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Derboghossian G, Foust JB, Hayman LL. Social and Religious Networks with Respect to the Health Behaviors of African American Women: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02147-9. [PMID: 39354273 DOI: 10.1007/s10943-024-02147-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/24/2024] [Indexed: 10/03/2024]
Abstract
The aim of this systematic mixed studies review was to examine how social networks influence physical activity and dietary patterns among African American women. We searched PUBMED, CINAHL, JSTOR, SocioIndex, Medline, Cochrane Library, sportDISCUS, and PsycINFO to review articles published between Jan 1, 2007, and July 1, 2021. Only 23 studies met the inclusion criteria. All studies were conducted in the US. Social support received from family members, friends, and churches was found to positively influence physical activity and/or dietary patterns among African American women. An inconsistent relationship was found between social network size, health behavior characteristics of social networks, and physical activity and/or dietary patterns among African American women. Future research should incorporate structural and functional social network strategies to promote physical activity and healthy eating behaviors effectively and sustainably among African American women.
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Affiliation(s)
- Grace Derboghossian
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
- University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02125, USA.
| | - Janice B Foust
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Laura L Hayman
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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2
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Ng BP, Ely E, Papali'i M, Cannon MJ. Delivering the National Diabetes Prevention Program: Assessment of Retention, Physical Activity, and Weight Loss Outcomes by Participant Characteristics and Delivery Modes. J Diabetes Res 2024; 2024:8461704. [PMID: 39165352 PMCID: PMC11335425 DOI: 10.1155/2024/8461704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/13/2024] [Accepted: 07/19/2024] [Indexed: 08/22/2024] Open
Abstract
Type 2 diabetes disproportionately affects older adults, persons from racial and ethnic minority groups, and persons of low socioeconomic status. It can be prevented or delayed through evidence-based interventions such as the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). This analysis is aimed at evaluating the outcomes (i.e., retention, physical activity, and weight loss) associated with participation in the National DPP LCP by participant characteristics and delivery mode (i.e., in-person, online, distance learning, and combination) using the 2012-2018 Diabetes Prevention Recognition Program (DPRP) data. Across all delivery modes, there were generally no substantial differences in retention between male and female participants, but male participants tended to have higher physical activity and weight loss (e.g., average weight loss for in-person delivery: 5.0% for males and 4.3% for females). Older participants had better retention rates than younger participants in all delivery modes and mostly higher physical activity and weight loss except for distance learning delivery (e.g., average weight loss for in-person delivery: 5.1% for those aged 65+ and 3.3% for those aged 18-34). Among the seven racial and ethnic groups studied, retention was generally highest for non-Hispanic/Latino (NH)-White participants and lowest for Hispanic/Latino participants. Physical activity varied by racial and ethnic groups and delivery mode. NH-White participants generally had the most weight loss except for distance learning delivery, and NH-Black/African American participants had the least (e.g., average weight loss for in-person delivery: 5.1% for NH-White participants, 3.3% for both NH-Black/African American and NH-American Indian/Alaska Native participants, and other racial and ethnic minority groups ranged from 3.4% to 4.9%). Monitoring and identifying disparities across demographics and delivery modes, particularly across multiple racial and ethnic groups, provides information that can be used to improve the implementation of the National DPP LCP by tailoring the intervention to reduce disparities.
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Affiliation(s)
- Boon Peng Ng
- College of Nursing and DisabilityAging and Technology ClusterUniversity of Central Florida, Orlando, Florida, USA
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Ely
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michelle Papali'i
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael J. Cannon
- Division of Diabetes TranslationCenters for Disease Control and Prevention, Atlanta, Georgia, USA
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3
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Chao AM, Moore M, Wadden TA. The past, present, and future of behavioral obesity treatment. Int J Obes (Lond) 2024:10.1038/s41366-024-01525-3. [PMID: 38678143 DOI: 10.1038/s41366-024-01525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024]
Abstract
Over the last century, hundreds of evaluations have been conducted to examine weight-management interventions related to diet, physical activity, and behavior therapy. These investigations have contributed to a growing body of knowledge that has consistently advanced the field of obesity treatment, while also revealing some persistent challenges. This narrative review summarizes key findings from randomized controlled trials conducted in adults that have combined diet, physical activity, and behavior therapy, an approach variously referred to as behavioral treatment, comprehensive lifestyle modification, or intensive lifestyle intervention. The review shows that current behavioral approaches induce average reductions in baseline body weight of 5 to 10% at 6 to 12 months. Such losses have proven effective in reducing the risk of type 2 diabetes in persons with impaired glucose tolerance and in improving other obesity-related complications. These benefits have also been associated with reductions in healthcare costs. Despite these advances, behavioral treatment is challenged by the need for larger losses to achieve optimal improvements in health, by difficulties associated with maintaining weight loss, and by barriers limiting access to treatment. New anti-obesity medications, when combined with behavioral obesity treatment, hold promise of addressing the first two issues.
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Affiliation(s)
- Ariana M Chao
- Johns Hopkins School of Nursing, Baltimore, MD, USA.
| | - Molly Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Githinji P, Uribe ALM, Seguin-Fowler RA, Ayine P, On A, Villarreal DL, McNeely A, Szeszulski J, Rethorst CD. A qualitative exploration of the health needs and goals of urban women to inform the tailoring and adaptation of Strong Hearts Healthy Communities: a community-based cardiovascular disease prevention intervention. BMC Public Health 2024; 24:296. [PMID: 38273284 PMCID: PMC10811835 DOI: 10.1186/s12889-024-17818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND In the United States, cardiovascular diseases (CVD) are the leading cause of death and disability in women. CVD-modifiable risk factors, including poor diet quality and inadequate physical activity, can be addressed through evidence-based interventions (EBIs). Strong Hearts Healthy Communities (SHHC) is an EBI that has demonstrated effectiveness in reducing CVD risk and improving health outcomes among rural white women. The aims of this study were to understand the general health, diet, and physical activity-related needs and goals of women living in an urban community, to inform the tailoring and adaptation of the SHHC EBI to an urban setting and more diverse population. METHODS Focus groups (FGs) were conducted with African American/Black and Hispanic/Latinx women in the Dallas metropolitan area who had a BMI ≥ 25 kg/m2 and engaged in ≤ 150 min per week of moderate physical activity. The data were coded using a team-based, deductive, and thematic analysis approach, that included multiple coders and in-depth discussions. RESULTS Four FGs with a total of 18 participants (79% Black and 21% Latinx) were conducted, and three themes were developed: (1) participants had adequate knowledge and positive attitudes towards healthy living but faced many barriers to practicing healthy behaviors; (2) culturally-based beliefs and community practices exerted a strong influence on behaviors related to food and stress, revealing barriers to healthy eating and generational differences in stress and stress management; (3) participants desired a more individualized approach to nutrition and physical activity interventions that included familiar and enjoyable activities and social support centered around shared health goals. CONCLUSIONS The SHHC intervention and similar health programs for Black/African American and Hispanic/Latinx women in urban settings should emphasize individualized nutrition and practical skills for healthy eating with accessible, familiar, and enjoyable exercises. Additionally, stress management strategies should be culturally and generationally sensitive and social support, whether through family, friends, or other program participants, should be based on shared health goals.
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Affiliation(s)
- Phrashiah Githinji
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA.
| | | | - Rebecca A Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Priscilla Ayine
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Anita On
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Deyaun L Villarreal
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Andrew McNeely
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Jacob Szeszulski
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
| | - Chad D Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, Dallas, TX, USA
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Shaw AR, Key MN, Fikru S, Lofton S, Sullivan DK, Berkley-Patton J, Glover CM, Burns JM, Vidoni ED. Development of a Culturally Adapted Dietary Intervention to Reduce Alzheimer's Disease Risk among Older Black Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6705. [PMID: 37681845 PMCID: PMC10488073 DOI: 10.3390/ijerph20176705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/18/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
The objective of this study is to identify and understand knowledge and attitudes that influence dietary practices among older Black adults using a community-engaged approach. This is a non-interventional mixed methods study designed to inform the development of an adapted brain-healthy soul food diet intervention. A purposive sampling approach was used to conduct seven semi-structured focus group discussions and an online quantitative survey. In total, 39 participants who self-identified as Black, aged 55 years and older, English speaking, and who were cognitively normal with an AD8 < 2; (25.6% men; 74.4% women) participated in the online survey and one of the seven 60 min virtual focus group discussions (5-7 per focus group). Quantitative frequency data from the online surveys were analyzed using descriptive statistics. Qualitative focus group data were analyzed using a 6-step thematic analysis process. Five themes emerged: dementia awareness; practices shaping food choices and consumption; barriers to eating healthy; instrumental support; and elements of a culturally adapted brain-healthy dietary intervention. Older Black adults perceived an adapted MIND dietary model as the most acceptable with the incorporation of salient cultural characteristics and strategies within both the design and delivery phases.
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Affiliation(s)
- Ashley R. Shaw
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Mickeal N. Key
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Samantha Fikru
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Saria Lofton
- College of Nursing, University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Debra K. Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jannette Berkley-Patton
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO 64108, USA;
| | - Crystal M. Glover
- Department of Psychiatry and Behavioral Sciences, Division of Behavioral Sciences, Rush Medical College, Chicago, IL 60612, USA;
- Department of Neurological Sciences, Rush Medical College, Chicago, IL 60612, USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Jeffrey M. Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Eric D. Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
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Rodgers RF, Goutama V, Sonneville K. At the Same Table: A Delphi Consensus-Based Model of Health-Promoting Eating Behaviors. Nutrients 2023; 15:3601. [PMID: 37630790 PMCID: PMC10458493 DOI: 10.3390/nu15163601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Eating behaviors and patterns are one of the key behavioral indicators of health, and as such these behaviors are a focus of interest across different areas of scholarship. Yet, to date, work in this area is impeded by the lack of a collective theoretical framework to conceptualize, assess, and intervene upon eating behaviors. The aim of this study was therefore to establish a consensus-based framework for health-promoting eating behaviors using a Delphi methodology. An initial systematic search identified constructs that yielded 150 items grouped into three topic areas: (1) the content, types of food and nutrition provided; (2) eating behaviors; and (3) thoughts and feelings related to eating and foods. Over the course of three iterative rounds of rating by a panel of n = 37 experts, a consensus was reached that included eight of the original items that represented the three topic areas. The findings from this study result in a novel consensus-based framework for health-promoting eating behaviors that can form the basis for collaborative work towards the integration of physical and mental health promotion.
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Affiliation(s)
- Rachel F. Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, 34295 Montpellier, France
| | - Valerie Goutama
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
| | - Kendrin Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
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Sweeney AM, Wilson DK, Resnicow K, Van Horn ML, Kitzman H. Engagement With Tailored Physical Activity Content: Secondary Findings From the Families Improving Together for Weight Loss Randomized Controlled Trial. J Med Internet Res 2023; 25:e42581. [PMID: 37043271 PMCID: PMC10134014 DOI: 10.2196/42581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/29/2023] [Accepted: 02/24/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Web-based tailored interventions offer rich opportunities for improved access to and personalization of behavioral interventions. However, despite the promise of this approach, the engagement and underrepresentation of minority groups remain major issues. OBJECTIVE This study evaluated whether engagement (log-in status and log-in duration) with different types of tailored behavioral content from the Families Improving Together for weight loss web-based intervention was associated with changes in moderate to vigorous physical activity (MVPA) among African American families with overweight or obesity. METHODS Parent-adolescent dyads were randomized to a web-based tailored intervention or web-based health education comparison program. The web-based intervention (N=119) was completed by parents and targeted 6 weight-related behaviors to support their adolescent children's weight loss goals (session contents included energy balance, fast food, fruits and vegetables, physical activity [PA], sedentary behavior, and sweetened beverages). MVPA was measured using accelerometers at baseline and after the intervention. RESULTS Using a hierarchical approach, the log-in status and duration for each web-based session were used to evaluate the additive effects of engagement with different types of tailored behavioral content on MVPA after the web-based intervention. Among parents, logging in to the PA session was not associated with greater MVPA (B=-12.561, 95% CI -18.759 to -6.367), but MVPA increased with greater log-in duration for the PA (B=0.008, 95% CI 0.004-0.012) and sedentary behavior (B= 0.008, 95% CI 0.004-0.012) sessions. These results suggest that parents who logged in to the PA session had lower MVPA, but MVPA increased with greater log-in duration for the PA and sedentary behavior sessions. These associations remained even after accounting for engagement with other content sessions. However, these engagement effects did not translate to the adolescents. CONCLUSIONS The results of this study highlight the need to disentangle the impact of engagement with different tailored content to improve the efficacy of tailored web-based interventions, especially for promoting PA in African American families. TRIAL REGISTRATION ClinicalTrials.gov NCT01796067; https://clinicaltrials.gov/ct2/show/NCT01796067.
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Affiliation(s)
- Allison M Sweeney
- Department of Biobehavioral Health & Nursing Science, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Kenneth Resnicow
- Department of Health Behavior & Health Education, University of Michigan, Ann Arbor, MI, United States
| | - M Lee Van Horn
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, United States
| | - Heather Kitzman
- Baylor Scott and White Health, Baylor Scott & White Health and Wellness Center, Dallas, TX, United States
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Lofton H, Ard JD, Hunt RR, Knight MG. Obesity among African American people in the United States: A review. Obesity (Silver Spring) 2023; 31:306-315. [PMID: 36695059 PMCID: PMC10107750 DOI: 10.1002/oby.23640] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/10/2022] [Accepted: 10/27/2022] [Indexed: 01/26/2023]
Abstract
Obesity is a growing public health crisis in the United States and is associated with a substantial disease burden due to an increased risk for multiple complications, including cardiovascular and metabolic diseases. As highlighted in this review, obesity disproportionately affects the African American population, women in particular, regardless of socioeconomic status. Structural racism remains a major contributor to health disparities between African American people and the general population, and it limits access to healthy foods, safe spaces to exercise, adequate health insurance, and medication, all of which impact obesity prevalence and outcomes. Conscious and unconscious interpersonal racism also impacts obesity care and outcomes in African American people and may adversely affect interactions between health care practitioners and patients. To reduce health disparities, structural racism and racial bias must be addressed. Culturally relevant interventions for obesity management have been successfully implemented that have shown benefits in weight management and risk-factor reduction. Strategies to improve health care practitioner-patient engagement should also be implemented to improve health outcomes in African American people with obesity. When managing obesity in African American people, it is critical to take a holistic approach and to consider an individual's social and cultural context in order to implement a successful treatment strategy.
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Affiliation(s)
- Holly Lofton
- NYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Jamy D. Ard
- Wake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Rameck R. Hunt
- Penn Medicine Princeton HealthPlainsboro TownshipNew JerseyUSA
- Rutgers RWJ Medical SchoolNew BrunswickNew JerseyUSA
| | - Michael G. Knight
- The George Washington University School of Medicine and Health SciencesWashingtonDCUSA
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Cultural appropriateness in randomized controlled trials (RCTs) aimed at reducing pesticide exposure among farmers and farmworkers: a systematic review. Int Arch Occup Environ Health 2023; 96:27-44. [PMID: 35838774 DOI: 10.1007/s00420-022-01880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/04/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies. METHODS A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers. RESULTS Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions. CONCLUSION Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers.
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10
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Sweeney AM, Wilson DK, Van Horn ML, Zarrett N, Resnicow K, Brown A, Quattlebaum M, Gadson B. Results from "Developing Real Incentives and Volition for Exercise" (DRIVE): A pilot randomized controlled trial for promoting physical activity in African American women. J Consult Clin Psychol 2022; 90:747-759. [PMID: 35834196 PMCID: PMC9669192 DOI: 10.1037/ccp0000740] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Motivation is a barrier to physical activity (PA) among African American (AA) women, but past studies have implemented a "one-size-fits-all" approach and have not addressed differences in autonomous motivation. This pilot randomized controlled trial assessed the preliminary efficacy of "Developing Real Incentives and Volition for Exercise," a community- and theory-based intervention, which evaluated whether a motivationally matched (vs. a nonmatched) intervention increases daily total PA. METHOD In total, 68 AA women (50.72 ± 13.66 years; 86.8% with obesity) were randomized to an 8-week challenge-focused program (targeted toward high autonomous motivation) or rewards-focused program (targeted toward low autonomous motivation). Randomization was stratified by baseline autonomous motivation. FitBits were used during the intervention to promote self-monitoring (both programs) and social connectedness (challenge program only). RESULTS Both programs retained ≥ 80% of participants. Process evaluation revealed high attendance, dose, and fidelity (both programs). However, contrary to expectations, across all motivational levels (low and high autonomous), the challenge-focused intervention resulted in a greater increase in total daily PA (primary outcome), with an average increase of 17.9 min in the challenge-focused intervention versus an average decrease of 8.55 min in the rewards-focused intervention. An exploratory follow-up analysis revealed that engagement with the FitBit mobile app predicted greater PA at postintervention in the challenge-focused program. CONCLUSIONS A team-based approach targeting social connectedness, enjoyment of PA, and positive intragroup competition is a promising approach for promoting PA among AA women. These findings are used to guide a discussion on best practices for engaging AA women in future behavioral interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina
| | - M Lee Van Horn
- Department of Education Psychology, University of New Mexico
| | | | - Kenneth Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Asia Brown
- Department of Psychology, University of South Carolina
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11
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Birch JM, Jones RA, Mueller J, McDonald MD, Richards R, Kelly MP, Griffin SJ, Ahern AL. A systematic review of inequalities in the uptake of, adherence to, and effectiveness of behavioral weight management interventions in adults. Obes Rev 2022; 23:e13438. [PMID: 35243743 PMCID: PMC9285567 DOI: 10.1111/obr.13438] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/12/2022] [Indexed: 12/26/2022]
Abstract
The extent to which behavioral weight management interventions affect health inequalities is uncertain, as is whether trials of these interventions directly consider inequalities. We conducted a systematic review, synthesizing evidence on how different aspects of inequality impact uptake, adherence, and effectiveness in trials of behavioral weight management interventions. We included (cluster-) randomized controlled trials of primary care-applicable behavioral weight management interventions in adults with overweight or obesity published prior to March 2020. Data about trial uptake, intervention adherence, attrition, and weight change by PROGRESS-Plus criteria (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other discriminating factors) were extracted. Data were synthesized narratively and summarized in harvest plots. We identified 91 behavioral weight loss interventions and 12 behavioral weight loss maintenance interventions. Fifty-six of the 103 trials considered inequalities in relation to at least one of intervention or trial uptake (n = 15), intervention adherence (n = 15), trial attrition (n = 32), or weight outcome (n = 34). Most trials found no inequalities gradient. If a gradient was observed for trial uptake, intervention adherence, and trial attrition, those considered "more advantaged" did best. Alternative methods of data synthesis that enable data to be pooled and increase statistical power may enhance understanding of inequalities in behavioral weight management interventions.
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Affiliation(s)
- Jack M. Birch
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | | | - Julia Mueller
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Matthew D. McDonald
- Curtin School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
| | | | - Michael P. Kelly
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Simon J. Griffin
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
- Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Amy L. Ahern
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
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12
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Wang X, Ammerman A, Orr CJ. Family‐based interventions for preventing overweight or obesity among preschoolers from racial/ethnic minority groups: A scoping review. Obes Sci Pract 2022; 8:371-386. [PMID: 35664252 PMCID: PMC9159561 DOI: 10.1002/osp4.578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/10/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022] Open
Abstract
Objective This scoping review aimed to synthesize the published literature on family‐based childhood obesity prevention interventions from 2015 to 2021 that focused on children 2–5 years of age from racial and/or ethnic minority households. Methods A PICOS (population, intervention, comparison, outcome, and setting) framework was used to guide the development of the research question, search strategy, and inclusion/exclusion criteria. To be included, the study must have been a randomized controlled trial or quasi‐experimental trial that enrolled participants 2–5 years of age and their caregivers who identified as being from a racial and/or ethnic minority group in the United States. The study must have also examined a family‐based intervention that incorporated components to prevent childhood obesity (i.e., fruits and vegetable intake, parental responsive feeding, physical activity), be conducted in a remote (i.e., online, text, mail), home, community, primary care setting, or early childhood education institution setting, and report on body mass index (BMI, kg/m2), BMI z‐score, anthropometric measures (weight, waist circumference, fat mass, etc.), changes in health behaviors, or increase in nutritional knowledge. Results Fourteen individual studies were identified. Most interventions used multiple components for promoting nutritional knowledge and behavioral changes among families. Eight interventions included culturally tailored components targeting four aspects: (1) language barriers, (2) food choices, (3) relationships between family members, and (4) rapport building. Conclusions There is limited research in this field focusing on children from racial and/or ethnic minority groups. Future efforts should invest in developing culturally appropriate interventions for these groups.
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Affiliation(s)
- Xiran Wang
- Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill North Carolina USA
| | - Alice Ammerman
- Health Promotion and Disease Prevention University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Colin J. Orr
- Department of Pediatrics University of North Carolina at Chapel Hill School of Medicine Chapel Hill North Carolina USA
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13
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Reicks M, Gold A, Tran N, LeBlanc K. Impacts of A Taste of African Heritage: A Culinary Heritage Cooking Course. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:388-396. [PMID: 35151603 DOI: 10.1016/j.jneb.2021.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To examine changes in cooking and dietary behaviors and health outcomes following participation in A Taste of African Heritage, a culinary heritage cooking course. DESIGN One group, pre-post program design, surveys, and physical assessments. SETTING Community centers, churches, health care settings, homes, and housing complexes. PARTICIPANTS Participants (n = 586, 84% women) were recruited by partner organizations from 2013-2018 across 21 states and the District of Columbia. INTERVENTION(S) A 6-week cooking curriculum that teaches history, nutrition, and cooking techniques to reconnect participants with the vibrant, healthy traditions of the African Diaspora. MAIN OUTCOME MEASURE(S) Weekly frequency of cooking, food group intake, and exercise assessed by surveys, measured weight, waist circumference, and blood pressure. ANALYSIS Linear and logistic mixed-effects models with random intercepts for participant and teacher, sex and site type as covariates comparing pre-post physical measurements and binary behavioral outcomes, P < 0.0033 for statistical significance after Bonferroni correction. RESULTS Intake frequencies of fruit, vegetable, and greens and exercise frequency were improved from preprogram to postprogram (all P < 0.0021). Weight, waist circumference, and systolic blood pressure were also improved from preprogram to postprogram (all P <0.0001). CONCLUSIONS AND IMPLICATIONS Participation in A Taste of African Heritage was associated with positive behavior changes and health outcomes. Integrating cultural heritage and behaviors are positive components to connect participants to healthy old ways or traditions.
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Affiliation(s)
- Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, Department of Food Science and Nutrition, St Paul, MN.
| | - Abby Gold
- Center for Family Development, University of Minnesota Extension, St Paul, MN
| | - Nicole Tran
- Department of Food Science and Nutrition, University of Minnesota, Department of Food Science and Nutrition, St Paul, MN
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Blackman Carr LT, Samuel-Hodge CD, Tate DF. The Multi-Caregiver Role and Its Relationship to Behavioral Adherence and Weight Among Treatment Engaged Black Women. Am J Health Promot 2022; 36:1162-1169. [PMID: 35417263 DOI: 10.1177/08901171221092389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention. DESIGN A secondary analysis of data from a behavioral weight loss intervention. SETTING The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. SUBJECTS Eighty-one Black women with overweight/obesity (age = 48.4 ± 10.9 years [M ± SD], BMI = 36.4 ± 4.5 kg/m2 [M ± SD]). MEASURES Identification with the multiple caregiver role and barriers was assessed with the Multiple Caregiving Measurement Instrument. Weight was measured with a digital scale and height with a stadiometer. The Block food frequency questionnaire evaluated dietary intake. Moderate-to-vigorous physical activity (MVPA) was measured objectively with an accelerometer. Study adherence was measured by session attendance, self-weighing, and self-monitoring (diet and physical activity) frequency. ANALYSIS Generalized linear models were used to examine the relationship between the multiple caregiver scales and the outcomes of interest, controlling for study arm, cohort, and income. Chi-square tests tested correlations. RESULTS Greater identification with the multiple caregiver role was associated with decreased session attendance (β = -.56 [SE = .27], P < .05) and a trend towards weight gain (β = .36, [SE = .19], P = .07). Greater multiple caregiver barriers score predicted a decrease in fruit/vegetable intake (β = -.17 [SE = .07], P < .05). All regression results are unstandardized. Negative correlations between multiple caregiver barriers and MVPA (r = -.24, P = .06) and daily self-weighing (r = -.19, P = .10) approached significance. CONCLUSIONS Participants' identification with multiple caregiving role and barriers can reduce adherence, behavior and weight change. Interventions to address Black women's multiple roles and barriers during weight loss are needed to maximize outcomes.
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Affiliation(s)
| | - Carmen D Samuel-Hodge
- Department of Nutrition, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah F Tate
- Department of Nutrition, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Behavior, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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15
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Harris CL, Goldman BM, Gurkas P, Butler C, Bookman P. Superwoman's kryptonite: The superwoman schema and perceived barriers to weight management among U.S. Black women. J Health Psychol 2022; 27:2887-2897. [PMID: 35086379 DOI: 10.1177/13591053211068974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The role that the superwoman schema (SWS) plays in U.S. Black women's perceptions of barriers (biological, psychological, and sociological) to healthy weight management is unknown. This exploratory study examined whether 122 women classified as normal weight, overweight or obese differed in their perceptions of types of barriers and if the SWS predicted perceived barriers to weight management. Women classified as obese reported more barriers than those classified as normal weight. The SWS uniquely positively predicted perceived psychological and sociological barriers. Our findings suggest that the SWS may play a vital role in the self-management of weight in U.S. Black women.
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Abel SL, Whitehead LC, Tipene-Leach DC, Coppell KJ. Proximal and distal influences on dietary change among a diverse group with prediabetes participating in a pragmatic, primary care nurse-led intervention: a qualitative study. Public Health Nutr 2021; 24:6015-6026. [PMID: 33966689 PMCID: PMC11148607 DOI: 10.1017/s1368980021001968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To understand motivators, facilitators and challenges to dietary change amongst a diverse sample of New Zealanders with prediabetes participating in a primary care nurse-led individualised dietary intervention. DESIGN A qualitative study involving semi-structured, face-to-face interviews with a stratified sample of adults with prediabetes and BMI ≥ 25 kg/m2, purposefully selected from a larger 2-year primary care-based prediabetes dietary intervention study. Thematic analysis was undertaken. A socio-ecological model guided interpretation. SETTING Hawke's Bay, Aotearoa/New Zealand, April 2018-March 2020. PARTICIPANTS Fifty-eight people aged 28-69 years, with similar numbers of men and women, indigenous Māori and non-Māori, and those who had and had not regressed to normoglycaemia at 6 months. RESULTS Motivators for wanting to make dietary changes were determination not to progress to diabetes; wanting to be healthy and contribute to others and encouragement by others. Facilitators for adopting and maintaining changes were a strong desire to be healthy; personal determination and feeling supported. Challenges were compromised control over life and environmental factors; feeling unsupported by others; social occasions; financial constraints and living with other health conditions. Developing their own strategies to overcome challenges was empowering, enabling a sense of control. These factors were similar across demographic and glycaemic outcome groups. CONCLUSIONS Influences on dietary change involved personal, interpersonal, organisational, environmental and policy factors. Although findings appeared similar across groups, dietary interventions need to address the specific ways motivators, facilitators and challenges manifest for individuals and social groups and be tailored accordingly within the context of the wider obesogenic and socio-economic environment.
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Affiliation(s)
- Sally L Abel
- Kaupapa Consulting Ltd, Napier, Aotearoa/New Zealand
| | - Lisa C Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - David C Tipene-Leach
- Eastern Institute of Technology, Taradale, Napier, Hawke's Bay, Aotearoa/New Zealand
| | - Kirsten J Coppell
- Department of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin9054, Aotearoa/New Zealand
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Dixson DD, Gentzis EA. To Hope and Belong in Adolescence: A Potential Pathway to Increased Academic Engagement for African American Males. SCHOOL PSYCHOLOGY REVIEW 2021. [DOI: 10.1080/2372966x.2021.1985927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Ostendorf DM, Blankenship JM, Grau L, Arbet J, Mitchell NS, Creasy SA, Caldwell AE, Melanson EL, Phelan S, Bessesen DH, Catenacci VA. Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis. Obes Sci Pract 2021; 7:569-582. [PMID: 34631135 PMCID: PMC8488452 DOI: 10.1002/osp4.530] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Substantial interindividual variability in response to behavioral weight loss interventions remains a critical challenge in obesity treatment. An improved understanding of the complex factors that contribute to this variability may improve obesity treatment outcomes. OBJECTIVE To identify weight change trajectories during a behavioral weight loss intervention and to explore differences between trajectory groups in sociodemographic, biologic, behavioral, and psychosocial factors. METHODS Adults (n = 170, 40 ± 9 years, BMI 34 ± 4 kg/m2, 84% female) participated in an 18-month behavioral weight loss intervention. Weight was measured at 0, 3, 6, 9, 12, 15, 18, and 24 months. Among participants with at least two weights after baseline (n = 140), clusters of longitudinal trajectories of changes in weight were identified using a latent class growth mixture model. The association between baseline factors or changes in factors over time and trajectory group was examined. RESULTS Two weight change trajectories were identified: "weight regainers" (n = 91) and "weight loss maintainers" (n = 49). Black participants (90%, 19/21) were more likely than non-Black participants to be regainers versus maintainers (p < 0.01). Maintainers demonstrated greater increases in device-measured physical activity, autonomous motivation for exercise, diet self-efficacy, cognitive restraint, and engagement in weight management behaviors and greater reductions in barriers for exercise, disinhibition, and depressive symptoms over 24 months versus regainers (p < 0.05). CONCLUSION Maintainers and regainers appear to be distinct trajectories that are associated with specific sociodemographic, behavioral, and psychosocial factors. Study results suggest potential targets for more tailored, multifaceted interventions to improve obesity treatment outcomes.
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Affiliation(s)
- Danielle M. Ostendorf
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Jennifer M. Blankenship
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Laura Grau
- Department of Biostatistics and InformaticsColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Jaron Arbet
- Department of Biostatistics and InformaticsColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Nia S. Mitchell
- Department of MedicineDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Seth A. Creasy
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Ann E. Caldwell
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Edward L. Melanson
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Geriatric MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Eastern Colorado Veterans Affairs Geriatric Research, Education, and Clinical CenterDenverColoradoUSA
| | - Suzanne Phelan
- Department of Kinesiology & Public HealthCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Daniel H. Bessesen
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Victoria A. Catenacci
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of MedicineDivision of Endocrinology, Metabolism, and DiabetesUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
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Daubenmier J, Chao MT, Hartogensis W, Liu R, Moran PJ, Acree MC, Kristeller J, Epel ES, Hecht FM. Exploratory Analysis of Racial/Ethnic and Educational Differences in a Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention. Psychosom Med 2021; 83:503-514. [PMID: 33214537 DOI: 10.1097/psy.0000000000000859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE People of color and lower socioeconomic groups have higher obesity prevalence, lose less weight compared with Whites and higher socioeconomic groups, and are underrepresented in randomized controlled trials of mindfulness-based interventions. We examined whether mindfulness approaches reduce disparities in weight loss interventions. METHODS We analyzed data from a randomized controlled trial of 194 participants with obesity (41% participants of color, 36% without college degree) comparing a 5.5-month mindfulness-based weight loss intervention to an active-control with identical diet-exercise guidelines. We assessed attendance, 18-month attrition, and weight change at 6, 12, and 18 months by race/ethnicity and education level using linear mixed models, adjusting for baseline body mass index, age, and education or race/ethnicity, respectively. RESULTS Participants without versus with a college degree attended fewer sessions and had higher attrition across interventions. Participants of color attended fewer intervention sessions in the mindfulness compared with the control intervention. Overall, participants of color lost significantly less weight at 12 and 18 months compared with Whites. However, during the 6- to 18-month maintenance period, we found an interaction of intervention arm, race/ethnicity, and time (p = .035), indicating that participants of color compared with Whites regained more weight in the control (0.33 kg/mo; p = .005) but not mindfulness intervention (0.06 kg/mo; p = .62). Participants without a college degree had greater initial weight loss in the mindfulness compared to control intervention from 0 to 6 months (-0.46 kg/mo; p = .039). CONCLUSIONS Although disparities persist, mindfulness approaches may mitigate some racial/ethnic and socioeconomic differences in weight loss compared with conventional diet-exercise programs.Trial Registration: Clinicaltrials.gov registration: NCT00960414.
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Affiliation(s)
- Jennifer Daubenmier
- From the Institute of Holistic Health Studies (Daubenmier), San Francisco State University; Osher Center for Integrative Medicine (Chao, Hartogensis, Liu, Moran, Acree, Hecht), University of California, San Francisco, San Francisco, California; Department of Psychology (Kristeller), Indiana State University, Terre Haute, Indiana; and Department of Psychiatry (Epel), University of California, San Francisco, San Francisco, California
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20
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Alsukait RF, Folta SC, Chui K, Seguin RA, Sinclair CG, Hudson LB. Healthy Hearts for an Abundant Life: Feasibility of a Culturally Adapted Cardiovascular Disease Prevention Curriculum for African American Women. Health Equity 2021; 5:398-407. [PMID: 34235364 PMCID: PMC8237101 DOI: 10.1089/heq.2021.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This study tested the feasibility of implementing Healthy Hearts for an Abundant Life (HHAL), a cultural adaptation for African American (AA) women of the evidence-based cardiovascular disease prevention program Strong Women-Healthy Hearts (SWHH). Methods: Using a quasi-experimental pre-post study design, this 12-week program was implemented in four faith-based organizations between 2017 and 2018. Eligible participants were AA women between 40 and 65 years who had a body mass index of 25 or higher and were currently sedentary. HHAL program participants met weekly for 2-h sessions led by program leaders. The curriculum has four modules: total health; relationships, family, and networks; material security and the environment; and emotional wellness. Each class included walking for 30 min, goal-setting session, and a group dialog called "making it work" for building collective efficacy. Results: Of the 27 participants (mean age=54.2±5.9), 24 completed postassessments (93% retention rate). All outcome measures proved feasible and weekly program attendance was 73%. Findings from in-depth interviews show high satisfaction with the program and suggest extending the class time and adding cooking demonstrations. Conclusions: The culturally adapted HHAL proved feasible and was positively received by the participants. Future studies will evaluate the effectiveness of the program.
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Affiliation(s)
- Reem F. Alsukait
- Community Health Department, King Saud University, Riyadh, Saudi Arabia
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Kenneth Chui
- Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Rebecca A. Seguin
- College of Agriculture and Life Sciences, Texas A&M University, College Station, Texas, USA
| | - Christine G. Sinclair
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Linda B. Hudson
- Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
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21
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Amoah S, Ennin R, Sagoe K, Steinbrecher A, Pischon T, Mockenhaupt FP, Danquah I. Feasibility of a Culturally Adapted Dietary Weight-Loss Intervention among Ghanaian Migrants in Berlin, Germany: The ADAPT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020510. [PMID: 33435519 PMCID: PMC7827981 DOI: 10.3390/ijerph18020510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 12/05/2022]
Abstract
Background: Dietary weight-loss interventions often fail among migrant populations. We investigated the practicability and acceptability of a culturally adapted dietary weight-loss intervention among Ghanaian migrants in Berlin. Methods: The national guidelines for the treatment of adiposity were adapted to the cultural characteristics of the target population, aiming at weight-loss of ≥2.5 kg in 3 months using food-based dietary recommendations. We invited 93 individuals of Ghanaian descent with overweight or obesity to participate in a 12-weeks intervention. The culturally adapted intervention included a Ghanaian dietician and research team, one session of dietary counselling, three home-based cooking sessions with focus on traditional Ghanaian foods, weekly smart-phone reminders, and monthly monitoring of diet and physical activity. We applied a 7-domains acceptability questionnaire and determined changes in anthropometric measures during clinic-based examinations at baseline and after the intervention. Results: Of the 93 invitees, five participants and four family volunteers completed the study. Reasons for non-participation were changed residence (13%), lack of time to attend examinations (10%), and no interest (9%); 64% did not want to give any reason. The intervention was highly accepted among the participants (mean range: 5.3–6.0 of a 6-points Likert scale). Over the 12 weeks, median weight-loss reached −0.6 kg (range: +0.5, −3.6 kg); the diet was rich in meats but low in convenience foods. The median contribution of fat to daily energy intake was 24% (range: 16–40%). Conclusions: Acceptance of our invitation to the intervention was poor but, once initiated, compliance was good. Assessment centers in the participants’ vicinity and early stakeholder involvement might facilitate improved acceptance of the invitation. A randomized controlled trial is required to determine the actual effects of the intervention.
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Affiliation(s)
- Stephen Amoah
- Institute for Social Medicine, Epidemiology and Health Economics, Charité–Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany;
- Correspondence:
| | - Ruth Ennin
- Institute of Tropical Medicine and International Health, Charité–Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (R.E.); (K.S.); (F.P.M.)
| | - Karen Sagoe
- Institute of Tropical Medicine and International Health, Charité–Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (R.E.); (K.S.); (F.P.M.)
| | - Astrid Steinbrecher
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany; (A.S.); (T.P.)
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), 13125 Berlin, Germany; (A.S.); (T.P.)
- Charité–Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany
| | - Frank P. Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité–Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (R.E.); (K.S.); (F.P.M.)
| | - Ina Danquah
- Institute for Social Medicine, Epidemiology and Health Economics, Charité–Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany;
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany
- Heidelberg Institute of Global Health, University Heidelberg, 69120 Heidelberg, Germany
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22
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Burse NR, Bhuiyan N, Mama SK, Schmitz KH. Physical activity barriers and resources among black women with a history of breast and endometrial cancer: a systematic review. J Cancer Surviv 2020; 14:556-577. [PMID: 32240461 PMCID: PMC8258672 DOI: 10.1007/s11764-020-00873-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 03/04/2020] [Indexed: 12/31/2022]
Abstract
Physical inactivity is a significant public health problem among black women. However, there is limited evidence regarding barriers to physical activity and the availability of opportunities to engage in physical activity, specifically for posttreatment black women with a history of cancer. PURPOSE The purpose of this paper was to systematically review, summarize, and synthesize findings on physical activity-related research including barriers, facilitators, and resources for physical activity among posttreatment black women with a history of breast and endometrial cancer. METHODS We developed a comprehensive search strategy and conducted searches in the following databases: PsycINFO, Web of Science, Cochrane, PubMed, and Sociological Abstracts. Summary measures were described qualitatively (e.g., themes) and quantitatively (e.g., frequencies). RESULTS This review identified 35 eligible articles describing 12 intervention and 23 observational studies. We described intervention preferences (e.g., resistance activities), beliefs about physical activity, and benefits of physical activity for quality of life (e.g., improvements in social wellbeing) in black cancer survivors. In addition, very few studies identified barriers to physical activity (n = 7) and focused on increasing physical activity (n = 12) among black women with a history of cancer. The most common reported barriers among the target population were fatigue, lack of social support, weather, illness/health issues, cost, time constraints, living too far away, and inability/unwillingness to obtain physician clearance, whereas the most common facilitators were faith, other health concerns, and social support. CONCLUSIONS/IMPLICATIONS Future studies should target barriers, facilitators, and culturally adapted strategies for physical activity at all levels of influence to develop multi-level interventions to engage and improve physical activity among black women with a history of breast and endometrial cancer. PROTOCOL REGISTRATION NUMBER CRD42018110008.
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Affiliation(s)
- Natasha R Burse
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Nishat Bhuiyan
- Department of Kinesiology, The Pennsylvania State University, University Park, State College, PA, USA
| | - Scherezade K Mama
- Department of Kinesiology, The Pennsylvania State University, University Park, State College, PA, USA
| | - Kathryn H Schmitz
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
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Kwarteng JL, Beyer KMM, Banerjee A, Stolley MR. Facilitators of behavior change and weight loss in an intervention for African American Breast Cancer Survivors. Cancer Causes Control 2020; 31:737-747. [PMID: 32415529 PMCID: PMC11196002 DOI: 10.1007/s10552-020-01315-y] [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: 08/21/2019] [Accepted: 05/05/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to examine facilitators of behavior change and weight loss among African-American women who participated in the Moving Forward Efficacy trial. METHODS Linear mixed models were used to examine the role of self-efficacy, social support, and perceived access to healthy eating, exercise, and neighborhood safety on weight, physical activity, and diet. We also examined the mediation of self-efficacy, social support, and perceived access to healthy eating, exercise, and neighborhood safety on weight loss, physical activity, and diet using the Freedman Schatzkin statistic. RESULTS We found no evidence to suggest mediation, but some direct associations of self-efficacy, certain types of social support and perceived access to exercise on weight loss, and behavior change. CONCLUSION We determined that self-efficacy, social support, and perceived access to exercise played a role in weight loss, increased MVPA, and better diet. The role of self-efficacy and perceived access to exercise were more consistent than social support.
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Affiliation(s)
- J L Kwarteng
- Division of Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - K M M Beyer
- Division of Epidemiology, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Banerjee
- Division of Biostatistics, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M R Stolley
- Division of Hematology and Oncology, Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Hampton-Anderson JN, Craighead LW. Psychosociocultural Contributors to Maladaptive Eating Behaviors in African American Youth: Recommendations and Future Directions. Am J Lifestyle Med 2020; 15:621-633. [PMID: 34916883 DOI: 10.1177/1559827620936951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/29/2020] [Accepted: 06/04/2020] [Indexed: 12/15/2022] Open
Abstract
Childhood overweight and obesity disproportionately affects African Americans, and these children benefit less from standard pediatric weight management treatment programs compared to other racial/ethnic groups. Maladaptive eating behavior has been identified as a behavioral contributor to obesity and is also associated with the development of nonrestrictive eating disorders over time. Unique psychosociocultural factors have been identified that may promote higher risk for maladaptive eating behaviors in African American children beyond the effects of economic disparity. To best treat this group, it is important for practitioners to have a thorough understanding of these factors. We review several of these considerations and describe ways they may interact to contribute to the subsequent development of maladaptive eating behaviors and increased weight. Recommendations are made regarding how attention to these factors could be incorporated into current pediatric weight management treatments to better serve this population via a patient-centered care approach. Future directions will also be discussed.
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Affiliation(s)
- Joya N Hampton-Anderson
- Department of Psychiatry and Behavioral Sciences (JNHA), Emory University, Atlanta, Georgia.,Psychology Department (LWC), Emory University, Atlanta, Georgia
| | - Linda W Craighead
- Department of Psychiatry and Behavioral Sciences (JNHA), Emory University, Atlanta, Georgia.,Psychology Department (LWC), Emory University, Atlanta, Georgia
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Pickett S, Burchenal CA, Haber L, Batten K, Phillips E. Understanding and effectively addressing disparities in obesity: A systematic review of the psychological determinants of emotional eating behaviours among Black women. Obes Rev 2020; 21:e13010. [PMID: 32067355 DOI: 10.1111/obr.13010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/21/2019] [Accepted: 01/17/2020] [Indexed: 11/28/2022]
Abstract
Emotional eating may be a particularly important contributor to differences in body weight and weight loss response to behavioural interventions among non-Hispanic Black women. We performed a systematic review on the impact of psychological factors (stress, anxiety, depression, and discrimination) upon emotional eating and weight among non-Hispanic Black women, applying the Preferred Reporting Items for Systematic Reviews and Meta-analysis for relevant studies. The initial search yielded 4593 articles with 15 accepted for review. Based on this review, there is a suggestion that negative emotions, in particular, perceived stress, may be predictive of emotional eating among non-Hispanic Black women. Results from the only two longitudinal studies identified by the review indicate that stress influences emotional eating, and emotional eating predicts weight gain over time. Findings from this review highlight the need for more studies that examine various negative emotions that may lead to emotional eating and weight gain among non-Hispanic Black women. Findings from this review also highlight the need for more rigorous studies to differentiate the effects of emotional eating from that of the physiologic (ie, activation of the hypothalamic-pituitary axis) responses to stress and its impact on high-risk groups.
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Affiliation(s)
- Stephanie Pickett
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Clare A Burchenal
- School of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Leora Haber
- School of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Kendra Batten
- School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY, USA
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Huang YC, Garcia AA. Culturally-tailored interventions for chronic disease self-management among Chinese Americans: a systematic review. ETHNICITY & HEALTH 2020; 25:465-484. [PMID: 29385815 DOI: 10.1080/13557858.2018.1432752] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/21/2017] [Indexed: 06/07/2023]
Abstract
Objectives: Literature review evaluating the effectiveness and cultural surface and deep structures of interventions designed to improve Chinese Americans' chronic disease self-management.Method: PubMed, PsycINFO, CINAHL, and Health Source databases were searched for research conducted from 1990 to 2016 on self-management interventions for Chinese Americans with chronic disease.Results: Ten articles comprised eight interventions, which each addressed a dimension of cultural surface structure, all providing linguistically appropriate messages delivered via bilingual staff. Five interventions also addressed cultural deep structure dimensions by providing culturally congruent counsellors or educators, or incorporating Chinese cultural values and social customs. Six interventions resulted in significant improvements in major outcome variables. Participants also reported high satisfaction and retention rates were high.Conclusion: Culturally-tailored interventions that incorporate surface and deep structural elements of culture are sensitive and generally effective for Chinese Americans to improve access to health care, disease awareness, social environment, and participants' ability to practice self-management skills.
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Affiliation(s)
- Ya-Ching Huang
- The School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Alexandra A Garcia
- Dell Medical School, The School of Nursing, The University of Texas at Austin, Austin, TX, USA
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Hu YL, Junge K, Nguyen A, Hiegel K, Somerville E, Keglovits M, Stark S. Evidence to Improve Physical Activity among Medically Underserved Older adults: A Scoping Review. THE GERONTOLOGIST 2020; 59:e279-e293. [PMID: 29668895 DOI: 10.1093/geront/gny030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Participation in leisure physical activity (PA) and engagement in PA interventions among older adults is influenced by socioeconomic status (SES), race/ethnicity, and environment. However, studies of PA for medically underserved older adults have not yet been systematically evaluated. The objective of this study is to map the nature and extent of research conducted on PA participation, interventions, and components of effective leisure PA programs for medically underserved older adults. RESEARCH DESIGN AND METHODS The five-stage approach was used to conduct this scoping review. We searched PubMed, CINAHL, and Cochrane Library for peer-reviewed studies published between 2006 and 2016. Data extracted from selected studies included study population, study type, purpose of intent, evidence level, barriers to PA participation, and components of PA intervention. RESULTS Three hundred and ninety-two articles were identified, and 60 studies were included in the final data charting. Existing literature showed that most studies remained descriptive in nature, and few intervention studies have achieved a high level of evidence. Among 21 intervention studies, only 4 were explicitly conducted for older adults. Culturally adapted materials, race/ethnicity-specific barriers and facilitators, and form of intervention were important components for intervention programs. DISCUSSION AND IMPLICATIONS Findings indicate that more studies are needed to reduce health disparities related to PA participation for medically underserved older adults. Intervention components such as race/ethnicity-relevant barriers and facilitators and culturally sensitive materials are also needed for PA interventions targeting underserved older adults in order to provide evidence for best practices.
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Affiliation(s)
- Yi-Ling Hu
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kristin Junge
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - An Nguyen
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kelsey Hiegel
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Emily Somerville
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Marian Keglovits
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Susan Stark
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
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Blackman Carr LT, Samuel-Hodge CD, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Comparative effectiveness of a standard behavioral and physical activity enhanced behavioral weight loss intervention in Black women. Women Health 2019; 60:676-691. [PMID: 31814531 DOI: 10.1080/03630242.2019.1700585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m2. Standard and enhanced groups' weight change (-2.83 kg and -2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.
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Affiliation(s)
- Loneke T Blackman Carr
- Department of Nutritional Sciences, University of Connecticut , Storrs, Connecticut, USA.,Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Carmen D Samuel-Hodge
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Dianne S Ward
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Kelly R Evenson
- Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University , Hamilton, Ontario, Canada
| | - Deborah F Tate
- Department of Health Behavior, Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA
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Kumanyika S. Overcoming Inequities in Obesity: What Don't We Know That We Need to Know? HEALTH EDUCATION & BEHAVIOR 2019; 46:721-727. [PMID: 31375036 DOI: 10.1177/1090198119867319] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Efforts to combat the U.S. obesity epidemic have been ongoing in earnest for nearly two decades, informed by a substantial body of knowledge and guided by numerous programmatic and policy recommendations. Yet, although there are some bright spots, I sense frustration in the public health community with the overall lack of clear progress in lowering high obesity prevalence. The fact that something is missing from current approaches is undeniable and must be a continued source of inquiry. This commentary focuses attention on an aspect that is especially concerning-inequities that predispose to a notably higher obesity prevalence in U.S. racial/ethnic minority populations compared with non-Hispanic Whites. Critical analyses of what we are doing now can point the way to improvements in both individually oriented and policy, systems, and environmental change strategies to overcome the epidemic. Success will require working with communities to co-design relevant and realistic interventions as well as broader social changes that address underlying causes.
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Turk MT, Kalarchian MA, Nolfi DA, Fapohunda A. Prevention and Treatment of Overweight and Obesity Among African Immigrant Populations: A Systematic Review of the Literature. ANNUAL REVIEW OF NURSING RESEARCH 2018; 37:161-186. [PMID: 30692156 DOI: 10.1891/0739-6686.37.1.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Bender MS, Cooper BA, Flowers E, Ma R, Arai S. Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial. Contemp Clin Trials Commun 2018; 12:76-84. [PMID: 30294699 PMCID: PMC6170935 DOI: 10.1016/j.conctc.2018.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/29/2018] [Accepted: 09/18/2018] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Filipino Americans are at higher risk for obesity and related Type 2 diabetes (T2D) compared to other Asian subgroups and non-Hispanic whites. Yet, there are limited research studies to reduce health disparities and improve health outcomes for Filipinos. Weight loss lifestyle intervention trials such as the Diabetes Prevention Program (DPP) can reduce obesity and T2D risks through physical activity and healthy eating. METHODS Thus, we conducted a pilot Fit&Trim (DPP-based) intervention study - a randomized controlled trial 3-month intervention augmented with mobile technology + 3-month maintenance follow-up with a waitlist control. The objective assessed the intervention feasibility and potential efficacy to reduce T2D risks in Filipino Americans with overweight/obesity. The overall study goal was a mean 5% weight reduction. RESULTS Sixty-seven eligible Filipino men and women were enrolled and randomized to either an intervention or waitlist control group. Participant retention was 91%. In Phase 1 (baseline to 3-months), the intervention group had greater weight reduction compared to the waitlist control (-4.3% vs. -0.88%; cross-level interaction = -0.85 (-1.4, -0.35). In Phase 2 (3- to 6-months), after receiving the Fit&Trim intervention, the waitlist group also had similar significant weight reduction [-4.8% (- 0.75 (-0.92, -0.58)]. A majority of intervention group (57%) also maintained their weight loss. Overall, 41% of study participants achieved a 5% weight loss. CONCLUSION The Fit&Trim intervention demonstrated feasibility and potential efficacy for Filipino Americans. Findings warrant a further larger, longer trial to test the Fit&Trim feasibility and effectiveness in a real-world Filipino community setting. CLINICALTRIALSGOV REGISTRATION NUMBER NCT02278939.
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Key Words
- A1C, Glycated Hemoglobin
- Asian americans
- Asians, Asian Americans
- CDC, Center for Disease Control and Prevention
- COPD, chronic obstructive pulmonary disease
- CVD, cardiovascular disease
- Culturally adapted
- DPP, Diabetes Prevention Program
- Filipinos
- Filipinos, Filipino Americans
- Fit&Trim, a culturally tailored DPP-based mobile Health lifestyle intervention for Filipinos
- Healthy nutrition
- Lifestyle intervention
- Mobile technology
- OGTT, oral glucose tolerance test
- PA, physical activity
- Physical activity
- RCT, randomized controlled trial
- Randomized trial
- SBV, screening baseline visit
- SF, San Francisco
- SPSS, Statistical Package for Social Sciences
- T2D, Type 2 Diabetes
- Weight loss
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Affiliation(s)
- Melinda S. Bender
- Family Health Care Nursing Department, University of California San Francisco, School of Nursing, United States
| | - Bruce A. Cooper
- Office of Research & Department of Community Health System, University of California San Francisco, School of Nursing, United States
| | - Elena Flowers
- Department of Physiologic Nursing, University of California San Francisco, School of Nursing, United States
- Institute for Human Genetics, University of California San Francisco, School of Nursing, United States
| | - Raymond Ma
- Institute for Health and Aging, Univeresity of California San Francisco, School of Nursing, United States
| | - Shoshana Arai
- Family Health Care Nursing Department, University of California San Francisco, School of Nursing, United States
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Wilfley DE, Hayes JF, Balantekin KN, Van Buren DJ, Epstein LH. Behavioral interventions for obesity in children and adults: Evidence base, novel approaches, and translation into practice. AMERICAN PSYCHOLOGIST 2018; 73:981-993. [PMID: 30394777 PMCID: PMC6220709 DOI: 10.1037/amp0000293] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Obesity in adults has nearly doubled in the past 30 years and has risen similarly in children and adolescents. Obesity affects all systems of the body, and the serious health consequences of obesity include an increased risk for cardiovascular disease, such as Type 2 diabetes or high blood pressure, which are occurring at ever younger ages. The present article introduces traditional behavioral weight loss strategies designed to change energy-balance behaviors (i.e., dietary and physical activity behaviors) and the contexts within which these interventions have typically been delivered. The applicability of findings from behavioral economics, cognitive processing, and clinical research that may lead to more potent weight loss and weight loss maintenance interventions are also considered. Given the pervasiveness of obesity, this article concludes with a discussion of efforts toward wider scale dissemination and implementation of behavioral treatments designed to address obesity and to reduce the risk of cardiovascular disease. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine
| | - Jacqueline F Hayes
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | | | | | - Leonard H Epstein
- Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo
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A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091859. [PMID: 30154333 PMCID: PMC6165382 DOI: 10.3390/ijerph15091859] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 07/30/2018] [Accepted: 08/23/2018] [Indexed: 11/17/2022]
Abstract
In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in the PCORI Addressing Disparities portfolio to examine cultural tailoring strategies across the following priority populations: racial and ethnic minorities, rural populations, people with low-income or low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities. The Common Strategies for Enhancing Cultural Appropriateness model was used to examine cultural tailoring strategies within trials. We hypothesized increased intersectionality within a patient population at risk for disparities would correlate with the dosage and type of cultural tailoring strategies applied. Thirty-three behavioral health trials applied cultural tailoring strategies and a majority of trials (n = 30) used three or more strategies. Trends in cultural tailoring were associated with certain racial and ethnic groups; however, increased use of tailoring was not associated with the number of priority populations included in a trial. The PCORI Addressing Disparities portfolio demonstrates how a range of cultural tailoring strategies are used, within comparative clinical effectiveness research trials, to address the needs and intersectionality of patients to reduce health and healthcare disparities.
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Cameron NO, Muldrow AF, Stefani W. The Weight of Things: Understanding African American Women's Perceptions of Health, Body Image, and Attractiveness. QUALITATIVE HEALTH RESEARCH 2018; 28:1242-1254. [PMID: 29357750 DOI: 10.1177/1049732317753588] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Negative attitudes toward being overweight or obese are widespread, and these notions perpetuate into conceptions about one's health. Clinically, being overweight is associated with health problems such as diabetes, hypertension, heart disease, and many other illnesses. African American women, who are generally larger in body size, are a particular target for health interventions. However, these women have resisted the "obesity" label, arguing that dominant measures of health are White norms and oppressive. Through the use of in-depth interviews, this study investigates how African American women understand and experience healthfulness, body image, and barriers to each. Findings show that African American women are ambivalent in their acceptance of dominant markers of health and expressed an almost universal disdain for the thin ideal as a marker of "good" health and a positive body image. Moreover, participants articulated a suspicion of formal medical measurements of obesity.
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Garbers S, Hunersen K, Nechitilo M, Fisch M, Bell DL, Byrne MW, Gold MA. Healthy Weight and Cardiovascular Health Promotion Interventions for Adolescent and Young Adult Males of Color: A Systematic Review. Am J Mens Health 2018; 12:1328-1351. [PMID: 29808765 PMCID: PMC6142141 DOI: 10.1177/1557988318777923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease is the leading cause of mortality in the United States, accounting for one fourth of deaths. Higher rates of obesity put Hispanic and Black men at increased risk. The American Heart Association cites diet quality, physical activity, and body weight as alterations responsive to health promotion intervention. Prevention strategies need to begin in adolescence and the emerging adulthood years to impact cumulative risk factors. A scoping review identified search terms and this was followed by a systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases for articles published in English from January 1, 2002, through May 11, 2017. This review explores community-based content, delivery, recruitment, or retention strategies used with young men of color aged 15 to 24 years. Of 17 articles describing 16 individual interventions and 1 describing multiple interventions (with samples ranging from 37 to 4,800), 13 reported significant results in one or more domains. No studies specifically targeted the needs of young men and only three had more than 50% male participants. There was a gap in studies that addressed young men in the ages of interest with most interventions reaching participants aged 11 to 19 years. Cultural tailoring was addressed through recruitment setting, interventionist characteristics, community involvement, and theoretical frameworks such as motivational interviewing that allow individual goal setting. Because young men seek access to preventive health services less than young women, it is suggested that interventions that are community based or use push technology (send information directly to the user) be increased.
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Affiliation(s)
- Samantha Garbers
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kara Hunersen
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Marylynn Fisch
- 2 Columbia University College of Physicians and Surgeons, New York, USA
| | - David L Bell
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
| | | | - Melanie A Gold
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
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Haughton CF, Silfee VJ, Wang ML, Lopez-Cepero AC, Estabrook DP, Frisard C, Rosal MC, Pagoto SL, Lemon SC. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review. Prev Med Rep 2018; 9:131-137. [PMID: 29616185 PMCID: PMC5880332 DOI: 10.1016/j.pmedr.2018.01.012] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 12/21/2022] Open
Abstract
Obesity remains a persistent public health and health disparity concern in the United States. Eliminating health disparities, particularly among racial/ethnic minority groups, is a major health priority in the US. The primary aim of this review was to evaluate representation of racial/ethnic sub-group members in behavioral weight loss interventions conducted among adults in the United States. The secondary aims were to assess recruitment and study design approaches to include racial/ethnic groups and the extent of racial/ethnic sub-group analyses conducted in these studies. PubMed, PsycInfo, Medline, and CINAHL were searched for behavioral weight loss intervention trials conducted in 2009–2015 using keywords: weight, loss, overweight, obese, intervention and trial. Most of the 94 studies included a majority of White participants compared to any other racial/ethnic group. Across the included studies, 58.9% of participants were White, 18.2% were African American, 8.7% were Hispanic/Latino, 5.0% were Asian and 1.0% were Native Americans. An additional 8.2% were categorized as “Other”. Nine of the 94 studies exclusively included minority samples. Lack of adequate representation of racial and ethnic minority populations in behavioral trials limits the generalizability and potential public health impact of these interventions to groups that might most benefit from weight loss. Given racial/ethnic disparities in obesity rates and the burden of obesity and obesity-related diseases among minority groups in the United States, greater inclusion in weight loss intervention studies is warranted. Describes racial/ethnic minority inclusion in behavioral weight loss studies Majority of studies continue to include a majority white sample. Modest increases in the representation of some racial/ethnic minority groups. Lack of adequate representation of minority groups limits generalizability. Greater racial/ethnic inclusion in weight loss intervention studies is warranted.
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Affiliation(s)
| | | | - Monica L. Wang
- Boston University School of Public Health, Boston, MA, USA
| | | | | | | | | | - Sherry L. Pagoto
- University of Massachusetts Medical School, Worcester, MA, USA
- University of Connecticut, Storrs, CT, USA
| | - Stephenie C. Lemon
- University of Massachusetts Medical School, Worcester, MA, USA
- Corresponding author at: UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.UMass Worcester Prevention Research CenterDivision of Preventive and Behavioral MedicineUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcesterMA01655USA
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Carnethon MR, Pu J, Howard G, Albert MA, Anderson CAM, Bertoni AG, Mujahid MS, Palaniappan L, Taylor HA, Willis M, Yancy CW. Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association. Circulation 2017; 136:e393-e423. [PMID: 29061565 DOI: 10.1161/cir.0000000000000534] [Citation(s) in RCA: 691] [Impact Index Per Article: 98.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. METHOD The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. RESULTS The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. CONCLUSIONS The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines.
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Stolley M, Sheean P, Gerber B, Arroyo C, Schiffer L, Banerjee A, Visotcky A, Fantuzzi G, Strahan D, Matthews L, Dakers R, Carridine-Andrews C, Seligman K, Springfield S, Odoms-Young A, Hong S, Hoskins K, Kaklamani V, Sharp L. Efficacy of a Weight Loss Intervention for African American Breast Cancer Survivors. J Clin Oncol 2017; 35:2820-2828. [PMID: 28628363 PMCID: PMC5562172 DOI: 10.1200/jco.2016.71.9856] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior. Patients and Methods Early-stage (I-III) AABCS were randomly assigned to a 6-month interventionist-guided (n = 125) or self-guided (n = 121) weight loss program supporting behavioral changes to promote a 5% weight loss. Anthropometric, body composition, and behavioral data were collected at baseline, postintervention (6 months), and follow-up (12 months). Descriptive statistics and mixed models analyses assessed differences between groups over time. Results Mean (± standard deviation) age, and body mass index were 57.5 (± 10.1) years and 36.1 (± 6.2) kg/m2, respectively, and 82% had stage I or II breast cancer. Both groups lost weight. Mean and percentage of weight loss were greater in the guided versus self-guided group (at 6 months: 3.5 kg v 1.3kg; P < .001; 3.6% v 1.4%; P < .001, respectively; at 12 months: 2.7 kg v 1.6 kg; P < .05; 2.6% v 1.6%; P < .05, respectively); 44% in the guided group and 19% in the self-guided group met the 5% goal. Body composition and behavioral changes were also greater in the interventionist-guided group at both time points. Conclusion The study supports the efficacy of a community-based interventionist-guided weight loss program targeting AABCS. Although mean weight loss did not reach the targeted 5%, the mean loss of > 3% at 6 months is associated with improved health outcomes. Affordable, accessible health promotion programs represent a critical resource for AABCS.
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Affiliation(s)
- Melinda Stolley
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Patricia Sheean
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Ben Gerber
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Claudia Arroyo
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Linda Schiffer
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Anjishnu Banerjee
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Alexis Visotcky
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Giamila Fantuzzi
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Desmona Strahan
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Lauren Matthews
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Roxanne Dakers
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Cynthia Carridine-Andrews
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Katya Seligman
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Sparkle Springfield
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Angela Odoms-Young
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Susan Hong
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Kent Hoskins
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Virginia Kaklamani
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
| | - Lisa Sharp
- Melinda Stolley, Anjishnu Banerjee, Alexis Visotcky, Lauren Matthews, Medical College of Wisconsin, Milwaukee WI; Patricia Sheean, Loyola University Chicago, Maywood; Ben Gerber, Claudia Arroyo, Linda Schiffer, Giamila Fantuzzi, Desmona Strahan, Roxanne Dakers, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Kent Hoskins, and Lisa Sharp, University of Illinois at Chicago; Cynthia Carridine-Andrews, Chicago Park District; Susan Hong, University of Chicago, Chicago IL; and Virginia Kaklamani, University of San Antonio, San Antonio TX
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Kitzman H, Dodgen L, Mamun A, Slater JL, King G, Slater D, King A, Mandapati S, DeHaven M. Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial. Contemp Clin Trials 2017; 62:77-90. [PMID: 28807739 DOI: 10.1016/j.cct.2017.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 01/02/2023]
Abstract
Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the diabetes prevention program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (Mage=48.8±11.2; MBMI=36.7±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design will be used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study will provide essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease.
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Affiliation(s)
- Heather Kitzman
- Baylor Scott & White Health and Wellness Center, Baylor Scott & White Health, 4500 Spring Ave, Dallas, TX 75210, United States.
| | - Leilani Dodgen
- School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - Abdullah Mamun
- School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - J Lee Slater
- Better Me Within Community Advisory Board, New Millennium Bible Fellowship Praise Center, 9026 Elam Rd, Dallas, TX 75217, United States
| | - George King
- Better Me Within Community Advisory Board, Cities of Refuge Church, 4801 Dolphin Rd, Dallas, TX 75223, United States
| | - Donna Slater
- Better Me Within Community Advisory Board, New Millennium Bible Fellowship Praise Center, 9026 Elam Rd, Dallas, TX 75217, United States
| | - Alene King
- Better Me Within Community Advisory Board, Cities of Refuge Church, 4801 Dolphin Rd, Dallas, TX 75223, United States
| | - Surendra Mandapati
- School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - Mark DeHaven
- Department of Public Health Science, University of North Carolina, 9201 University City Blvd, Charlotte, NC 28223, United States
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40
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Lutes LD, Cummings DM, Littlewood K, Dinatale E, Hambidge B. A Community Health Worker-Delivered Intervention in African American Women with Type 2 Diabetes: A 12-Month Randomized Trial. Obesity (Silver Spring) 2017; 25:1329-1335. [PMID: 28660719 DOI: 10.1002/oby.21883] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a community health worker (CHW)-delivered lifestyle intervention for African American women with type 2 diabetes. METHODS Participants were randomized to either 16 phone-based lifestyle intervention sessions aimed at making small changes in their diet and activity or 16 educational mailings sent across 12 months. Main outcomes included glycosylated hemoglobin (HbA1c), blood pressure (BP), and weight (kg) changes. RESULTS Two hundred middle-aged (mean = 53 ± 10.24 years), rural, African American women with moderate obesity (mean BMI = 37.7 ± 8.02) and type 2 diabetes (mean HbA1c = 9.1 ± 1.83) were enrolled. At 12 months, the intervention group exhibited no significant differences in HbA1c (-0.29 ± 1.84 vs. + 0.005 ± 1.61; P = 0.789) or BP (-1.01 ± 20.46/+0.66 ± 13.24 vs. + 0.22 ± 25.33/-2.87 ± 1.52; P = 0.100) but did exhibit greater weight loss (-1.35 ± 6.22 vs. -0.39 ± 4.57 kg, respectively; P = 0.046) compared with controls. Exploratory post hoc analyses revealed that participants not using insulin had significantly greater reductions in HbA1c (-0.70 ± 1.86 vs. + 0.07 ± 2.01; P = 0.000), diastolic BP (-5.17 ± 14.16 vs. -3.40 ± 14.72 mmHg; P = 0.035), and weight (-2.36 ± 6.59 vs. -1.64 ± 4.36 kg; P = 0.003) compared to controls not on insulin. CONCLUSIONS A phone-based CHW intervention resulted in no significant improvements in HbA1c or BP but did demonstrate modest improvements in weight. Women not using insulin showed significant improvements in all primary outcomes.
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Affiliation(s)
- Lesley D Lutes
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Doyle M Cummings
- Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
- Center for Health Disparities, East Carolina University, Greenville, North Carolina, USA
| | - Kerry Littlewood
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Emily Dinatale
- Primary Care Mental Health Integration, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, USA
| | - Bertha Hambidge
- Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
- Center for Health Disparities, East Carolina University, Greenville, North Carolina, USA
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Page-Reeves J, Regino L, Murray-Krezan C, Bleecker M, Erhardt E, Burge M, Bearer E, Mishra S. A comparative effectiveness study of two culturally competent models of diabetes self-management programming for Latinos from low-income households. BMC Endocr Disord 2017; 17:46. [PMID: 28738902 PMCID: PMC5525248 DOI: 10.1186/s12902-017-0192-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/05/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Diabetes risk is extremely high for Latinos from low-income households. Health guidelines recommend that individuals learn strategies to self-manage their diabetes, but getting people to adopt required lifestyle changes is challenging and many people are not able to prevent their pre-diabetes from escalating or effectively control their diabetes. Systematic reviews show that culturally competent self-management programs can significantly improve diabetes outcomes and different models for culturally competent programming have been developed. METHODS This patient-engaged study will compare the effectiveness of two distinct evidence-based models for culturally competent diabetes health promotion at two sites that serve a large Latino patient population from low-income households: 1) The Diabetes Self-Management Support Empowerment Model, an educational session approach, and 2) The Chronic Care Model, a holistic community-based program. Data collection will involve interviews, focus groups, surveys and assessments of each program; and testing of patient participants for A1c, depression, Body Mass Index (BMI), and chronic stress with hair cortisol levels. We will recruit a total of 240 patient-social support pairs: Patients will be adults (men and women over the age of 18) who: 1.) Enter one of the two diabetes programs during the study; 2.) Self-identify as "Latino;" 3.) Are able to identify a social support person or key member of their social network who also agrees to participate with them; 4.) Are not pregnant (participants who become pregnant during the study will be excluded); and 5.) Have household income 250% of the Federal Poverty Level (FPL) or below. Social supports will be adults who are identified by the patient participants. PRIMARY OUTCOME Improved capacity for diabetes self-management measured through improvements in diabetes knowledge and diabetes-related patient activation. SECONDARY OUTCOME Successful diabetes self-management as measured by improvements in A1c, depression scale scores, BMI, and circulating levels of cortisol to determine chronic stress. DISCUSSION Our hypothesis is that the program model that interfaces most synergistically with patients' culture and everyday life circumstances will have the best diabetes health outcomes. TRIAL REGISTRATION This study was registered with ClinicalTrials.gov on December 16, 2016 (Registration # NCT03004664 ).
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Affiliation(s)
| | - Lidia Regino
- University of New Mexico Health Sciences Center, Albuquerque, USA
| | | | - Molly Bleecker
- University of New Mexico Health Sciences Center, Albuquerque, USA
| | - Erik Erhardt
- University of New Mexico Health Sciences Center, Albuquerque, USA
| | - Mark Burge
- University of New Mexico Health Sciences Center, Albuquerque, USA
| | - Elaine Bearer
- University of New Mexico Health Sciences Center, Albuquerque, USA
| | - Shiraz Mishra
- University of New Mexico Health Sciences Center, Albuquerque, USA
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Pickett S, McCoy TP. Effect of Psychosocial Factors on Eating Behaviors and BMI Among African American Women. Clin Nurs Res 2017; 27:917-935. [PMID: 28618835 DOI: 10.1177/1054773817713420] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Psychosocial stress and negative emotions have been associated with the consumption of highly palatable foods and excess weight. Few studies have examined these variable relationships among young African American women. The purpose of this cross-sectional study was to examine the relationship of perceived stress, depressive symptoms, eating behaviors, and body mass index (BMI) among 191 African American women who were 18 to 40 years old. Multivariate analysis indicated that depressive symptoms had a greater impact on highly palatable eating behaviors compared with perceived stress. This study extends understanding of depressive symptoms on eating behaviors among young African American women.
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Affiliation(s)
| | - Thomas P McCoy
- 1 The University of North Carolina at Greensboro, NC, USA
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Dodgen L, Spence-Almaguer E. Beyond Body Mass Index: Are Weight-loss Programs the Best Way to Improve the Health of African American Women? Prev Chronic Dis 2017; 14:E48. [PMID: 28617664 PMCID: PMC5477783 DOI: 10.5888/pcd14.160573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
African American women have higher prevalence (82%) of overweight (body mass index [BMI] 25–29) and obesity (BMI ≥30) than white women (63.2%) or Hispanic women (77.2%), and weight-loss programs yield minimal results in this population. We examine the concept of BMI as a measure of health for African American women and suggests a more holistic, multifaceted approach to preventing chronic disease.
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Affiliation(s)
- Leilani Dodgen
- University of North Texas Health Science Center, 3500 Camp Bowie Blvd., EAD 738, Fort Worth, TX 76107.
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Zhou YE, Jackson CD, Oates VJ, Davis GW, Davis C, Takizala ZM, Akatue RA, Williams K, Liu J, Hébert JR, Patel KA, Buchowski MS, Schlundt DG, Hargreaves MK. Refining a Church-Based Lifestyle Intervention Targeting African-American Adults at Risk for Cardiometabolic Diseases: A Pilot Study. ACTA ACUST UNITED AC 2017; 7:96-114. [PMID: 33457107 DOI: 10.4236/ojepi.2017.72009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P < 0.001). The baseline PSS score was positively associated with baseline adiposity levels (e.g., weight, β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
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Affiliation(s)
- Yuan E Zhou
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Cynthia D Jackson
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Veronica J Oates
- Department of Family and Consumer Sciences, Tennessee State University, Nashville, TN, USA
| | - Gerald W Davis
- Ralph H Boston Wellness Center, Tennessee State University, Nashville, TN, USA
| | | | - Zudi-Mwak Takizala
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Richmond A Akatue
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - Konya Williams
- Participant and Clinical Interactions Resources, Meharry Medical College, Nashville, TN, USA
| | - Jianguo Liu
- Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA
| | - Kushal A Patel
- Department of Public Health, Tennessee State University, Nashville, USA
| | | | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Brown AGM, Hudson LB, Chui K, Metayer N, Lebron-Torres N, Seguin RA, Folta SC. Improving heart health among Black/African American women using civic engagement: a pilot study. BMC Public Health 2017; 17:112. [PMID: 28118823 PMCID: PMC5259944 DOI: 10.1186/s12889-016-3964-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 12/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite increased risk for cardiovascular disease (CVD) and related conditions, evaluations of health interventions indicate that Black/African American women are less likely to benefit than their white counterparts and are not as likely to engage in behaviors that reduce CVD risk. The purpose of this study was to test the feasibility and effectiveness of civic engagement as an intervention strategy to address heart health in Black/African American women. METHODS Using a quasi-experimental pre-post study design, civic engagement was tested by convening a convenience sample of self-identified Black/African American women, ages 30-70 years, English-speaking, and BMI ≥25.0 (n = 28) into "Change Clubs" in four churches. Feasibility was examined through adherence, satisfaction, retention, and ability of Change Clubs to meet at least 50% of self-identified action steps for community change. Effectiveness data included: dietary intake, measures of physical activity, cardiorespiratory fitness, blood pressure, and anthropometrics. Psychosocial factors hypothesized to serve as the mechanisms by which civic engagement enacts behavior change were also assessed. RESULTS At baseline, the study sample (n = 28) had a mean age of 50.5 y; 53.6% had an associate degree or higher; 60.7% had an income of $35,000 or higher; and 57.4% were employed full time. At the conclusion of the study, all participants were satisfied with the progress of their Change Club and with the overall experience and Change Clubs met their self-identified action steps for community change. The intervention had a significant effect on finish time on the cardiorespiratory fitness test (p < 0.001) and systolic blood pressure (p < 0.001). CONCLUSIONS Study results suggest feasibility and evidence of preliminary effectiveness of using a civic engagement approach to address behavior change in a way that is appealing and acceptable to Black/African American women. TRIAL REGISTRATION NCT02173366.
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Affiliation(s)
- Alison G. M. Brown
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA USA
| | - Linda B. Hudson
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA USA
| | - Kenneth Chui
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA USA
| | - Nesly Metayer
- Moakley Center for Public Management, Suffolk University, Boston, MA USA
| | | | | | - Sara C. Folta
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA USA
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Kozak AT, Buscemi J, Hawkins MAW, Wang ML, Breland JY, Ross KM, Kommu A. Technology-based interventions for weight management: current randomized controlled trial evidence and future directions. J Behav Med 2016; 40:99-111. [PMID: 27783259 DOI: 10.1007/s10865-016-9805-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 10/12/2016] [Indexed: 01/19/2023]
Abstract
Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs. In the present paper, a summary of the most current literature is provided along with potential solutions to methodological challenges (e.g., high attrition, minimal participant racial/ethnic diversity, heterogeneity of technology delivery modes). Dissemination and policy implications will be highlighted as future directions for the field of eHealth weight management.
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Affiliation(s)
- Andrea T Kozak
- Department of Psychology, Oakland University, Rochester, MI, 48309, USA.
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Monica L Wang
- Department of Community Health Sciences, Boston University, Boston, MA, USA
| | - Jessica Y Breland
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Della LJ, D'Silva MU, Best L, Smith SE, Carthan Q, Rajack-Talley T. Modeling message preferences: an adaptive conjoint analysis of persuasive messaging to increase fruit and vegetable consumption. ACTA ACUST UNITED AC 2016; 9:164-177. [PMID: 33598045 DOI: 10.1080/17538068.2016.1238179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few past studies have used conjoint analysis to assess message design features and even fewer have looked at health issues. This research applies conjoint analysis to the quest to design motivational messages for African Americans at risk for diet-related adverse health outcomes (e.g., heart disease) in Kentucky. African American health in the state of Kentucky can benefit from a diet high in fruit and vegetable consumption, but little past research has been conducted with African American Kentuckians to explore the best message structure for communicating about increased fruit and vegetable consumption. This study reports on the outcome of the final phase of formative campaign research. We use an adaptive conjoint analysis to identify the most important elements of message design for this group of Kentucky residents. Results indicate that the message's source (i.e., the person delivering the message) is the most important design element for creating persuasive health messaging about fruit and vegetables for African Americans in Kentucky, followed by the stated benefit of eating more fruit and vegetables and the manner in which the behavior is described, respectively. To our knowledge, this study is the first to treat campaign message features as the subject of a conjoint analysis in order to identify which combination of features might be most motivating for a specific target audience. Recommendations for future health communication campaign application, as well as future research are discussed.
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Affiliation(s)
- Lindsay J Della
- 310 Strickler Hall, Department of Communication, University of Louisville, Louisville, KY 40292: +1 502-852-6976
| | - Margaret U D'Silva
- 310 Strickler Hall, Department of Communication, University of Louisville, Louisville, KY 40292: +1 502-852-6976
| | - Latrica Best
- 435 Strickler Hall, Pan-African Studies Department, University of Louisville, Louisville, KY 40292: +1 502-852-5123
| | - Siobhan E Smith
- 310 Strickler Hall, Department of Communication, University of Louisville, Louisville, KY 40292: +1 502-852-6976
| | - Quaniqua Carthan
- 435 Strickler Hall, Pan-African Studies Department, University of Louisville, Louisville, KY 40292: +1 502-852-5123
| | - Theresa Rajack-Talley
- 435 Strickler Hall, Pan-African Studies Department, University of Louisville, Louisville, KY 40292: +1 502-852-5123
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Peeters A, Blake MRC. Socioeconomic Inequalities in Diet Quality: from Identifying the Problem to Implementing Solutions. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0167-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Liao Y, Siegel PZ, Garraza LG, Xu Y, Yin S, Scardaville M, Gebreselassie T, Stephens RL. Reduced Prevalence of Obesity in 14 Disadvantaged Black Communities in the United States: A Successful 4-Year Place-Based Participatory Intervention. Am J Public Health 2016; 106:1442-8. [PMID: 27310344 DOI: 10.2105/ajph.2016.303253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the impact of a large-scale place-based intervention on obesity prevalence in Black communities. METHODS The Racial and Ethnic Approaches to Community Health across the United States (REACH US) project was conducted in 14 predominantly Black communities in California, Illinois, Massachusetts, New York, Ohio, Pennsylvania, South Carolina, Virginia, Washington, and West Virginia. We measured trends from 2009 to 2012 in the prevalence of obesity. We used Behavioral Risk Factor Surveillance System data to compare these trends with trends among non-Hispanic Whites and non-Hispanic Blacks in the United States and in the 10 states where REACH communities were located, and with a propensity score-matched national sample of non-Hispanic Blacks. RESULTS The age-standardized prevalence of obesity decreased in REACH US communities (P = .045), but not in the comparison populations (P = .435 to P = .996). The relative change was -5.3% in REACH US communities versus +2.4% in propensity score-matched controls (P value for the difference = .031). The net effect on the reduction of obesity prevalence was about 1 percentage point per year for REACH. CONCLUSIONS Obesity prevalence was reduced in 14 disadvantaged Black communities that participated in the REACH project.
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Affiliation(s)
- Youlian Liao
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Paul Z Siegel
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Lucas G Garraza
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Ye Xu
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Shaoman Yin
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Melissa Scardaville
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Tesfayi Gebreselassie
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
| | - Robert L Stephens
- Youlian Liao, Paul Z. Siegel, and Shaoman Yin are with the Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Lucas G. Garraza, Ye Xu, Melissa Scardaville, Tesfayi Gebreselassie, and Robert L. Stephens are with ICF International, Atlanta, GA
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Dean LT, Zhang X, Latif N, Giuntoli R, Lin L, Haggerty A, Kim S, Shalowitz D, Stashwick C, Simpkins F, Burger R, Morgan M, Ko E, Schmitz K. Race-based disparities in loss of functional independence after hysterectomy for uterine cancer. Support Care Cancer 2016; 24:3573-80. [PMID: 27025595 DOI: 10.1007/s00520-016-3185-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 03/21/2016] [Indexed: 12/27/2022]
Abstract
PURPOSE Racial disparities in uterine cancer-related outcomes have been reported. The goal of this study was to determine if race, pre-operative body mass index (BMI), and medical comorbidities are predictors of loss of functional independence after hysterectomy for uterine cancer. METHODS Loss of independence was defined as a change from pre-operative functional independence, to a post-operative requirement of discharge to a post-care facility, or death within the first 30 days following uterine cancer surgery. Demographic factors, comorbidities, BMI, intra-operative and post-operative outcomes, and discharge status were abstracted from the 2011 and 2012 American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Statistical analyses included multivariable logistic regression and Wald tests for interaction. RESULTS A total of 4005 patients had uterine cancer and were functionally independent pre-operatively. After adjusting for clinical features and comorbidities, Black women were not significantly more likely to lose functional independence than non-Black women. However, a significant interaction (OR = 1.17, p < 0.001) was found between race and BMI for loss of functional independence. Interaction plots revealed worsening functional outcomes for Black women with BMI >40 but not in non-Blacks. CONCLUSIONS The interaction suggests a 17 % increased odds of losing independence for each unit of BMI difference for Black uterine cancer patients, or 170 % increased odds of losing independence for a 10-point increase in BMI, given a linear association. To reduce the likelihood of losing post-operative functional independence, Black, high-BMI patients with or at risk for uterine cancer may especially benefit from weight loss or interventions to optimize physical function.
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Affiliation(s)
- Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Xiaochen Zhang
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Nawar Latif
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Giuntoli
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lilie Lin
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ashley Haggerty
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Kim
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - David Shalowitz
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Caitlin Stashwick
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fiona Simpkins
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Burger
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Morgan
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily Ko
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kathryn Schmitz
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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