset of type 2 diabetes mellitus. In addition to the landmark trials, this systematic review examines 14 studies that retained a focus on prediabetic individuals and measured the efficacy of physical activity on improving glucose tolerance. Results: Type, duration and intensity of structured physical activity can have unique benefits to prediabetic individuals. It is posited that diabetes prevention programmes must target prediabetic individuals as belonging to a high-risk group, separate and distinct from those identified with overall risk factors. While the transition from prediabetes to type 2 diabetes mellitus is not completely deterministic, the conversion rate is phenomenally higher among those with impaired glucose tolerance than those with normal glucose levels. Conclusion: Tenets of health behaviour models do support inferences that prediabetic individuals are potentially more inclined to weighing the risks and benefits of progressive illnesses and would therefore be more receptive to active participation in interventions. More research is required to develop evidence-based diabetes prevention programmes linked to structured physical activity intervention.
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Affiliation(s)
- Joseph Edwards
- School of Health & Society, University of Wollongong, NSW, Australia
| | - Hassan Hosseinzadeh
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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Shuval K, Li Q, Gabriel KP, Tchernis R. Income, physical activity, sedentary behavior, and the 'weekend warrior' among U.S. adults. Prev Med 2017; 103:91-97. [PMID: 28802654 DOI: 10.1016/j.ypmed.2017.07.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/02/2017] [Accepted: 07/31/2017] [Indexed: 11/19/2022]
Abstract
The present study examines the association between income and physical activity intensity along the entire continuum using accelerometry in a nationally representative sample of U.S. adults. Specifically, we assessed the relationship between annual household income, sedentary behavior, light, and moderate-vigorous intensity physical activity, and meeting physical activity guidelines over a brief, 2-day period ('weekend warrior'), and during the entire week. The sample consisted of 5206 National Health and Examination Survey adult participants (2003-2006) who wore accelerometers and completed pertinent survey questions. Ordinary Least Square models were computed to examine the relationship between income and the dependent variables (sedentary behavior, light, and moderate to vigorous intensity activity) adjusting for covariates. Logistic regression was employed to examine the association between income and meeting physical activity guidelines during a 2-day and 7-day time-period. Results indicate that individuals with an annual income of ≥$75,000 engaged in 4.6 more daily minutes of moderate to vigorous activity (p-value<0.01), in comparison to the reference group (<$20,000 annual income). Those in the high-income strata were 1.6 and 1.9 times more likely to meet physical activity guidelines during a 2 and 7-day period (respectively) than their lower income counterparts (p<0.05 for both). Further, those in the high-income strata spent 11.8 more minutes daily being sedentary than their lower income counterparts (p-value<0.01). In conclusion, higher annual household income is related to more intense, less frequent (per week) patterns of physical activity and more daily sedentary time.
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Affiliation(s)
- Kerem Shuval
- Economic and Health Policy Research Program, Department of Intramural Research, American Cancer Society, Atlanta, GA, United States.
| | - Qing Li
- Economic and Health Policy Research Program, Department of Intramural Research, American Cancer Society, Atlanta, GA, United States
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Texas Health Science Center at Houston (UT Health), School of Public Health - Austin Campus, Austin, TX, United States
| | - Rusty Tchernis
- Department of Economics, Georgia State University, Atlanta, GA, United States
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Shuval K, Leonard T, Drope J, Katz DL, Patel AV, Maitin-Shepard M, Amir O, Grinstein A. Physical activity counseling in primary care: Insights from public health and behavioral economics. CA Cancer J Clin 2017; 67:233-244. [PMID: 28198998 DOI: 10.3322/caac.21394] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle. In the current study, the authors evaluate pertinent literature from the fields of medicine/public health and economics/psychology to suggest a comprehensive approach to physical activity counseling at the primary care level. They first examine the public health approach to physical activity counseling, and then proceed to offer insights from behavioral economics, an emerging field that combines principles from psychology and economics. The application of key behavioral economics tools (eg, precommitment contracts, framing) to physical activity counseling in primary care is elaborated. CA Cancer J Clin 2017;67:233-244. © 2017 American Cancer Society.
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Affiliation(s)
- Kerem Shuval
- Director, Physical Activity and Nutrition Research, Economic & Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - Tammy Leonard
- Associate Professor, Department of Economics, University of Dallas, Irving, TX
| | - Jeffrey Drope
- Vice President, Economic & Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - David L Katz
- Director, Yale University Prevention Research Center, Griffin Hospital, Derby, CT
| | - Alpa V Patel
- Strategic Director, Cancer Prevention Study-3, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | | | - On Amir
- Associate Professor, Rady School of Management, University of California-San Diego, La Jolla, CA
| | - Amir Grinstein
- Associate Professor of Marketing, D'Amore-McKim School of Business, Northeastern University, Boston, MA
- Associate Professor of Marketing, Faculty of Economics and Business Administration, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Sun Y, You W, Almeida F, Estabrooks P, Davy B. The Effectiveness and Cost of Lifestyle Interventions Including Nutrition Education for Diabetes Prevention: A Systematic Review and Meta-Analysis. J Acad Nutr Diet 2017; 117:404-421.e36. [PMID: 28236962 PMCID: PMC5330213 DOI: 10.1016/j.jand.2016.11.016] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 11/28/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Type 2 diabetes is a significant public health concern. With the completion of the Diabetes Prevention Program, there has been a proliferation of studies attempting to translate this evidence base into practice. However, the cost, effectiveness, and cost-effectiveness of these adapted interventions is unknown. OBJECTIVE The purpose of this systematic review was to conduct a comprehensive meta-analysis to synthesize the effectiveness, cost, and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent (dietitian vs non-dietitian) and channel (in-person vs technology-delivered). METHODS English and full-text research articles published up to July 2015 were identified using the Cochrane Library, PubMed, Education Resources Information Center, CAB Direct, Science Direct, and Google Scholar. Sixty-nine studies met inclusion criteria. Most employed both dietary and physical activity intervention components (four of 69 were diet-only interventions). Changes in weight, fasting and 2-hour blood glucose concentration, and hemoglobin A1c were extracted from each article. Heterogeneity was measured by the I2 index, and study-specific effect sizes or mean differences were pooled using a random effects model when heterogeneity was confirmed. RESULTS Participants receiving intervention with nutrition education experienced a reduction of 2.07 kg (95% CI 1.52 to 2.62; P<0.001; I2=90.99%, 95% CI 88.61% to 92.87%) in weight at 12 months with effect sizes over time ranging from small (0.17, 95% CI 0.04 to 0.30; P=0.012; I2= 86.83%, 95% CI 80.42% to 91.14%) to medium (0.65, 95% CI 0.49 to 0.82; P<0.001; I2=98.75%, 95% CI 98.52% to 98.94). Effect sizes for 2-hour blood glucose and hemoglobin A1c level changes ranged from small to medium. The meta-regression analysis revealed a larger relative weight loss in dietitian-delivered interventions than in those delivered by nondietitians (full sample: -1.0 kg; US subsample: -2.4 kg), and did not find statistical evidence that the delivery channel was an important predictor of weight loss. The average cost per kilogram weight loss ranged from $34.06 over 6 months to $1,005.36 over 12 months. The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non-dietitians, although few studies reported costs. CONCLUSIONS Lifestyle interventions are effective in reducing body weight and glucose-related outcomes. Dietitian-delivered interventions, compared with those delivered by other personnel, achieved greater weight reduction. No consistent trend was identified across different delivery channels.
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Lagisetty PA, Priyadarshini S, Terrell S, Hamati M, Landgraf J, Chopra V, Heisler M. Culturally Targeted Strategies for Diabetes Prevention in Minority Population. THE DIABETES EDUCATOR 2017; 43:54-77. [PMID: 28118127 PMCID: PMC5408505 DOI: 10.1177/0145721716683811] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize 4 key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with 4 domains (FiLLM: Facilitating [ie, delivering] Interventions Through Language, Location, and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were RCTs, and 22 were QE trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least 3 culturally targeted domains. Seven studies used all 4 domains and were all successful. The least utilized domain was delivery (4/34) of the intervention's key educational message. Conclusions Culturally tailoring interventions across the 4 domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain.
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Affiliation(s)
- Pooja A Lagisetty
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Dr Lagisetty, Dr Heisler)
| | - Shubadra Priyadarshini
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Stephanie Terrell
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Mary Hamati
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Jessica Landgraf
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Vineet Chopra
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Michele Heisler
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Dr Lagisetty, Dr Heisler)
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Bertran EA, Pinelli NR, Sills SJ, Jaber LA. The Arab American experience with diabetes: Perceptions, myths and implications for culturally-specific interventions. Prim Care Diabetes 2017; 11:13-19. [PMID: 27460886 PMCID: PMC5201435 DOI: 10.1016/j.pcd.2016.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/20/2016] [Accepted: 07/10/2016] [Indexed: 10/21/2022]
Abstract
AIMS Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans' knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. METHODS Sixty-nine self-identified Arab or Arab Americans ≥30 years of age and without diabetes participated in 8 focus groups. RESULTS Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma. The main barrier to healthcare was lack of health insurance and/or cost of care. Intervention preferences included gender-specific exercise, group-delivered education featuring religious ideology, inclusion of the family, and utilization of community facilities. CONCLUSION Lifestyle interventions for Arab Americans need to address cultural preferences, diabetes myths, and folk remedies. Interventions should incorporate Arabic cultural content and gender-specific group education and exercise. Utilization of family support and religious centers will enable culturally-acceptable and cost-effective interventions.
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Affiliation(s)
- Elizabeth A Bertran
- Eugene Applebaum School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI 48201, USA(2).
| | - Nicole R Pinelli
- Eugene Applebaum School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI 48201, USA(2).
| | - Stephen J Sills
- The University of North Carolina at Greensboro, 320 Graham Building UNCG, Greensboro, NC 27402-6170, USA.
| | - Linda A Jaber
- Eugene Applebaum School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI 48201, USA(2).
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Davies MJ, Gray LJ, Ahrabian D, Carey M, Farooqi A, Gray A, Goldby S, Hill S, Jones K, Leal J, Realf K, Skinner T, Stribling B, Troughton J, Yates T, Khunti K. A community-based primary prevention programme for type 2 diabetes mellitus integrating identification and lifestyle intervention for prevention: a cluster randomised controlled trial. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BackgroundPrevention of type 2 diabetes mellitus (T2DM) is a global priority; however, there is a lack of evidence investigating how to effectively translate prevention research into a primary care setting.Objectives(1) To develop and validate a risk score to identify individuals at high risk of T2DM in the UK; and (2) to establish whether or not a structured education programme targeting lifestyle and behaviour change was clinically effective and cost-effective at preventing progression to T2DM in people with prediabetes mellitus (PDM), identified through a risk score screening programme in primary care.DesignA targeted screening study followed by a cluster randomised controlled trial (RCT), with randomisation at practice level. Participants were followed up for 3 years.SettingA total of 44 general practices across Leicestershire, UK. The intervention took place in the community.ParticipantsA total of 17,972 individuals from 44 practices identified through the risk score as being at high risk of T2DM were invited for screening; of these, 3449 (19.2%) individuals attended. All received an oral glucose tolerance test. PDM was detected in 880 (25.5%) of those screened. Those with PDM were included in the trial; of these, 36% were female, the average age was 64 years and 16% were from an ethnic minority group.InterventionPractices were randomised to receive either standard care or the intervention. The intervention consisted of a 6-hour group structured education programme, with an annual refresher and regular telephone contact.Main outcome measuresThe primary outcome was progression to T2DM. The main secondary outcomes were changes in glycated haemoglobin concentrations, blood glucose levels, cardiovascular risk, the presence of metabolic syndrome, step count and the cost-effectiveness of the intervention.ResultsA total of 22.6% of the intervention group did not attend the education and 29.1% attended all sessions. A total of 131 participants developed T2DM (standard care,n = 67; intervention,n = 64). There was a 26% reduced risk of T2DM in the intervention arm compared with standard care, but this did not reach statistical significance (hazard ratio 0.74, 95% confidence interval 0.48 to 1.14;p = 0.18). There were statistically significant improvements in glycated haemoglobin concentrations, low-density lipoprotein cholesterol levels, psychosocial well-being, sedentary time and step count in the intervention group. The intervention was found to result in a net gain of 0.046 quality-adjusted life-years over 3 years at a cost of £168 per patient, with an incremental cost-effectiveness ratio of £3643 and a probability of 0.86 of being cost-effective at a willingness-to-pay threshold of £20,000.ConclusionsWe developed and validated a risk score for detecting those at high risk of undiagnosed PDM/T2DM. We screened > 3400 people using a two-stage screening programme. The RCT showed that a relatively low-resource pragmatic programme may lead to a reduction in T2DM and improved biomedical and psychosocial outcomes, and is cost-effective.LimitationsOnly 19% of those invited to screening attended, which may limit generalisability. The variation in cluster size in the RCT may have limited the power of the study.Future workFuture work should focus on increasing attendance to both screening and prevention programmes and offering the programme in different modalities, such as web-based modalities. A longer-term follow-up of the RCT participants would be valuable.Trial registrationCurrent Controlled Trials ISRCTN80605705.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Dariush Ahrabian
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Marian Carey
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Azhar Farooqi
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stephanie Goldby
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Sian Hill
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Kenneth Jones
- Patient and Public Involvement Group, Leicester Diabetes Centre, Leicester, UK
| | - Jose Leal
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn Realf
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Timothy Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, NT, Australia
| | - Bernie Stribling
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Jacqui Troughton
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Effects of a Community-Based Healthy Lifestyle Intervention Program (Co-HELP) among Adults with Prediabetes in a Developing Country: A Quasi-Experimental Study. PLoS One 2016. [DOI: 10.1371/journal.pone.0167123 52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Ibrahim N, Ming Moy F, Awalludin IAN, Mohd Ali Z, Ismail IS. Effects of a Community-Based Healthy Lifestyle Intervention Program (Co-HELP) among Adults with Prediabetes in a Developing Country: A Quasi-Experimental Study. PLoS One 2016; 11:e0167123. [PMID: 27935988 PMCID: PMC5147835 DOI: 10.1371/journal.pone.0167123] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 11/04/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes among Malaysian adults has increased by more than two folds over the past two decades. Strategies to collaborate with the existing community partners may become a promising channel for wide-scale dissemination of diabetes prevention in the country. The objectives of this study were to determine the effects of community-based lifestyle interventions delivered to adults with prediabetes and their health-related quality of life as compared to the usual care group. METHODS This was a quasi-experimental study conducted in two sub-urban communities in Seremban, Malaysia. A total of 268 participants with prediabetes aged between 18 to 65 years old were assigned to either the community-based lifestyle intervention (Co-HELP) (n = 122) or the usual care (n = 146) groups. The Co-HELP program was delivered in partnership with the existing community volunteers to incorporate diet, physical activity, and behaviour modification strategies. Participants in the Co-HELP group received twelve group-based sessions and two individual counselling to reinforce behavioural change. Participants in the usual care group received standard health education from primary health providers in the clinic setting. Primary outcomes were fasting blood glucose, 2-hour plasma glucose, and HbA1C. Secondary outcomes included weight, BMI, waist circumference, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, systolic and diastolic blood pressure, physical activity, diet, and health-related quality of life (HRQOL). RESULTS An intention-to-treat analysis of between-groups at 12-month (mean difference, 95% CI) revealed that the Co-HELP participants' mean fasting plasma glucose reduced by -0.40 mmol/l (-0.51 to -0.28, p<0.001), 2-hour post glucose by -0.58 mmol/l (-0.91 to -0.24, p<0.001), HbA1C by -0.24% (-0.34 to -0.15, p<0.001), diastolic blood pressure by -2.63 mmHg (-3.79 to -1.48, p<0.01), and waist circumference by -2.44 cm (-4.75 to -0.12, p<0.05) whereas HDL cholesterol increased by 0.12 mmol/l (0.05 to 0.13, p<0.01), compared to the usual care group. Significant improvements were also found in HRQOL for both physical component (PCS) by 6.51 points (5.21 to 7.80, p<0.001) and mental component (MCS) by 7.79 points (6.44 to 9.14, p<0.001). Greater proportion of participants from the Co-HELP group met the clinical recommended target of 5% or more weight loss from the initial weight (24.6% vs 3.4%, p<0.001) and physical activity of >600 METS/min/wk (60.7% vs 32.2%, p<0.001) compared to the usual care group. CONCLUSIONS This study provides evidence that a culturally adapted diabetes prevention program can be implemented in the community setting, with reduction of several diabetes risk factors and improvement of HRQOL. Collaboration with existing community partners demonstrated a promising channel for the wide-scale dissemination of diabetes prevention at the community level. Further studies are required to determine whether similar outcomes could be achieved in communities with different socioeconomic backgrounds and geographical areas. TRIAL REGISTRATION IRCT201104106163N1.
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Affiliation(s)
- Norliza Ibrahim
- Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Foong Ming Moy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Zainudin Mohd Ali
- State Health Department of Negeri Sembilan, Seremban, Negeri Sembilan, Malaysia
| | - Ikram Shah Ismail
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
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Schwingel A, Gálvez P. Divine Interventions: Faith-Based Approaches to Health Promotion Programs for Latinos. JOURNAL OF RELIGION AND HEALTH 2016; 55:1891-1906. [PMID: 26541338 DOI: 10.1007/s10943-015-0156-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Few interventions have used faith-based approaches in health promotion programs among US Latinos, a notably religious population. This article explores the perceptions of church leaders, promotoras, and program participants on the Catholic religious context and content of a community-based intervention addressing physical activity, nutrition, and stress management for Chicago Latinas aged 50+. Nineteen in-depth interviews were conducted. Viewed as trustworthy, natural, and authentic, the church setting nurtured community bonds. Moreover, the program's religious content encouraged Latinas to feel motivated, connected, and engaged with the program in meaningful ways. Overall, faith-based health promotion programs offer a promising approach for Latino-centered interventions.
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Affiliation(s)
- Andiara Schwingel
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 212A Huff Hall, 1206 S. Fourth St., Champaign, IL, 61820, USA.
| | - Patricia Gálvez
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 212B Huff Hall, 1206 S. Fourth St., Champaign, IL, 61820, USA
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de Oliveira ACM, Leonard TCM, Shuval K, Skinner CS, Eckel C, Murdoch JC. Economic Preferences and Obesity among a Low-Income African American Community. JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION 2016; 131:196-208. [PMID: 28133400 PMCID: PMC5267327 DOI: 10.1016/j.jebo.2015.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Obesity has reached epidemic proportions in the US, with a significantly higher fraction of African Americans who are obese than whites. Yet there is little understanding of why some individuals become obese while others do not. We conduct a lab-in-field experiment in a low-income African American community to investigate whether risk and time preferences play a role in the tendency to become obese. We examine the relationship between incentivized measures of risk and time preferences and weight status (BMI), and find that individuals who are more tolerant of risk are more likely to have a higher BMI. This result is driven by the most risk tolerant individuals. Patience is not independently statistically related to BMI in this sample, but those who are more risk averse and patient are less likely to be obese.
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Affiliation(s)
- Angela C M de Oliveira
- University of Massachusetts Amherst, Department of Resource Economics, 203 Stockbridge Hall, 80 Campus Center Way, Amherst, MA 01003 USA, Ph: 413-545-5716
| | - Tammy C M Leonard
- University of Texas at Dallas, School of Economic, Political and Policy Sciences, Department of Economics, 800 W. Campbell Rd., GR31, Richardson, Texas 75080 USA. Present address : University of Dallas, Economics Department, 1845 East Northgate Drive, Irving, Texas 75062 USA
| | - Kerem Shuval
- University of Texas Health Science Center at Houston School of Public Health, Dallas Regional Campus, Dallas, Texas USA and The Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas USA. Present address: American Cancer Society, Intramural Research Department, Health Economics and Policy Program, 250 Williams St., Atlanta, GA 30303 USA
| | - Celette Sugg Skinner
- Department of Clinical Sciences, Harold C. Simmons Cancer Center The University of Texas Southwestern Medical Center, Dallas, Texas USA 5323 Harry Hines Blvd, Dallas, TX 75390-9066
| | - Catherine Eckel
- Texas A&M University, Department of Economics, 4228 TAMU, College Station, TX 77845
| | - James C Murdoch
- University of Texas at Dallas, School of Economic, Political and Policy Sciences, Department of Economics, 800 W. Campbell Rd., GR31, Richardson, Texas 75080 USA
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Stull AJ. Lifestyle Approaches and Glucose Intolerance. Am J Lifestyle Med 2016; 10:406-416. [PMID: 30202302 PMCID: PMC6124975 DOI: 10.1177/1559827614554186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 07/13/2014] [Accepted: 07/14/2014] [Indexed: 01/13/2023] Open
Abstract
Glucose intolerance is a global health concern that encompasses glucose metabolism abnormalities such as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2D). There is an urgent need to focus on the prediabetes (ie, IGT and IFG) stage before the disease actually occurs. The progression from IGT to T2D can be prevented or delayed by modifying the lifestyles in high-risk individuals, and these health benefits are well documented in various ethnicities with prediabetes across the world. Specifically, consuming a healthy diet (high in polyunsaturated fatty acids, monounsaturated fatty acids, fiber, and whole grains), losing weight, quitting smoking, consuming alcohol in moderation, and increasing physical activity can improve glucose tolerance and reduce the risk of T2D. Also, pharmacological agents and botanicals can be used to manage glucose intolerance if the implementation of lifestyle changes is challenging. Pharmacological treatments have been successful in managing glucose intolerance; however, they have adverse effects. Also, more research on botanicals is warranted before a definitive recommendation can be made for their use in managing glucose intolerance. To make progress on this worldwide problem, efforts are needed to improve the awareness of prediabetes, increase promotion of healthy behaviors, and improve the availability of evidence-based lifestyle intervention programs to the community.
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Affiliation(s)
- April J. Stull
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
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Mudaliar U, Zabetian A, Goodman M, Echouffo-Tcheugui JB, Albright AL, Gregg EW, Ali MK. Cardiometabolic Risk Factor Changes Observed in Diabetes Prevention Programs in US Settings: A Systematic Review and Meta-analysis. PLoS Med 2016; 13:e1002095. [PMID: 27459705 PMCID: PMC4961455 DOI: 10.1371/journal.pmed.1002095] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/17/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The Diabetes Prevention Program (DPP) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk. No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in nonresearch settings in the United States. METHODS AND FINDINGS In this systematic review and meta-analysis, we pooled data from studies in the United States implementing DPP lifestyle modification programs (focused on modest [5%-7%] weight loss through ≥150 min of moderate physical activity per week and restriction of fat intake) in clinical, community, and online settings. We reported aggregated pre- and post-intervention weight and cardiometabolic risk factor changes (fasting blood glucose [FBG], glycosylated hemoglobin [HbA1c], systolic or diastolic blood pressure [SBP/DBP], total [TC] or HDL-cholesterol). We searched the MEDLINE, EMBASE, Cochrane Library, and Clinicaltrials.gov databases from January 1, 2003, to May 1, 2016. Two reviewers independently evaluated article eligibility and extracted data on study designs, populations enrolled, intervention program characteristics (duration, number of core and maintenance sessions), and outcomes. We used a random effects model to calculate summary estimates for each outcome and associated 95% confidence intervals (CI). To examine sources of heterogeneity, results were stratified according to the presence of maintenance sessions, risk level of participants (prediabetes or other), and intervention delivery personnel (lay or professional). Forty-four studies that enrolled 8,995 participants met eligibility criteria. Participants had an average age of 50.8 years and body mass index (BMI) of 34.8 kg/m2, and 25.2% were male. On average, study follow-up was 9.3 mo (median 12.0) with a range of 1.5 to 36 months; programs offered a mean of 12.6 sessions, with mean participant attendance of 11.0 core sessions. Sixty percent of programs offered some form of post-core maintenance (either email or in person). Mean absolute changes observed were: weight -3.77 kg (95% CI: -4.55; -2.99), HbA1c -0.21% (-0.29; -0.13), FBG -2.40 mg/dL (-3.59; -1.21), SBP -4.29 mmHg (-5.73, -2.84), DBP -2.56 mmHg (-3.40, 1.71), HDL +0.85 mg/dL (-0.10, 1.60), and TC -5.34 mg/dL (-9.72, -0.97). Programs with a maintenance component achieved greater reductions in weight (additional -1.66kg) and FBG (additional -3.14 mg/dl). Findings are subject to incomplete reporting and heterogeneity of studies included, and confounding because most included studies used pre-post study designs. CONCLUSIONS DPP lifestyle modification programs achieved clinically meaningful weight and cardiometabolic health improvements. Together, these data suggest that additional value is gained from these programs, reinforcing that they are likely very cost-effective.
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Affiliation(s)
- Uma Mudaliar
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Azadeh Zabetian
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Michael Goodman
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Justin B. Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Hypertension, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ann L. Albright
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Edward W. Gregg
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mohammed K. Ali
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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A qualitative exploration of fishing and fish consumption in the Gullah/Geechee culture. J Community Health 2016; 39:1161-70. [PMID: 24737279 DOI: 10.1007/s10900-014-9871-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Gullah/Geechee (G/G) heritage is rooted in a culture largely dependent on fish and seafood as a primary food source. Research suggests that African-American (AA) fishers in the Southeastern US consume larger amounts of fish, potentially exposing them to higher environmental contaminant levels. This in-depth study was conducted to explore G/G and AA Sea Island attitudes, perceptions, and cultural beliefs about fishing in one urban and two rural South Carolina coastal counties. Results indicated that study participants in rural counties had slightly different perspectives of fishing (e.g. fishing as an essential dietary supplement) than in urban counties where fishing was viewed more as relaxation. Major misperceptions existed in all counties between fish consumption advisories related to pollution versus harvesting restrictions associated with fishing regulations. Providing clear, culturally tailored health messages regarding fish advisories will promote more informed choices about fish consumption that will minimize potential exposures to environmental pollutants.
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Sattin RW, Williams LB, Dias J, Garvin JT, Marion L, Joshua TV, Kriska A, Kramer MK, Narayan KMV. Community Trial of a Faith-Based Lifestyle Intervention to Prevent Diabetes Among African-Americans. J Community Health 2016; 41:87-96. [PMID: 26215167 PMCID: PMC4715566 DOI: 10.1007/s10900-015-0071-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
About 75% of African-Americans (AAs) ages 20 or older are overweight and nearly 50% are obese, but community-based programs to reduce diabetes risk in AAs are rare. Our objective was to reduce weight and fasting plasma glucose (FPG) and increase physical activity (PA) from baseline to week-12 and to month-12 among overweight AA parishioners through a faith-based adaptation of the Diabetes Prevention Program called Fit Body and Soul (FBAS). We conducted a single-blinded, cluster randomized, community trial in 20 AA churches enrolling 604 AAs, aged 20-64 years with BMI ≥ 25 kg/m(2) and without diabetes. The church (and their parishioners) was randomized to FBAS or health education (HE). FBAS participants had a significant difference in adjusted weight loss compared with those in HE (2.62 vs. 0.50 kg, p = 0.001) at 12-weeks and (2.39 vs. -0.465 kg, p = 0.005) at 12-months and were more likely (13%) than HE participants (3%) to achieve a 7% weight loss (p < 0.001) at 12-weeks and a 7% weight loss (19 vs. 8%, p < 0.001) at 12-months. There were no significant differences in FPG and PA between arms. Of the 15.2% of participants with baseline pre-diabetes, those in FBAS had, however, a significant decline in FPG (10.93 mg/dl) at 12-weeks compared with the 4.22 mg/dl increase in HE (p = 0.017), and these differences became larger at 12-months (FBAS, 12.38 mg/dl decrease; HE, 4.44 mg/dl increase) (p = 0.021). Our faith-based adaptation of the DPP led to a significant reduction in weight overall and in FPG among pre-diabetes participants. CLINICALTRIALS. GOV IDENTIFIER NCT01730196.
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Affiliation(s)
- Richard W Sattin
- Department of Emergency Medicine, Medical College of Georgia, Georgia Regents University, 1120 15th Street, AF-1001, Augusta, GA, 30912, USA.
- College of Nursing, Georgia Regents University, 987 St. Sebastian Way, Augusta, GA, 30912, USA.
| | - Lovoria B Williams
- College of Nursing, Georgia Regents University, 987 St. Sebastian Way, Augusta, GA, 30912, USA
| | - James Dias
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Georgia Regents University, 1120 15th Street, AE-1036, Augusta, GA, 30912, USA
| | - Jane T Garvin
- College of Nursing, Georgia Regents University, 987 St. Sebastian Way, Augusta, GA, 30912, USA
| | - Lucy Marion
- College of Nursing, Georgia Regents University, 987 St. Sebastian Way, Augusta, GA, 30912, USA
| | - Thomas V Joshua
- College of Nursing, Georgia Regents University, 987 St. Sebastian Way, Augusta, GA, 30912, USA
| | - Andrea Kriska
- Department of Epidemiology, University of Pittsburgh, 505B Parran Hall, Pittsburgh, PA, 15261, USA
| | - M Kaye Kramer
- Department of Epidemiology, University of Pittsburgh, 505B Parran Hall, Pittsburgh, PA, 15261, USA
| | - K M Venkat Narayan
- Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, Room 7040 N., Atlanta, GA, 30322, USA
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Cyril S, Smith BJ, Possamai-Inesedy A, Renzaho AMN. Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review. Glob Health Action 2015; 8:29842. [PMID: 26689460 PMCID: PMC4685976 DOI: 10.3402/gha.v8.29842] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/02/2015] [Accepted: 11/20/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. DESIGN The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. RESULTS Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. CONCLUSIONS The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way.
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Affiliation(s)
- Sheila Cyril
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Ben J Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alphia Possamai-Inesedy
- Office of the Pro-Vice Chancellor Arts (Education), Western Sydney University, Bankstown, NSW, Australia
| | - Andre M N Renzaho
- Humanitarian and Development Studies, School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia;
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Stoutenberg M, Stanzilis K, Falcon A. Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings. Int J Behav Med 2015; 22:312-27. [PMID: 25200447 DOI: 10.1007/s12529-014-9438-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Lifestyle modification programs (LMPs) can provide individuals with behavioral skills to sustain long-term changes to their physical activity (PA) levels and dietary habits. Yet, there is much work to be done in the translation of these programs to community settings. PURPOSE This review identified LMPs that focused on changing both PA and dietary behaviors and examined common features and barriers faced in their translation to community settings. METHODS A search of multiple online databases was conducted to identify LMPs that included participants over the age of 18 who enrolled in LMPs, offered in community settings, and had the goal of improving both PA and dietary behaviors. Data were extracted on participant demographics, study design characteristics, and study outcome variables including changes in PA, dietary habits, body weight, and clinical outcomes. RESULTS We identified 27 studies that met inclusion criteria. Despite high levels of retention and adherence to the interventions, varying levels of success were observed in increasing PA levels, improving dietary habits, reducing body weight, and improving clinic outcomes. CONCLUSION LMPs addressing issues of PA and dietary habits can be successfully implemented in a community setting. However, inconsistent reporting of key components in the translation of these studies (participant recruitment, utilization of behavioral strategies) may limit their replication and advancement of future programs. Future efforts should better address issues such as identifying barriers to participation and program implementation, utilization of community resources, and evaluating changes across multiple health behaviors.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA,
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Perez A, Alos VA, Scanlan A, Maia CM, Davey A, Whitaker RC, Foster GD, Ackermann RT, O'Brien MJ. The rationale, design, and baseline characteristics of PREVENT-DM: A community-based comparative effectiveness trial of lifestyle intervention and metformin among Latinas with prediabetes. Contemp Clin Trials 2015; 45:320-327. [PMID: 26597415 PMCID: PMC4674352 DOI: 10.1016/j.cct.2015.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/19/2015] [Accepted: 10/23/2015] [Indexed: 11/18/2022]
Abstract
Promotora Effectiveness Versus Metformin Trial (PREVENT-DM) is a randomized comparative effectiveness trial of a lifestyle intervention based on the Diabetes Prevention Program delivered by community health workers (or promotoras), metformin, and standard care. Eligibility criteria are Hispanic ethnicity, female sex, age ≥ 20 years, fluent Spanish-speaking status, BMI ≥ 23 kg/m(2), and prediabetes. We enrolled 92 participants and randomized them to one of the following three groups: standard care, DPP-based lifestyle intervention, or metformin. The primary outcome of the trial is the 12-month difference in weight between groups. Secondary outcomes include the following cardiometabolic markers: BMI, waist circumference, blood pressure, and fasting plasma glucose, hemoglobin A1C (HbA1c), total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, and insulin. PREVENT-DM participants are socioeconomically disadvantaged Latinas with a mean annual household income of $15,527 ± 9922 and educational attainment of 9.7 ± 3.6 years. Eighty-six percent of participants are foreign born, 20% have a prior history of gestational diabetes, and 71% have a first-degree relative with diagnosed diabetes. At baseline, PREVENT-DM participants had a mean age of 45.1 ± 12.5 years, weight of 178.8 ± 39.3 lbs, BMI of 33.3 ± 6.5 kg/m(2), HbA1c of 5.9 ± 0.2%, and waist circumference of 97.4 ± 11.1cm. Mean baseline levels of other cardiometabolic markers were normal. The PREVENT-DM study successfully recruited and randomized an understudied population of Latinas with prediabetes. This trial will be the first U.S. study to test the comparative effectiveness of metformin and lifestyle intervention versus standard care among prediabetic adults in a "real-world" setting.
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Affiliation(s)
- Alberly Perez
- Center for Obesity Research and Education, Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA 19140, USA; Puentes de Salud Health and Wellness Center, 1700 South Street, Philadelphia, PA 19146, USA
| | - Victor A Alos
- Center for Obesity Research and Education, Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA 19140, USA; Puentes de Salud Health and Wellness Center, 1700 South Street, Philadelphia, PA 19146, USA
| | - Adam Scanlan
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Catarina M Maia
- Center for Obesity Research and Education, Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA 19140, USA; Puentes de Salud Health and Wellness Center, 1700 South Street, Philadelphia, PA 19146, USA
| | - Adam Davey
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 9th Floor, Philadelphia, PA 19122, USA
| | - Robert C Whitaker
- Center for Obesity Research and Education, Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA 19140, USA; Department of Epidemiology and Biostatistics, College of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, 9th Floor, Philadelphia, PA 19122, USA
| | - Gary D Foster
- Weight Watchers International, Inc., 675 Avenue of the Americas, 6th Floor, New York, NY 10010, USA
| | - Ronald T Ackermann
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611, USA; Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 6th Floor, Chicago, IL 60611, USA
| | - Matthew J O'Brien
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611, USA; Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 6th Floor, Chicago, IL 60611, USA.
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Haw JS, Tantry S, Vellanki P, Pasquel FJ. National Strategies to Decrease the Burden of Diabetes and Its Complications. Curr Diab Rep 2015; 15:65. [PMID: 26255260 DOI: 10.1007/s11892-015-0637-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Comparative results from national strategies for diabetes care and prevention are needed to understand the impact and barriers encountered during the implementation process. Long-term outcomes are limited, but results on intermediate outcomes and processes of diabetes care measures are available from translational research studies. In this narrative review, we highlight programs with nationwide reach, targeting various ethnic, racial, and socioeconomic populations with diabetes. We describe the implementation strategies, the impact on clinical outcomes, specific barriers, and cost-effectiveness results of national efforts aimed at improving diabetes care and prevention in the USA.
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Affiliation(s)
- J Sonya Haw
- Division of Endocrinology, Emory University School of Medicine, 49 Jesse Hill Dr SE, FOB Rm 439, Atlanta, GA, 30303, USA,
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Evaluation of physical activity reporting in community Diabetes Prevention Program lifestyle intervention efforts: A systematic review. Prev Med 2015; 77:191-9. [PMID: 26051204 DOI: 10.1016/j.ypmed.2015.05.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/29/2015] [Accepted: 05/30/2015] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The Diabetes Prevention Program (DPP) lifestyle intervention has been translated to community settings using the DPP goals of 7% weight loss and 150min of moderate physical activity (PA) per week. Given that PA is a primary lifestyle goal and has been linked to improvements in metabolic health in the DPP, it is important to understand the role that PA plays in translation effort success. The purpose of this review is to thoroughly evaluate the reporting of PA methodology and results in DPP-based translations in order to guide future prevention efforts. METHODS PubMed and Ovid databases were searched to identify peer-reviewed original research articles on DPP-based translations for adults at-risk for developing diabetes or cardiovascular disease, limited to English language publications from January 2002-March 2015. RESULTS 72 original research articles describing 57 translation studies met eligibility criteria. All 57 study interventions included a PA goal, 47 studies (82%) collected participant PA information, and 34 (60%) provided PA results. CONCLUSIONS Despite PA being a primary intervention goal, PA methodology and results are under-reported in published DPP translation studies. This absence and inconsistency in reporting PA needs addressed in order to fully understand translation efforts' impact on participant health.
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Steinsbekk A, Rygg LØ, Lisulo M, By Rise M, Fretheim A. WITHDRAWN: Group based diabetes self-management education compared to routine treatment, waiting list control or no intervention for people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2015; 2015:CD003417. [PMID: 26125655 PMCID: PMC10658837 DOI: 10.1002/14651858.cd003417.pub3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The review authors of this review update are unable to continue with their work. The Cochrane Metabolic and Endocrine Disorders Review Group is seeking very experienced new authors to perform an update on this complex intervention review. At June 2015, this review has been withdrawn. This review is out of date although it is correct as the date of publication. The latest version is available in the 'Other versions' tab on the Cochrane Library, and may still be useful to readers. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- Aslak Steinsbekk
- Norwegian University of Science and Technology, MTFSDepartment of Public Health and General PracticeTrondheimNorwayN‐7489
| | - Lisbeth Ø. Rygg
- Norwegian University of Science and Technology, MTFSDepartment of Public Health and General PracticeTrondheimNorwayN‐7489
| | - Monde Lisulo
- Norwegian University of Science and Technology, MTFSDepartment of Public Health and General PracticeTrondheimNorwayN‐7489
| | - Marit By Rise
- Norwegian University of Science and Technology, MTFSDepartment of Public Health and General PracticeTrondheimNorwayN‐7489
| | - Atle Fretheim
- Norwegian Knowledge Centre for the Health ServicesGlobal Health UnitOsloNorway
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Newlin Lew K, Arbauh N, Banach P, Melkus G. Diabetes: Christian worldview, medical distrust and self-management. JOURNAL OF RELIGION AND HEALTH 2015; 54:1157-1172. [PMID: 25735754 PMCID: PMC4673985 DOI: 10.1007/s10943-015-0022-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To inform the development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N = 44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical distrust and self-management as prominent themes. Findings suggest that diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African-American community to improve health outcomes.
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O'Brien MJ, Perez A, Alos VA, Whitaker RC, Ciolino JD, Mohr DC, Ackermann RT. The feasibility, acceptability, and preliminary effectiveness of a Promotora-Led Diabetes Prevention Program (PL-DPP) in Latinas: a pilot study. DIABETES EDUCATOR 2015; 41:485-94. [PMID: 26023095 DOI: 10.1177/0145721715586576] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this pilot study is to test the feasibility, acceptability, and preliminary effectiveness of a Promotora-Led Diabetes Prevention Program (PL-DPP) in Hispanic women (Latinas). METHODS Twenty Latina adults with prediabetes were enrolled in this single-arm pilot trial of PL-DPP. Participants underwent a year-long lifestyle intervention consisting of 24 sessions divided into 14 weekly core sessions and 10 post-core sessions offered either biweekly or monthly. Each session was led by a promotora in Spanish. The primary outcome was weight change over the 12-month study period. RESULTS The study participants were socioeconomically challenged, middle-aged Latinas with limited access to health care. Eighteen participants (90%) completed at least 12 sessions, and 1 was lost to follow-up. Overall, participants reported high levels of satisfaction with PL-DPP. At 12 months, the participants achieved a mean weight loss of 10.8 pounds, which corresponded to 5.6% of initial body weight. Significant pre-post reductions in waist circumference, diastolic blood pressure, LDL cholesterol, and insulin levels were also observed. Modest reductions in A1C and fasting plasma glucose were not significant. CONCLUSIONS The PL-DPP demonstrated feasibility, acceptability, and preliminary effectiveness in a high-risk population of Latinas. Future research examining this intervention in a randomized clinical trial should explore factors impacting its effects using both qualitative and quantitative methods.
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Affiliation(s)
- Matthew J O'Brien
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr O'Brien, Dr Ackermann),Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr O'Brien, Dr Ackermann),Center for Obesity Research and Education, Temple University, Philadelphia, PA (Dr O'Brien, Ms Perez, Dr Alos, Dr Whitaker),Puentes de Salud Health and Wellness Center, Philadelphia, PA, USA (Dr O'Brien, Ms Perez, Dr Alos)
| | - Alberly Perez
- Center for Obesity Research and Education, Temple University, Philadelphia, PA (Dr O'Brien, Ms Perez, Dr Alos, Dr Whitaker),Puentes de Salud Health and Wellness Center, Philadelphia, PA, USA (Dr O'Brien, Ms Perez, Dr Alos)
| | - Victor A Alos
- Center for Obesity Research and Education, Temple University, Philadelphia, PA (Dr O'Brien, Ms Perez, Dr Alos, Dr Whitaker),Department of Public Health, Temple University, Philadelphia, PA, USA (Dr Alos, Dr Whitaker),Puentes de Salud Health and Wellness Center, Philadelphia, PA, USA (Dr O'Brien, Ms Perez, Dr Alos)
| | - Robert C Whitaker
- Center for Obesity Research and Education, Temple University, Philadelphia, PA (Dr O'Brien, Ms Perez, Dr Alos, Dr Whitaker),Department of Public Health, Temple University, Philadelphia, PA, USA (Dr Alos, Dr Whitaker)
| | - Jody D Ciolino
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Ciolino, Dr Mohr)
| | - David C Mohr
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Ciolino, Dr Mohr)
| | - Ronald T Ackermann
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr O'Brien, Dr Ackermann),Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr O'Brien, Dr Ackermann)
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Newton RL, Johnson WD, Hendrick C, Harris M, Andrews E, Johannsen N, Rodarte RQ, Hsia DS, Church TS. A randomized controlled exercise training trial on insulin sensitivity in African American men: The ARTIIS study: Major category: study design, statistical design, study protocols. Contemp Clin Trials 2015; 43:75-82. [PMID: 25979318 DOI: 10.1016/j.cct.2015.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/06/2015] [Accepted: 05/09/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Lack of regular physical activity at prescribed intensity levels is a modifiable risk factor for insulin resistance and the development of diabetes. African American men are at increased risk for developing diabetes and most African American men are not meeting the current recommended levels of physical activity. The primary objective of the Aerobic Plus Resistance Training and Insulin Resistance in African American Men (ARTIIS) study is to determine the effectiveness of an exercise training intervention aimed at reducing diabetes risk factors in African American men at risk for developing diabetes. METHODS Insufficiently active 35-70 year old African American men with a family history of diabetes were eligible for the study. The 5-month randomized controlled trial assigns 116 men to an exercise training or healthy living control arm. The exercise training arm combines aerobic and resistance training according to the current national physical activity recommendations and is conducted in community (YMCA) facilities. The healthy living arm receives information promoting healthy lifestyle changes. OUTCOMES Insulin response to an oral glucose load is the primary outcome measure, and changes in physiological parameters, cardiorespiratory fitness, strength, body composition, and psychological well-being comprise the secondary outcomes. CONCLUSIONS The ARTIIS study is one of the first adequately powered, rigorously designed studies to investigate the effects of an aerobic plus resistance exercise training program and to assess adherence to exercise training in community facilities, in African American men.
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Affiliation(s)
- Robert L Newton
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - William D Johnson
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - Chelsea Hendrick
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - Melissa Harris
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - Emanuel Andrews
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - Neil Johannsen
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA; Louisiana State University, 112 Huey P. Long Field House, Baton Rouge, LA, 70803, USA.
| | - Ruben Q Rodarte
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA; ACAP Health, 12712 Park Central Dr., Suite 100, Dallas, TX 75251, USA.
| | - Daniel S Hsia
- Louisiana State University, 112 Huey P. Long Field House, Baton Rouge, LA, 70803, USA.
| | - Timothy S Church
- Pennington Biomedical Research Center, 6400 Perkins Rd., Baton Rouge, LA 70808, USA; ACAP Health, 12712 Park Central Dr., Suite 100, Dallas, TX 75251, USA.
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Tussing-Humphreys LM, Thomson JL, Onufrak SJ. A church-based pilot study designed to improve dietary quality for rural, lower Mississippi Delta, African American adults. JOURNAL OF RELIGION AND HEALTH 2015; 54:455-469. [PMID: 24442772 DOI: 10.1007/s10943-014-9823-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We piloted a 6-month, church-based, behavioral intervention, Delta Body and Soul (DBS), for African American (AA) adults in the Lower Mississippi Delta (LMD). DBS was designed to improve overall dietary quality in LMD AA adults. The intervention included six once monthly group-based educational sessions implemented by trained church members. Program implementation, session attendance, congregational feedback, and baseline and post-intervention, demographic, health, behavioral, and clinical parameters were assessed. Participants were predominately AA, female, and overweight or obese. Retention rate was 79 %. High adherence, defined as attendance at four or more educational sessions, was associated with dietary quality improvement and reduced blood glucose. Implementation of the DBS pilot intervention was feasible and may result in dietary quality and clinical improvements.
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Affiliation(s)
- Lisa M Tussing-Humphreys
- Division of Health Promotion Research, Department of Medicine, University of Illinois at Chicago, Chicago, IL, 60608, USA,
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Harris J, Springett J, Croot L, Booth A, Campbell F, Thompson J, Goyder E, Van Cleemput P, Wilkins E, Yang Y. Can community-based peer support promote health literacy and reduce inequalities? A realist review. PUBLIC HEALTH RESEARCH 2015. [DOI: 10.3310/phr03030] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BackgroundCommunity-based peer support (CBPS) has been proposed as a potentially promising approach to improve health literacy (HL) and reduce health inequalities. Peer support, however, is described as a public health intervention in search of a theory, and as yet there are no systematic reviews exploring why or how peer support works to improve HL.ObjectiveTo undertake a participatory realist synthesis to develop a better understanding of the potential for CBPS to promote better HL and reduce health inequalities.Data sourcesQualitative evidence syntheses, conceptual reviews and primary studies evaluating peer-support programmes; related studies that informed theoretical or contextual elements of the studies of interest were included. We conducted searches covering 1975 to October 2011 across Scopus, Global Health (including MEDLINE), ProQuest Dissertations & Theses database (PQDT) [including the Education Resources Information Center (ERIC) and Social Work Abstracts], The King’s Fund Database and Web of Knowledge, and the Institute of Development Studies supplementary strategies were used for the identification of grey literature. We developed a new approach to searching called ‘cluster searching’, which uses a variety of search techniques to identify papers or other research outputs that relate to a single study.Study eligibility criteriaStudies written in English describing CBPS research/evaluation, and related papers describing theory, were included.Study appraisal and synthesis methodsStudies were selected on the basis of relevance in the first instance. We first analysed within-programme articulation of theory and appraised for coherence. Cross-programme analysis was used to configure relationships among context, mechanisms and outcomes. Patterns were then identified and compared with theories relevant to HL and health inequalities to produce a middle-range theory.ResultsThe synthesis indicated that organisations, researchers and health professionals that adopt an authoritarian design for peer-support programmes risk limiting the ability of peer supporters (PSs) to exercise autonomy and use their experiential knowledge to deliver culturally tailored support. Conversely, when organisations take a negotiated approach to codesigning programmes, PSs are enabled to establish meaningful relationships with people in socially vulnerable groups. CBPS is facilitated when organisations prioritise the importance of assessing community needs; investigate root causes of poor health and well-being; allow adequate time for development of relationships and connections; value experiential cultural knowledge; and share power and control during all stages of design and implementation. The theory now needs to be empirically tested via further primary research.LimitationsAnalysis and synthesis were challenged by a lack of explicit links between peer support for marginalised groups and health inequalities; explicitly stated programme theory; inconsistent reporting of context and mechanism; poor reporting of intermediate process outcomes; and the use of theories aimed at individual-level behaviour change for community-based interventions.ConclusionsPeer-support programmes have the potential to improve HL and reduce health inequalities but potential is dependent upon the surrounding equity context. More explicit empirical research is needed, which establishes clearer links between peer-supported HL and health inequalities.Study registrationThis study is registered as PROSPERO CRD42012002297.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Janet Harris
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Jane Springett
- Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Liz Croot
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Fiona Campbell
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Jill Thompson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Patrice Van Cleemput
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Emma Wilkins
- Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Yajing Yang
- Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, AB, Canada
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Yako-Suketomo H, Katanoda K, Sobue T, Imai H. Practical Use of Cancer Control Promoters in Municipalities in Japan. Asian Pac J Cancer Prev 2014; 15:8239-44. [DOI: 10.7314/apjcp.2014.15.19.8239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lancaster KJ, Carter-Edwards L, Grilo S, Shen C, Schoenthaler AM. Obesity interventions in African American faith-based organizations: a systematic review. Obes Rev 2014; 15 Suppl 4:159-76. [PMID: 25196412 DOI: 10.1111/obr.12207] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 01/14/2023]
Abstract
African Americans, especially women, have higher obesity rates than the general US population. Because of the importance of faith to many African Americans, faith-based organizations (FBOs) may be effective venues for delivering health messages and promoting adoption of healthy behaviours. This article systematically reviews interventions targeting weight and related behaviours in faith settings. We searched literature published through July 2012 for interventions in FBOs targeting weight loss, diet and/or physical activity (PA) in African Americans. Of 27 relevant articles identified, 12 were randomized controlled trials; seven of these reported a statistically significant change in an outcome. Four of the five quasi-experimental and single-group design studies reported a statistically significant outcome. All 10 pilot studies reported improvement in at least one outcome, but most did not have a comparison group. Overall, 70% of interventions reported success in reducing weight, 60% reported increased fruit and vegetable intake and 38% reported increased PA. These results suggest that interventions in African American FBOs can successfully improve weight and related behaviours. However, not all of the findings about the success of certain approaches were as expected. This review identifies gaps in knowledge and recommends more rigorous studies be conducted to strengthen the comparative methodology and evidence.
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Affiliation(s)
- K J Lancaster
- Steinhardt School of Culture, Education, and Human Development, Department of Nutrition, Food Studies and Public Health, New York University, New York, NY, USA
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Whitt-Glover MC, Keith NR, Ceaser TG, Virgil K, Ledford L, Hasson RE. A systematic review of physical activity interventions among African American adults: evidence from 2009 to 2013. Obes Rev 2014; 15 Suppl 4:125-45. [PMID: 25196410 DOI: 10.1111/obr.12205] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 10/24/2022]
Abstract
This review extends findings from four previous reviews of physical activity (PA) interventions among African Americans (AA) and includes papers published between January 2009 and August 2013. Eligible papers were retrieved using strategies employed in previous reviews. Overall, 16 relevant papers were identified, including four pilot studies and 12 full trials. Interventions were based on a variety of behavioural sciences theories. The most common setting for interventions was churches. Most interventions lasted >6 months; few interventions included >6 months of post-intervention follow-up. Overall, studies identified within-group differences showing positive improvements in PA, and most studies showed statistically significant between-group differences in at least one measure of PA. A quality score was used to rate various elements of the studies and provide a numerical assessment of each paper; scores ranged from 3 to 10 out of 13 possible points. The current review indicates a continued need for studies that use objective PA measures, assess long-term intervention impact, provide specific PA goals for interventions, include more attention to strategies that can increase retention and adherence among AA study participants, include AA men and determine the independent and synergistic effects of individual and environmental (socio-cultural and built) change strategies.
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Kumanyika SK, Whitt-Glover MC, Haire-Joshu D. What works for obesity prevention and treatment in black Americans? Research directions. Obes Rev 2014; 15 Suppl 4:204-12. [PMID: 25196414 DOI: 10.1111/obr.12213] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 06/13/2014] [Accepted: 06/14/2014] [Indexed: 12/01/2022]
Abstract
Obesity prevalence in black/African American children and adults of both sexes is high overall and compared with US whites. What we know, and do not know, about how to enhance the effectiveness of obesity prevention and treatment interventions in African Americans is the focus of the 10 articles in this special issue of Obesity Reviews. The evidence base is limited in quantity and quality and insufficient to provide clear guidance. With respect to children, there is relatively consistent, but not definitive support for prioritizing the systematic implementation and evaluation of child-focused interventions in pre-school and school settings and outside of school time. For adults or all ages, developing and refining e-health approaches and faith-based or other culturally and contextually relevant approaches, including translation of the Diabetes Prevention Program intervention to community settings is indicated. Major evidence gaps were identified with respect to interventions with black men and boys, ways to increase participation and retention of black adults in lifestyle behaviour change programmes, and studies of the impact of environmental and policy changes on eating and physical activity in black communities. Bold steps related to research funding priorities, research infrastructure and methodological guidelines are recommended to improve the quantity and quality of research in this domain.
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Affiliation(s)
- S K Kumanyika
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Almeida FA, Pardo KA, Seidel RW, Davy BM, You W, Wall SS, Smith E, Greenawald MH, Estabrooks PA. Design and methods of "diaBEAT-it!": a hybrid preference/randomized control trial design using the RE-AIM framework. Contemp Clin Trials 2014; 38:383-96. [PMID: 24956325 DOI: 10.1016/j.cct.2014.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diabetes prevention is a public health priority that is dependent upon the reach, effectiveness, and cost of intervention strategies. However, understanding each of these outcomes within the context of randomized controlled trials is problematic. PURPOSE To describe the methods and design of a hybrid preference/randomized control trial using the RE-AIM framework. METHODS The trial, which was developed using the RE-AIM framework, will contrast the effects of 3 interventions: (1) a standard care, small group, diabetes prevention education class (SG), (2) the small group intervention plus 12 months of interactive voice response telephone follow-up (SG-IVR), and (3) a DVD version of the small group intervention with the same IVR follow-up (DVD-IVR). Each intervention includes personal action planning with a focus on key elements of the lifestyle intervention from the Diabetes Prevention Program (DPP). Adult patients at risk for diabetes will be randomly assigned to either choice or RCT. Those assigned to choice (n=240) will have the opportunity to choose between SG-IVR and DVD-IVR. Those assigned to RCT group (n=360) will be randomly assigned to SG, SG-IVR, or DVD-IRV. Assessment of primary (weight loss, reach, & cost) and secondary (physical activity, & dietary intake) outcomes will occur at baseline, 6, 12, and 18 months. CONCLUSION This will be the first diabetes prevention trial that will allow the research team to determine the relationships between reach, effectiveness, and cost of different interventions.
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Affiliation(s)
- Fabio A Almeida
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Kimberlee A Pardo
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Richard W Seidel
- Department of Psychiatry, Carilion Clinic, Roanoke, VA 24014, United States.
| | - Brenda M Davy
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Wen You
- Department of Agriculture and Applied Economics, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Sarah S Wall
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Erin Smith
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.
| | - Mark H Greenawald
- Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA 24013, United States.
| | - Paul A Estabrooks
- Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States; Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA 24013, United States.
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