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Williams LB, Abu Farsakh B, Karle ER, Almogheer ZS, Coughlin S, Kim Yeary KH. How effective are church-based weight-loss interventions among Black adults? A systematic review. Obesity (Silver Spring) 2024. [PMID: 39199014 DOI: 10.1002/oby.24115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/18/2024] [Accepted: 06/10/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE Churches are frequently used to reach Black adults to effect weight loss. However, there has been no recent review, to our knowledge, inclusive of solely Black adults in church settings. We sought to comprehensively examine the methodological approaches and weight-loss outcomes of church-based weight-loss lifestyle interventions conducted among Black adults to provide insights on literature gaps and offer suggestions for future research. METHODS Google Scholar, PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for trials conducted in churches that reported weight outcomes at any time point. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guided manuscript development. RESULTS A total of 15 studies (N = 2285) from 2007 to 2023 met inclusion criteria, and 33% were high-quality randomized trials. The majority were pilot studies (60%) conducted in the Southern United States. Most reported significant postintervention weight loss. The follow-up time points varied from 2 to 12 months. Methodological approaches included the following: cultural adaptations (93%); theory-guided (93%); delivered by community health workers (80%); and delivered in person in a group format (100%). Only one study offered individual-level attention beyond texts/emails. Most participants were well-educated female individuals. CONCLUSIONS Weight-loss interventions among Black church settings effect statistically significant weight loss, albeit in a small way. Limitations include pilot studies and small samples. More rigorously designed studies are warranted.
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Affiliation(s)
| | | | - Erika R Karle
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | | | - Steven Coughlin
- College of Allied Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Karen H Kim Yeary
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Gance-Cleveland B, Frenn M, Browne N, Greenberg CS, Snethen JA, Hodges EA, Fial AV, Small L, Irving SY. A scoping review of the role of policy in mitigating childhood obesity in underserved populations using the RE-AIM framework. Worldviews Evid Based Nurs 2024; 21:445-453. [PMID: 38584314 DOI: 10.1111/wvn.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Childhood obesity is an escalating crisis in the United States. Health policy may impact this epidemic which disproportionally affects underserved populations. AIM The aim was to use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to assess health policy impact on preventing or treating school-aged children (5 > 18 years) with obesity in underserved populations. METHODS A scoping review of 842 articles was conducted. Twenty-four articles met the inclusion criteria and underwent data extraction. RESULTS Twelve studies included subgroup analysis, with four suggesting an impact of policy on at-risk groups. None of the 24 studies fully applied the RE-AIM framework. Policies positively impacted childhood obesity in 12 studies across the sample. LINKING EVIDENCE TO ACTION Our review revealed inconsistent evidence for the effectiveness of policy on childhood obesity, perhaps due to the lack of focus on the social determinants of health. In addition, many studies did not evaluate the outcomes for underserved populations. Therefore, we propose more attention to social determinants in future legislation and evaluation of policy effectiveness on underserved populations. Findings identify an urgent need for the design, implementation, and evaluation of policies specifically directed to address the inequities of racism, social injustices, and social determinants of health that impact childhood obesity in the United States. Future work needs to identify who was reached by the policy, who benefitted from the policy, and how policies were implemented to address obesity-related health disparities. Nurses should advocate for the evaluation of childhood obesity policies, particularly in underserved populations, to determine effectiveness. Nurses, particularly those trained in population and community health and research, should advocate for policy research that considers inequities rather than controls for these variables. Multi-layered interventions can then be tailored to sub-populations and evaluated more effectively.
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Affiliation(s)
- Bonnie Gance-Cleveland
- University of Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marilyn Frenn
- Marquette University College of Nursing, Milwaukee, Wisconsin, USA
| | | | | | - Julia A Snethen
- University of Wisconsin-Milwaukee, School of Nursing, Milwaukee, Wisconsin, USA
| | - Eric A Hodges
- The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Alissa V Fial
- Marquette University, Raynor Memorial Libraries, Milwaukee, Wisconsin, USA
| | - Leigh Small
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Sharon Y Irving
- University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania, USA
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Bauer AG, Shah B, Johnson N, Aduloju-Ajijola N, Bowe-Thompson C, Christensen K, Berkley-Patton JY. Feasibility and Acceptability of the Project Faith Influencing Transformation Intervention in Faith-Based Settings. HEALTH EDUCATION & BEHAVIOR 2024; 51:291-301. [PMID: 37978814 DOI: 10.1177/10901981231211538] [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] [Indexed: 11/19/2023]
Abstract
African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.
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Affiliation(s)
- Alexandria G Bauer
- Rutgers University-New Brunswick, Piscataway, NJ, USA
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Binoy Shah
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Nia Johnson
- Saint Louis University School of Medicine, St. Louis, MO, USA
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Ramisetty-Mikler S, Willis A, Tiwari C. Pre-pregnancy Weight and Racial-Ethnic Disparities in Pregnancy-Associated Conditions in the State of Georgia: A Population-Based Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01932-2. [PMID: 38378940 DOI: 10.1007/s40615-024-01932-2] [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: 09/25/2023] [Revised: 01/13/2024] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION We investigate racial-ethnic disparities in pre-pregnancy obesity and pregnancy weight gain, which are known to increase the risk of pregnancy-associated conditions. METHODS We used 4-year (2017-2020) combined Georgia Pregnancy Risk Assessment Monitoring System data (N = 3208) to investigate racial-ethnic disparities in the incidence of gestational hypertension (GHT), gestational diabetes mellitus (GDM), and postpartum depression (PPD) and their associated risk with pre-pregnancy overweight/obesity after controlling for demographic and other confounders using regression modeling. The geographic distributions of hypertension and PPD rates at the county level were compared to the patterns of racial-ethnic populations and hospitals. RESULTS The PPD rates were higher among Asian (17.6), Hispanic (14.4), and Black (14.3); GDM was highest among Asian (16.0) mothers; and GHT was the highest among Black (11.7) followed by White mothers (9.0). Pre-pregnancy overweight and obese conditions increased the odds of hypertension in Black (2 ½ times) and White (> 3 ½ times) mothers. Premature birth increased the odds of hypertension (2-3 times) in all mothers. Pre-pregnancy weight also increased the odds of GDM (3-7 times) in these racial groups. Premature birth increases the odds twice as likely for PPD in Hispanic and White mothers. The convergence of high PPD and hypertension rates with high proportions of racial and ethnic minorities, and lack of hospital presence, indicates areas where healthcare interventions are required. CONCLUSIONS These findings underscore the importance of promoting a healthy pre-pregnancy weight to reduce the burden of maternal morbidity and pregnancy outcomes in general. More comprehensive prenatal monitoring using technological interventions for self-care has a great promise of being effective in maintaining a healthy pregnancy.
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Affiliation(s)
- Suhasini Ramisetty-Mikler
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, USA.
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, USA.
- Urban Life Building, Room 406, 140 Decatur St, Atlanta, GA, 30303, USA.
| | - Angelique Willis
- Department of Geosciences, Georgia State University, Atlanta, USA
| | - Chetan Tiwari
- Department of Geosciences, Georgia State University, Atlanta, USA
- Center for Disaster Informatics and Computational Epidemiology, Georgia State University, Atlanta, USA
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Sun Y, Zhang Y, Liu X, Liu Y, Wu F, Liu X. Association between body mass index and respiratory symptoms in US adults: a national cross-sectional study. Sci Rep 2024; 14:940. [PMID: 38195711 PMCID: PMC10776771 DOI: 10.1038/s41598-024-51637-z] [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: 07/04/2023] [Accepted: 01/08/2024] [Indexed: 01/11/2024] Open
Abstract
The correlation between body mass index (BMI) and the development of cough, shortness of breath, and dyspnea is unclear. Therefore, this study aimed to investigate the association between these parameters. Data from individuals who participated in the National Health and Nutrition Examination Survey between 2003 and 2012 were analyzed. Weighted logistic regression analysis and smoothed curve fitting were used to examine the correlation between BMI and respiratory symptoms. In addition, the relationship between BMI, chronic obstructive pulmonary disease (COPD), and bronchial asthma was examined. Stratified analysis was used to discover inflection points and specific groups. Weighted logistic regression and smoothed curve fitting revealed a U-shaped relationship between BMI and respiratory symptoms. The U-shaped relationship in BMI was also observed in patients with bronchial asthma and COPD. Stratified analysis showed that the correlation between BMI and wheezing and dyspnea was influenced by race. In addition, non-Hispanic black individuals had a higher risk of developing cough than individuals of the other three races [OR 1.040 (1.021, 1.060), p < 0.0001], and they also exhibited an inverted U-shaped relationship between BMI and bronchial asthma. However, the association of BMI with cough, wheezing, dyspnea, COPD, and asthma was not affected by sex. High or low BMI was associated with cough, shortness of breath, and dyspnea, and has been linked to bronchial asthma and COPD. These findings provide new insights into the management of respiratory symptoms and respiratory diseases.
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Affiliation(s)
- Yuefeng Sun
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yueyang Zhang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiangyang Liu
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yingying Liu
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fan Wu
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xue Liu
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
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6
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Abshire DA, Wippold GM, Wilson DK, Pinto BM, Probst JC, Hardin JW. A qualitative study of ecological and motivational factors to inform weight management interventions for Black men in the rural South of the United States. Soc Sci Med 2023; 326:115898. [PMID: 37087973 PMCID: PMC10354809 DOI: 10.1016/j.socscimed.2023.115898] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
RATIONALE AND OBJECTIVE Black men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South. METHODS We conducted individual telephone interviews with 23 Black men (mean age 50 ± 14 years) with overweight or obesity living in rural South Carolina communities in 2020 and 2021. Interviews were audio recorded, professionally transcribed, and coded by two men's health researchers who achieved an intercoder reliability of 70%. Content analysis using QSR NVivo 12 was used to generate themes using deductive and inductive approaches. RESULTS Physical health and health behaviors were perceived as key determinants of overall health. Family, friends, and other social contacts often provided positive social support that increased motivation but also hindered motivation by engaging in behaviors men were trying to avoid. Younger participants had stronger views of rural environments not supporting healthy lifestyles, which compounded personal challenges such as time constraints and lack of motivation. Comfort was discussed as a critical program consideration, and gender concordance among program participants and facilitators was perceived as promoting comfort. Participants noted preferences and benefits of in-person, group programs emphasizing physical activity, and younger participants more strongly endorsed programs that incorporated sports and competition. CONCLUSIONS Findings from this study provide important evidence to inform the development of weight management interventions for Black men in the rural US South. Based on these findings, an innovative, competitive "football-themed" weight management program promoting peer support and integrating competitive physical activities is being evaluated for younger Black men in the rural South.
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Affiliation(s)
- Demetrius A Abshire
- University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC, 29208, USA.
| | - Guillermo M Wippold
- University of South Carolina, Department of Psychology, Barnwell College 224, 1512 Pendleton Street, Columbia, SC, 29208, USA.
| | - Dawn K Wilson
- University of South Carolina, Department of Psychology, Barnwell College 224, 1512 Pendleton Street, Columbia, SC, 29208, USA.
| | - Bernardine M Pinto
- University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC, 29208, USA.
| | - Janice C Probst
- University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA.
| | - James W Hardin
- University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA.
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7
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Dodgen L, Kitzman H, Spence E, Mamun A, Walters ST, Cervantes D. What's theory got to do with it: measuring effects of theory on lifestyle behaviors and weight in the Better Me Within Randomized Trial. AMERICAN JOURNAL OF HEALTH EDUCATION 2023; 54:86-98. [PMID: 37396565 PMCID: PMC10311983 DOI: 10.1080/19325037.2022.2163007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/08/2022] [Indexed: 02/19/2023]
Abstract
Background Knowing which theoretical constructs work best to design effective interventions is essential for populations with increased disease burden. African American women (AAW) experience greater prevalence of chronic diseases and fewer benefits from weight loss interventions compared to White women. Purpose To examine how theoretical constructs were associated with lifestyle behaviors and weight outcomes in the Better Me Within (BMW) Randomized Trial. Methods BMW used a tailored diabetes prevention program implemented in churches among AAW with BMI ≥ 25. Regression models assessed relationships between constructs (self-efficacy, social support and motivation), and outcomes (physical activity (PA), calories, and weight). Results Among 221 AAW (mean (SD) age 48.8 years (11.2); mean weight 215.1 pounds (50.5), several significant relationships were found including an association between change in motivation for activity and change in PA (p=.003), and change in motivation for diet and weight at follow-up (p=<.001). Discussion The clearest relationships emerged for PA with motivation for activity and weight management social support demonstrating significance in all models. Translation to Practice Self-efficacy, motivation and social support show promise to promote changes in PA and weight among church-going AAW. Opportunities to keep engaging AAW in research are essential for eliminating health inequities in this population.
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Affiliation(s)
- Leilani Dodgen
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
| | - Heather Kitzman
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
- Robbins Institute for Health Policy & Leadership, Baylor University, Waco, TX, USA
| | - Emily Spence
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Abdullah Mamun
- Research, Baylor Scott & White Health and Wellness Center, Dallas, TX, USA
- Ethicon, Raritan, NJ, USA
| | - Scott T. Walters
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Diana Cervantes
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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8
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Abstract
Population-based solutions are needed to stabilize and then reverse the continued upward trends in obesity prevalence in the US population and worldwide. This review focuses on the related, urgent issue of disparities in obesity prevalence affecting US racial/ethnic minority and other socially marginalized populations. The review provides background on these disparities from a health equity perspective and highlights evidence of progress in equity-focused obesity efforts. Five recommendations for advancing equity efforts are offered as potential approaches to build on progress to date: (a) give equity issues higher priority, (b) adopt a health equity lens, (c) strengthen approaches by using health equity frameworks, (d) broaden the types of policies considered, and (e) emphasize implementation science concepts and tools. Potential challenges and opportunities are identified, including the prospect of longer-term, transformative solutions that integrate global and national initiatives to address obesity, undernutrition, and climate change.
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Affiliation(s)
- Shiriki K Kumanyika
- Dornsife School of Public Health, Drexel University, and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;
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9
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Webber-Ritchey KJ, Taylor-Piliae RE, Loescher LJ. Recruiting African American parents of school-aged children in a physical activity study: Lessons learned. Chronic Illn 2022; 18:181-192. [PMID: 32483997 DOI: 10.1177/1742395320928389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge. METHODS Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment. RESULTS We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers (n = 87, 69%) and males/fathers (n = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust. DISCUSSION Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.
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Affiliation(s)
| | - Ruth E Taylor-Piliae
- Biobehavioral Health Sciences, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Lois J Loescher
- College of Nursing, University of Arizona, Tucson, AZ, USA.,Biobehavioral Health Sciences, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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10
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Wade J, Alexander R, Giscombé CW, Keegan D, Parker S, Jackson K, Gibbs J, McElroy A, Ferguson JV. Using Black Feminist Theory and Methods to Uncover Best Practices in Health Promotion Programming. QUALITATIVE HEALTH RESEARCH 2022; 32:581-594. [PMID: 34931558 PMCID: PMC8879412 DOI: 10.1177/10497323211061108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study was created to uncover the social determinants of Black American women's success in health promotion programs. We used the Superwoman Schema to understand the complexities of Black womanhood and uncover best practices in the promotion of their health. The sample consisted of women ages 18-25 who attend a large southern HBCU. We collected data using qualitative focus groups. Participants reported the greatest health-related concerns Black American women facing are mental health, obesity, and relationships with Black men. When it comes to health promotion programs, respondents reported a desire for classes that are fun, interactive, informative, educational, and include group interaction, accessible, and incentivize participation. Uncovering the social determinants of Black American women's health and program success is central in decreasing extant health disparities. Future health scholars are urged to incorporate Black feminist theory and methods into their work to create health promotion interventions tailored for Black women.
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Affiliation(s)
- Jeannette Wade
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Ramine Alexander
- Department of Food and Nutritional Sciences, North Carolina A&T State University, Greensboro, NC, USA
| | - Cheryl Woods Giscombé
- Division & Program Levine Family Distinguished Scholar in Quality of Life, Health Promotion, and Wellness, University of North Carolina, Chapel Hill, NC, USA
| | - Daniel Keegan
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Sharon Parker
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Katia Jackson
- Department of Psychology, North Carolina A&T State University, Greensboro, NC, USA
| | - Jasmine Gibbs
- Department of Social Work and Sociology, North Carolina A&T State University, Greensboro, NC, USA
| | - Asha McElroy
- Department of Food and Nutritional Sciences, North Carolina A&T State University, Greensboro, NC, USA
| | - Ja Vae Ferguson
- Department of Food and Nutritional Sciences, North Carolina A&T State University, Greensboro, NC, USA
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11
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Roberts SB, Das SK, Sayer RD, Caldwell AE, Wyatt HR, Mehta TS, Gorczyca AM, Oslund JL, Peters JC, Friedman JE, Chiu CY, Greenway FL, Donnelly JE, Dao MC, Cuevas AG, Affuso O, Wilkinson LL, Thomas D, Al-Ozairi E, Yannakoulia M, Khazrai YM, Manalac RJ, Bachiashvili V, Hill JO. Technical report: an online international weight control registry to inform precision approaches to healthy weight management. Int J Obes (Lond) 2022; 46:1728-1733. [PMID: 35710944 PMCID: PMC9201790 DOI: 10.1038/s41366-022-01158-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Personalizing approaches to prevention and treatment of obesity will be a crucial aspect of precision health initiatives. However, in considering individual susceptibility to obesity, much remains to be learned about how to support healthy weight management in different population subgroups, environments and geographical locations. SUBJECTS/METHODS The International Weight Control Registry (IWCR) has been launched to facilitate a deeper and broader understanding of the spectrum of factors contributing to success and challenges in weight loss and weight loss maintenance in individuals and across population groups. The IWCR registry aims to recruit, enroll and follow a diverse cohort of adults with varying rates of success in weight management. Data collection methods include questionnaires of demographic variables, weight history, and behavioral, cultural, economic, psychological, and environmental domains. A subset of participants will provide objective measures of physical activity, weight, and body composition along with detailed reports of dietary intake. Lastly, participants will be able to provide qualitative information in an unstructured format on additional topics they feel are relevant, and environmental data will be obtained from public sources based on participant zip code. CONCLUSIONS The IWCR will be a resource for researchers to inform improvements in interventions for weight loss and weight loss maintenance in different countries, and to examine environmental and policy-level factors that affect weight management in different population groups. This large scale, multi-level approach aims to inform efforts to reduce the prevalence of obesity worldwide and its associated comorbidities and economic impacts. TRIAL REGISTRATION NCT04907396 (clinicaltrials.gov) sponsor SB Roberts; Tufts University IRB #13075.
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Affiliation(s)
- Susan B. Roberts
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - Sai Krupa Das
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - R. Drew Sayer
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Ann E. Caldwell
- grid.430503.10000 0001 0703 675XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO 80045 USA
| | - Holly R. Wyatt
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Tapan S. Mehta
- grid.265892.20000000106344187Department of Family and Community Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - Anna M. Gorczyca
- grid.412016.00000 0001 2177 6375Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160 USA
| | - Jennifer L. Oslund
- grid.429997.80000 0004 1936 7531Energy Metabolism, Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA 02111 USA
| | - John C. Peters
- grid.430503.10000 0001 0703 675XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, CO 80045 USA
| | - James E. Friedman
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
| | - Chia-Ying Chiu
- grid.265892.20000000106344187Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - Frank L. Greenway
- grid.410428.b0000 0001 0665 5823Clinical Trials Unit, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808 USA
| | - Joseph E. Donnelly
- grid.412016.00000 0001 2177 6375Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160 USA
| | - Maria Carlota Dao
- grid.167436.10000 0001 2192 7145Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH 03824 USA
| | - Adolfo G. Cuevas
- grid.429997.80000 0004 1936 7531Department of Community Health, Tufts University, Medford, MA 02155 USA
| | - Olivia Affuso
- grid.265892.20000000106344187Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Larrell L. Wilkinson
- grid.265892.20000000106344187Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Diana Thomas
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Ebaa Al-Ozairi
- grid.452356.30000 0004 0518 1285Clinical Research Unit, Dasman Diabetes Institute, 15462 Kuwait City, Kuwait
| | - Mary Yannakoulia
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, Harokopio University, El. Venizelou 70, 176 71 Kallithea, Greece
| | - Yeganeh M. Khazrai
- grid.9657.d0000 0004 1757 5329Department of Food Science and Human Nutrition, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, RM Italy
| | - Raoul J. Manalac
- grid.64337.350000 0001 0662 7451Bariatric & Metabolic Institute, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA USA
| | - Vasil Bachiashvili
- grid.265892.20000000106344187Department of Family and Community Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL 35233 USA
| | - James O. Hill
- grid.265892.20000000106344187Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294 USA
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12
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Examining current physical activity interventions in Black school-age children and parents: A systematic review. Prev Med 2021; 153:106814. [PMID: 34597612 DOI: 10.1016/j.ypmed.2021.106814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/10/2021] [Accepted: 09/26/2021] [Indexed: 11/21/2022]
Abstract
Obesity is prevalent in Black children and adults; increasing physical activity (PA) can aid in reducing childhood obesity in both age groups. The purpose of this systematic review is to examine current research on PA interventions in school-age Black children. Adhering to PRISMA guidelines, a systematic search was conducted in six databases for PA interventions in Black children. A total of 13 articles met inclusion criteria (n = 7 randomized controlled trial, n = 5 quasi-experimental, n = 1 cross-sectional). The majority of the articles were on a combination of diet and PA programs (n = 9). Four articles targeted PA and parental role modeling of PA as the outcome showing positive intervention effects. Nine additional studies included PA as an outcome variable along with at least one additional obesity-related predictor. PA interventions for Black school-age children typically use a parent-child dyadic approach (n = 13), are guided by theory (n = 11) and are high quality. However, continued investigation is warranted to draw definitive conclusions and determine how to best involve parents within the PA interventions. Theory-driven higher quality trials that clearly describe the structured PA component and outcomes among Black parent-child dyads are needed.
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Woods-Giscombe CL, Lobel M, Zimmer C, Brooks J, Sheffield-Abdullah K, Bey G, Bravo L, Lackey C, Smith R, Frazier T, Muhirwa A. Use of Food to Cope With Culturally Relevant Stressful Life Events Is Associated With Body Mass Index in African American Women. Nurs Res 2021; 70:S53-S62. [PMID: 34173375 DOI: 10.1097/nnr.0000000000000532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although stress is an established contributor to obesity (in general population studies), mechanisms to explain this association in African American women that incorporate culturally relevant frameworks have received little attention. OBJECTIVE To investigate how stress is associated with body mass index (BMI) in this population, we examined multivariate models of BMI predicted by race-related, gender-related, and generic stressful life events and by use of food to cope with stress. We hypothesized that the three types of stressful life events would be indirectly associated with BMI through using food to cope with stress. METHODS Psychometrically robust measures were included in surveys administered to a socioeconomically diverse sample of 189 African American women aged 21-78 years. Hypotheses were tested using structural equation modeling. We examined race-related, gender-related, and generic stressful life events as latent constructs indicated by exposure to and appraisal of potential stressors predicting a mediator, using food to cope, which predicted BMI; this model also included direct paths from the three latent stressful life event constructs to BMI. RESULTS Almost every participant reported using food in some way to cope with stress; 33% and 42% met established criteria for overweight and obesity, respectively. The race-related stressful life event construct was the only latent construct predicting using food to cope with stress, and using food to cope with stress predicted BMI. A significance test of indirect effects demonstrated that the race-related stressful life event construct was indirectly associated with BMI through the mediator, using food to cope. DISCUSSION Culturally relevant stress exposures and stress-related eating are important areas of foci for tackling overweight, obesity, and related health inequities in African American women. Findings highlight the importance of developing more complex models to understand the stress-related factors that elevate risk for overweight and obesity in this population.
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Justin TA, Jette S. "That chart ain't for us": How Black women understand "obesity," health, and physical activity. Health (London) 2021; 26:605-621. [PMID: 34523360 DOI: 10.1177/13634593211046844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this article, we use qualitative methodology to explore how eight physically active Black women, who self-identify as "obese," understand and experience health and physical activity, as well as how they position themselves in relation to discourses pertaining to "obesity" and Black femininity. Drawing on Foucauldian-informed critical obesity scholarship and Black feminist thought, we explore the ways in which physically active Black women concurrently resist, reproduce, and navigate racialized and gendered obesity discourse. Our findings advance critical obesity scholarship as we indicate that participants simultaneously adapt to, negotiate, and resist obesity discourse by re-defining health, questioning the BMI, and centering their desire for corporeal "thickness" as critical to their identity as Black women.
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15
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"I Want a Program That Looks at My Whole Life." A Focus Group Study on the Ideal Components for an mHealth Weight Management Program for African American Women. J Acad Nutr Diet 2021; 122:139-148. [PMID: 34351276 DOI: 10.1016/j.jand.2021.06.310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The high rate of obesity, ownership of smartphones, and online search for nutrition and dieting information among African American women (AAW) provide a unique opportunity to develop cost-effective, accessible, and acceptable mHealth weight management programs for them. Furthermore, they should participate in the development and evaluation of these programs. OBJECTIVE To explore ideal components of a culturally relevant mHealth weight management program for AAW and to examine how these components may vary by age group. DESIGN Twelve focus group triads were conducted with AAW in north central Florida. The framework method was used to manage, organize, synthesize, and analyze data themes by age groups: 18 to 29 (young), 30 to 50 (middle age), and 51+ (older). PARTICIPANTS/SETTING Thirty-six smartphone owners who expressed a desire to lose weight were recruited through several community partnerships. RESULTS Based on body mass index (BMI), young women were classified as overweight (BMI 26.23 ± 6.7), middle-aged women as obese (BMI30.72 ± 8.31), and older women as obese (BMI 31.03 ± 5.67). Most searched online for dieting information within the past 12 months. Five overarching themes for designing mHealth weight management programs were identified: (1) holistic program that goes beyond dieting; (2) social media integration for support and sense of community; (3) self-monitoring app; (4) two-way text messaging; and (5) programs of varying lengths and meaningful incentives. CONCLUSION AAW were receptive to mHealth weight management programs, which may be appealing during and after the COVID-19 pandemic. Holistic programs of 4 to 6 weeks that addressed stress eating, had a social media component, and included a few educational texts per week may be appealing to AAW.
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16
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Jung S, Whittemore R, Jeon S, Nam S. Mediating roles of psychological factors and physical and social environments between socioeconomic status and dietary behaviors among African Americans with overweight or obesity. Res Nurs Health 2021; 44:513-524. [PMID: 33782981 PMCID: PMC8068664 DOI: 10.1002/nur.22130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/01/2021] [Accepted: 03/14/2021] [Indexed: 11/09/2022]
Abstract
The study aim was to examine the relationship between socioeconomic status (SES) and dietary behaviors through psychological and environmental mediators among African Americans with overweight or obesity. We conducted a cross-sectional study in 225 African American men and women. Data were analyzed using structural equation modeling with bootstrapping procedures. In the multiple mediation model, SES had a significant indirect effect on dietary behaviors through psychological and environmental factors (β = -.27; p = .01; 95% confidence interval [CI] = -0.59--0.10), but it had no significant direct effect on dietary behaviors (β = .06; p = .70; 95% CI = -0.21-0.39). SES had significant direct effects on psychological (β = .52; p = .01; 95% CI = 0.31-0.77) and environmental factors (β = -.40; p = .03; 95% CI = -0.53--0.25). Psychological (β = -.31; p = .02; 95% CI = -0.68--0.04) and environmental factors (β = .26; p = .01; 95% CI = 0.04-0.47) also showed significant direct effects on dietary behaviors. Thus, psychological and environmental factors mediated the relationship between SES and dietary behaviors in African Americans with overweight or obesity. Interventions that enhance psychological and environmental factors such as self-efficacy, perceived barriers to healthy eating, health perceptions, and physical and social environments may improve dietary behaviors among socioeconomically disadvantaged African Americans.
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Affiliation(s)
- Sunyoung Jung
- Yale University, School of Nursing, Orange, CT 06477
| | | | | | - Soohyun Nam
- Yale University, School of Nursing, Orange, CT 06477
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17
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Berkley-Patton J, Huffman MM, Thompson CB, Johnson N, Ervie K, Lindsey C, Reuchter V, Christensen K, Davis A, Burgin T. Increasing Reach of the Diabetes Prevention Program in African American Churches: Project FIT Lessons Learned in Using an Interprofessional Student Service-Learning Approach. MISSOURI MEDICINE 2021; 118:264-271. [PMID: 34149088 PMCID: PMC8210992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention proven to reduce/delay diabetes onset with diet change, physical activity, and modest weight loss. However, access to the program is limited in low-resource communities. Having health profession students facilitate DPP groups as a service learning course-credit opportunity may benefit their interprofessional training while also expanding DPP access in underserved communities. We sought to use student reflections to identify themes to assist with program evaluation and to inform program refinements. Students (N=95) from the University of Missouri-Kansas City (UMKC) medical, physician assistant, and pharmacy programs led DPP groups in urban Kansas City African American churches alongside church health liaisons as part of an interprofessional service-learning course. Students reported creating satisfying, ongoing relationships with participants; developing a deeper understanding of obstacles to weight loss; and learning the role of other health professionals in the care of patients. They also identified obstacles to successful program implementation, such as needing less time in training and having equal participation from students across their interprofessional teams. Students learned important lessons by leading the DPP, but interprofessional service-learning courses have multiple obstacles to successful delivery. Still, this approach has great potential to increase access to the DPP in African American communities and promote skill development in health profession students.
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Affiliation(s)
- Jannette Berkley-Patton
- Professor and the director of the Community Health Research Group, in the School of Medicine (SOM) Department of Biomedical and Health Informatics at the University of Missouri-Kansas City, Kansas City, Missouri (DMHI UMKC-KCMO)
| | - Miranda M Huffman
- Associate professor in the Department of Family and Community Medicine at Meharry Medical College in Nashville, Tennessee
| | | | - Nia Johnson
- Research associate previously in the Community Health Research Group, SOM DMHI UMKC-KCMO, and is currently a medical student in the School of Medicine at Saint Louis University, St. Louis, Missouri
| | - Katherine Ervie
- Program director of the physician assistant program in the SOM UMKC-KCMO
| | - Cameron Lindsey
- Interim chair and director of Co-Curriculum and Professor of Pharmacy Practice and Administration in the School of Pharmacy, UMKC-KCMO
| | - Valerie Reuchter
- Director of Experiential Learning and Clinical Associate Professor in the Division of Pharmacy Practice and Administration in the School of Pharmacy, UMKC-KCMO
| | | | | | - Tacia Burgin
- Doctoral student in the Psychology Department, UMKC-KCMO
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18
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Kliewer W, Robins JL. Adverse Childhood Experiences Are Associated with Cardiometabolic Risk Indicators and Telomere Length in Low-Income African-American Adolescents. Int J Behav Med 2021; 29:131-135. [PMID: 33821432 DOI: 10.1007/s12529-021-09978-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been linked to increased risk for cardiovascular disease later in life, and to shortened telomere length in children and adolescents, but few studies have examined associations between ACEs and cardiometabolic risk in adolescence or potential associations between ACEs, cardiometabolic risk indicators, and telomere length in this population. The present study examined competing models of associations between adolescent ACEs (as reported by mothers); cardiovascular, inflammatory, and metabolic indicators of health risk; and leukocyte telomere length in youth. METHOD Data was collected from 108 low-income African-American adolescents (42.6% male; Mage = 14.27 years, SD = 1.17) living in the southeastern USA. Waist circumference was measured during a home interview, and measures of C-reactive protein, insulin resistance, and leukocyte telomere length were obtained from blood following overnight fasting. RESULTS Path analysis supported a main effects model, whereby ACEs were significantly associated with shortened leukocyte telomere length, higher levels of C-reactive protein, and larger waist circumferences, controlling for maternal education and adolescent sex. Exploratory analyses examining whether cardiometabolic risk mediated associations between ACEs and telomere length, or whether telomere length mediated associations between ACEs and cardiometabolic risk, were not supported. CONCLUSIONS ACEs are associated with risk of future cardiometabolic disorders and shortened leukocyte telomere length. Because cytogenetic changes are potentially modifiable, interventions to decrease family ACEs or alter responses to ACEs may lessen chronic disease risk in the African-American population. Targeted interventions to improve health are discussed.
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Affiliation(s)
- Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, USA.
| | - Jo Lynne Robins
- Department of Family and Community Health, School of Nursing, Virginia Commonwealth University, Box 980567, Richmond, VA, 23298-0567, USA
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Abstract
Financial resources are known to affect health outcomes. Many types of social policies and programs, including social assistance and social insurance, have been implemented around the world to increase financial resources. We refer to these as cash transfers. In this article, we discuss theory and evidence on whether, how, for whom, and to what extent purposeful cash transfers improve health. Evidence suggests that cash transfers produce positive health effects, but there are many complexities and variations in the outcomes. Continuing research and policy innovation-for example, universal basic income and universal Child Development Accounts-are likely to be productive.
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Affiliation(s)
- Sicong Sun
- Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA; , ,
| | - Jin Huang
- College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri 63103, USA;
| | - Darrell L Hudson
- Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA; , ,
| | - Michael Sherraden
- Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA; , ,
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20
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Clausing ES, Non AL. Epigenetics as a Mechanism of Developmental Embodiment of Stress, Resilience, and Cardiometabolic Risk Across Generations of Latinx Immigrant Families. Front Psychiatry 2021; 12:696827. [PMID: 34354616 PMCID: PMC8329078 DOI: 10.3389/fpsyt.2021.696827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/16/2021] [Indexed: 12/24/2022] Open
Abstract
Psychosocial stressors can become embodied to alter biology throughout the life course in ways that may have lasting health consequences. Immigrants are particularly vulnerable to high burdens of stress, which have heightened in the current sociopolitical climate. This study is an investigation of how immigration-related stress (IRS) may impact the cardiometabolic risk and epigenetic markers of Latinx immigrant mothers and children in Nashville, TN. We compared stress and resilience factors reported by Latina immigrant mothers and their children (aged 5-13) from two time points spanning the 2016 U.S. presidential election (June 2015-June 2016 baseline, n = 81; March-September 2018 follow-up, n = 39) with cardiometabolic risk markers (BMI, waist circumference, and blood pressure). We also analyzed these factors in relation to DNA methylation in saliva of stress-related candidate genes (SLC6A4 and FKBP5), generated via bisulfite pyrosequencing (complete case n's range from 67-72 baseline and 29-31 follow-up) (n's range from 80 baseline to 36 follow-up). We found various associations with cardiometabolic risk, such as higher social support and greater acculturation were associated with lower BMI in mothers; discrimination and school stress associated with greater waist circumferences in children. Very few exposures associated with FKBP5, but various stressors associated with methylation at many sites in SLC6A4, including immigrant-related stress in both mothers and children, and fear of parent deportation in children. Additionally, in the mothers, total maternal stress, health stress, and subjective social status associated with methylation at multiple sites of SLC6A4. Acculturation associated with methylation in mothers in both genes, though directions of effect varied over time. We also find DNA methylation at SLC6A4 associates with measures of adiposity and blood pressure, suggesting that methylation may be on the pathway linking stress with cardiometabolic risk. More research is needed to determine the role of these epigenetic differences in contributing to embodiment of stress across generations.
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Affiliation(s)
- Elizabeth S Clausing
- Department of Anthropology, University of California San Diego (UCSD), La Jolla, CA, United States
| | - Amy L Non
- Department of Anthropology, University of California San Diego (UCSD), La Jolla, CA, United States
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21
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Rauchwerk A, Vipperman-Cohen A, Padmanabhan S, Parasram W, Burt KG. The Case for a Health at Every Size Approach for Chronic Disease Risk Reduction in Women of Color. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:1066-1072. [PMID: 32948446 DOI: 10.1016/j.jneb.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
The conventional approach to chronic disease management in women of color is a dieting-for-weight-loss approach, which has not been proven to be effective. The purpose of this article is to highlight the shortcomings of the dieting-for-weight-loss approach and demonstrate the potential efficacy of the Health at Every Size approach when working with women of color to prevent and address chronic diseases. The article's areas of focus are weight stigma, bias, and size discrimination; the implications of differing weight perceptions and motivations for change; and weight as the primary determinant of health and biological factors affecting weight.
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Affiliation(s)
- Autumn Rauchwerk
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Anne Vipperman-Cohen
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Sridevi Padmanabhan
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Woheema Parasram
- Program in Nutrition, Health, and Behavior Studies, Teachers College, Columbia University, New York, NY
| | - Kate G Burt
- Dietetics, Foods, and Nutrition, Department of Health Sciences, Lehman College, City University of New York, New York, NY.
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22
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Haire-Joshu D, Schwarz C, Jacob R, Kristen P, Johnston S, Quinn K, Tabak R. Raising Well at Home: a pre-post feasibility study of a lifestyle intervention for caregivers and their child with obesity. Pilot Feasibility Stud 2020; 6:149. [PMID: 33042569 PMCID: PMC7541221 DOI: 10.1186/s40814-020-00692-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 09/21/2020] [Indexed: 01/15/2023] Open
Abstract
Background Few efficacious pediatric obesity interventions have been successfully translated and sustained in real-world practice, often due to inadequate fit with the priorities of under-resourced populations. Lifestyle interventions, which incorporate tailoring of essential weight loss ingredients and adaptation of mode and intensity to the living circumstances of children with obesity, are needed. The purpose of this pilot study was to test the feasibility and efficacy of a tailored lifestyle intervention for caregivers and their children with obesity, conducted in partnership with Envolve, Inc., a family of comprehensive health solutions and wholly owned subsidiary of Centene Corporation. Methods This 6-month pilot study employed a pretest-posttest design to assess the impact of a tailored lifestyle intervention delivered by peer coaches on (a) caregiver and child weight impacted by changes in dietary intake, walking, and screen time; (b) changes in the home environment; and (c) caregiver engagement and satisfaction. The intervention was delivered via 3 core home visits every 4-6 weeks, with additional support via text. Results The majority of caregivers were female (95.2%) and Black (73.7%). Children had median age of 11.1 years and majority were female (57.6%), with a median BMI near the 99th percentile (Mdn 98.8, IQR 3.5) or 118.3% (IQR 35.8) of the 95th percentile for their sex and age. Participants expressed high satisfaction with the program (mean range 96.7-100.0% agreement on satisfaction items). From baseline to post, caregivers' BMI decreased by 1.8% (p = 0.016, r = 0.22), while children's BMI percentile z-score decreased significantly (p = 0.023, r = 0.18) and BMI percent of the 95th percentile remained constant (p = 0.05, r = 0.15). Caregivers and children decreased sugar-sweetened beverage intake (p = 0.026, r = 0.22; p = 0.006, r = 0.23, respectively), reduced presence of soda in the home (p = 0.002, g = 0.43), and decreased screen time (p = 0.046, g = 0.22). Other eating and walking behaviors remained stable for caregivers and child. Conclusion The Raising Well at Home pilot demonstrated that tailored lifestyle interventions, delivered by peer coaches in the home and via text, are feasible and can improve weight, eating, and environmental measures of caregivers and children with obesity. Future work should determine the effectiveness, sustainability, and scalability of this intervention in sites located across the country. Trial registration ClinicalTrials.gov (NCT04224623). Registered 9 January 2020-retrospectively registered.
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Affiliation(s)
- Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA.,Center for Diabetes Translation Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Cindy Schwarz
- Center for Obesity Prevention and Policy Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Rebekah Jacob
- Prevention Research Center in St. Louis, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Pat Kristen
- Centene Center for Health Transformation, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Shelly Johnston
- Center for Diabetes Translation Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Karyn Quinn
- Centene Center for Health Transformation, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Rachel Tabak
- Center for Diabetes Translation Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA.,Prevention Research Center in St. Louis, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
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23
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Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197143. [PMID: 33003573 PMCID: PMC7579470 DOI: 10.3390/ijerph17197143] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Abstract
Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual's perceptions of food swamp and food desert exposure may be related to diet habits among adults.
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Anselma M, Chinapaw MJM, Kornet-van der Aa DA, Altenburg TM. Effectiveness and promising behavior change techniques of interventions targeting energy balance related behaviors in children from lower socioeconomic environments: A systematic review. PLoS One 2020; 15:e0237969. [PMID: 32870928 PMCID: PMC7462275 DOI: 10.1371/journal.pone.0237969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/06/2020] [Indexed: 01/22/2023] Open
Abstract
This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9–12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniëlle A. Kornet-van der Aa
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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25
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Thomson JL, Landry AS, Tussing‐Humphreys LM, Goodman MH. Diet quality of children in the United States by body mass index and sociodemographic characteristics. Obes Sci Pract 2020; 6:84-98. [PMID: 32128246 PMCID: PMC7042025 DOI: 10.1002/osp4.388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/24/2019] [Accepted: 11/03/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The primary objective was to use the Healthy Eating Index-2015 (HEI-2015) to describe diet quality by categories of body mass index (BMI) and by sociodemographic characteristics within categories of BMI using a nationally representative sample of US children. METHODS Dietary datasets from three cycles of the National Health and Nutrition Examination Survey (2009-2014) were analysed for children 2 to 18 years of age (N = 8894). Using the population ratio method, mean and 95% confidence intervals for HEI-2015 total and component scores were computed by BMI (underweight, normal weight, overweight, and obese) and by age (2-5, 6-11, and 12-18 y), gender, race/ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race), and family poverty to income ratio (below and at/above poverty threshold). RESULTS HEI-2015 mean total scores were 50.4, 55.2, 55.1, and 54.0 out of 100 points for children with underweight, normal weight, overweight, and obesity, respectively, and were not significantly different. Within BMI categories, significant differences in total and mean component scores were present for age and race/ethnicity groups. CONCLUSIONS Total and most components of diet quality did not significantly differ among child populations classified by BMI status. Within BMI categories, significant diet quality differences were found for age and race/ethnicity groups, although scores were low for all child groups. Researchers may need to address or target specific dietary components with low quality in various child populations to have the greatest effect on improving nutrition nationwide.
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Affiliation(s)
- Jessica L. Thomson
- US Department of AgricultureAgricultural Research ServiceStonevilleMississippi
| | - Alicia S. Landry
- Department of Family and Consumer SciencesUniversity of Central ArkansasConwayArkansas
| | | | - Melissa H. Goodman
- US Department of AgricultureAgricultural Research ServiceStonevilleMississippi
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Moore CJ, Lindke A, Cox GO. Using Sensory Science to Evaluate Consumer Acceptance of Recipes in a Nutrition Education Intervention for Limited Resource Populations. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:134-144. [PMID: 31446110 DOI: 10.1016/j.jneb.2019.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/15/2019] [Accepted: 07/21/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study evaluated consumer acceptance of recipes in a nutrition education intervention and assessed participants' intentions to change dietary behaviors. DESIGN Study participants tasted and evaluated 16 recipes in the University of Georgia Food Talk curriculum using the 9-point hedonic scale and indicated their likelihood of engaging in behaviors to improve diet quality on a similar, ordinal scale. SETTING AND PARTICIPANTS Convenience samples of 89 to 122 adult participants in the Expanded Food and Nutrition Education Program in Georgia evaluated each recipe. INTERVENTION Eight interactive nutrition education sessions in which study participants sampled and evaluated 2 recipes per session. MAIN OUTCOME MEASURES Mean scores for overall liking of each recipe and likelihood of engaging in promoted behaviors to improve diet quality were outcomes of interest. ANALYSIS Descriptive statistics were generated. Relationships between overall liking of recipes and intention to engage in promoted behaviors were assessed with Spearman correlation coefficients. RESULTS Results showed that 13 of the 16 recipes in the curriculum met criteria for acceptable sensory quality. Overall liking was significantly correlated with participants' intentions to engage in behaviors to improve diet quality. Notable age- and sex-related differences were identified. CONCLUSIONS AND IMPLICATIONS Evaluations of consumer acceptance may be useful in interventions designed to improve diet quality through the introduction of new recipes as improving consumer acceptance of recipes may improve program outcomes.
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Affiliation(s)
- Carla J Moore
- Department of Foods and Nutrition, University of Georgia, Athens, GA.
| | - Allie Lindke
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Ginnefer O Cox
- Department of Foods and Nutrition, University of Georgia, Athens, GA
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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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Messiah SE, Sacher PM, Yudkin J, Qureshi FG, Hoelscher DM, Barlow SE. Partnering Support Interventions with Bariatric Surgery to Maximize Health Outcomes in Adolescents with Severe Obesity. Obesity (Silver Spring) 2019; 27:1784-1795. [PMID: 31562699 DOI: 10.1002/oby.22612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/19/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Rates of adolescents with severe obesity continue to rise worldwide, with concurrent increases in metabolic and bariatric surgery (MBS) uptake. The gap between support (lifestyle, pharmacotherapy) interventions and MBS as treatment options for adolescents has been understudied. This review, couched in a socio-ecological framework, investigates how support interventions for adolescents with severe obesity could be combined or sequenced with MBS to optimize health outcomes. METHODS A comprehensive search revealed 36 published articles between 1995 and 2019 that included the combination of support interventions and MBS among adolescents. RESULTS There were no studies that specifically reported outcomes or effect sizes for the combination of lifestyle intervention with MBS. Previous studies have reported individual results for either lifestyle intervention or MBS but not for their compound effect. CONCLUSIONS As rates of adolescents with severe obesity are on the rise globally, future research should focus on how partnering support interventions with MBS can amplify positive short- and long-term health outcomes and within a socio-ecological framework. Understanding the sequence of these approaches will be of particular importance. High-risk and vulnerable populations such as ethnic minorities who have suffered a disproportionate burden of the obesity epidemic must be included in rigorously tested future trials of combination interventions to maximize health outcomes worldwide.
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Affiliation(s)
- Sarah E Messiah
- University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, Texas, USA
| | - Paul M Sacher
- Childhood Nutrition Research Centre, University College London, London, UK
| | - Joshua Yudkin
- University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, Texas, USA
| | - Faisal G Qureshi
- Division of Pediatric Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Deanna M Hoelscher
- University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, Texas, USA
- Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Sarah E Barlow
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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West DS, Dutton G, Delahanty LM, Hazuda HP, Rickman AD, Knowler WC, Vitolins MZ, Neiberg RH, Peters A, Gee M, Cassidy Begay M. Weight Loss Experiences of African American, Hispanic, and Non-Hispanic White Men and Women with Type 2 Diabetes: The Look AHEAD Trial. Obesity (Silver Spring) 2019; 27:1275-1284. [PMID: 31338998 PMCID: PMC6658112 DOI: 10.1002/oby.22522] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to characterize weight loss, treatment engagement, and weight control strategies utilized by African American, Hispanic, and non-Hispanic white participants in the Action for Health in Diabetes (Look AHEAD) Intensive Lifestyle Intervention by racial/ethnic and sex subgroups. METHODS Weight losses at 1, 4, and 8 years among 2,361 adults with obesity and type 2 diabetes randomized to intervention (31% minority; 42% men) are reported by subgroup. Multivariable models within subgroups examine relative contributions of treatment engagement variables and self-reported weight control behaviors. RESULTS All subgroups averaged weight losses ≥ 5% in year 1 but experienced regain; losses ≥ 5% were sustained at year 8 by non-Hispanic white participants and minority women (but not men). Session attendance was high (≥ 86%) in year 1 and exceeded protocol-specified minimum levels into year 8. Individual session attendance had stronger associations with weight loss among Hispanic and African American participants than non-Hispanic white participants at 4 years (P = 0.04) and 8 years (P = 0.001). Daily self-weighing uptake was considerable in all subgroups and was a prominent factor associated with year 1 weight loss among African American men and women. Greater meal replacement use was strongly associated with poorer 1-year weight losses among African American women. CONCLUSIONS Experiences of minority men and women with diabetes in lifestyle interventions fill important gaps in the literature that can inform treatment delivery.
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Affiliation(s)
- Delia Smith West
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Gareth Dutton
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Linda M Delahanty
- Diabetes Research Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Helen P Hazuda
- Division of Nephrology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Amy D Rickman
- Department of Exercise & Rehabilitative Sciences, Slippery Rock University, Slippery Rock, Pennsylvania, USA
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, NIDDK, Phoenix, Arizona, USA
| | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rebecca H Neiberg
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Anne Peters
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Molly Gee
- Behavioral Medicine Research Center, Baylor College of Medicine, Houston, Texas, USA
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Han P, Nicholson W, Norton A, Graffeo K, Singerman R, King S, Sundaresan A, Bennett W. DiabetesSistersVoices: Virtual Patient Community to Identify Research Priorities for Women Living With Diabetes. J Med Internet Res 2019; 21:e13312. [PMID: 31094360 PMCID: PMC6533875 DOI: 10.2196/13312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 01/16/2023] Open
Abstract
Background Women with or at high risk of diabetes have unique health concerns across their life course. Effective methods are needed to engage women living with diabetes to develop and carry out a patient-centered research agenda. Objective This study aimed to (1) describe the creation of DiabetesSistersVoices, a virtual patient community for women living with and at risk for diabetes and (2) assess the feasibility and acceptability of DiabetesSistersVoices for engaging women in talking about their experiences, health care, and research priorities. Methods We partnered with a national advocacy organization to create DiabetesSistersVoices and to develop recruitment strategies, which included use of social media, Web-based newsletters, and weblinks through partnering organizations. Study inclusion criteria were as follows: Being a woman aged ≥18 years, residing in the United States, and self-reporting a diagnosis of diabetes or risk of diabetes. Eligible participants were given access to DiabetesSistersVoices and completed online surveys at enrollment and 6 months. We assessed trends in participants’ activities, including posting questions, sharing experiences about living with diabetes, and searching for posted resources. Results We enrolled 332 women (white: 86.5%; type 1 diabetes: 76.2%; median age: 51 years [interquartile range: 31 to 59 years]) over 8 months. Most (41.6%, 138/332) were classified as being active users (ie, posting) of the virtual community, 36.1% (120/332) as observers (ie, logged in but no posts), and 22.3% (74/332) as never users (ie, completed baseline surveys but then never logged in). Online activities were constant during the study, although participants had the highest website usage during the first 10 weeks after their enrollment. Conclusions We demonstrated the feasibility and acceptability of an online patient community for women living with diabetes by showing durability of recruitment and online usage over 6 months of testing. Next steps are to address barriers to joining a virtual patient community for women of color and women with type 2 diabetes to enhance inclusiveness and gain diverse perspectives to inform diabetes research.
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Affiliation(s)
- Peijin Han
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Wanda Nicholson
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States.,Public Health Leadership Program, The University of North Carolina School of Medicine and, Gillings Global School of Public Health, Chapel Hill, NC, United States
| | - Anna Norton
- DiabetesSisters, #180, 1112 W Boughton Road, Bolingbrook, IL, United States
| | - Karen Graffeo
- DiabetesSisters, #180, 1112 W Boughton Road, Bolingbrook, IL, United States
| | | | | | - Aditi Sundaresan
- Center for Women's Health Research, Department of Obstetrics and Gynecology, Chapel Hill, NC, United States
| | - Wendy Bennett
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Johns Hopkins University School of Medicin, Division of General Internal Medicine, Baltimore, MD, United States
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Sayer J, Paniagua D, Ballentine S, Sheehan L, Carson M, Nieweglowski K, Corrigan P. Perspectives on diet and physical activity among urban African Americans with serious mental illness. SOCIAL WORK IN HEALTH CARE 2019; 58:509-525. [PMID: 30907271 PMCID: PMC6658098 DOI: 10.1080/00981389.2019.1587662] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/22/2019] [Accepted: 02/22/2019] [Indexed: 06/09/2023]
Abstract
African Americans are burdened by high rates of obesity that contribute to chronic disease and early mortality. To tailor a weight loss intervention to meet the needs of African Americans with serious mental illness, a community-based participatory research (CBPR) team comprised primarily of African Americans with serious mental illness guided qualitative research to understand factors that affect weight and interventions that may diminish obesity. Data from five focus groups (n = 55) were analyzed to better understand this group's needs. Participants voiced individual, social, and structural barriers to maintaining and achieving a healthy weight and provided perspectives on potential solutions.
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Affiliation(s)
- Janis Sayer
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Deysi Paniagua
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Sonya Ballentine
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Lindsay Sheehan
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | - Margaret Carson
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
| | | | - Patrick Corrigan
- a Department of Psychology , Illinois Institute of Technology , Chicago , IL , USA
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Anselma M, Altenburg T, Chinapaw M. Kids in Action: the protocol of a Youth Participatory Action Research project to promote physical activity and dietary behaviour. BMJ Open 2019; 9:e025584. [PMID: 30928943 PMCID: PMC6475341 DOI: 10.1136/bmjopen-2018-025584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/07/2019] [Accepted: 03/05/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION In this study, researchers collaborate with children from a low socioeconomic neighbourhood in Amsterdam in developing, implementing and evaluating interventions targeting their health behaviours. This Youth Participatory Action Research project focuses on the promotion of physical activity and healthy dietary behaviour. METHODS AND ANALYSIS This study is a controlled trial using participatory methods to develop interventions together with children aged 9-12 years. At four primary schools in a low socioeconomic neighbourhood in Amsterdam, an 'Action Team' is installed: a group of six to eight children who actively participate as co-researchers in developing, implementing and evaluating interventions. An academic researcher facilitates the participatory process. Four control schools, also located in low socioeconomic areas in and around Amsterdam, continue with their regular curriculum and do not participate in the participatory process. For the effect evaluation, physical activity and sedentary behaviour are assessed using accelerometers and self-reporting; dietary behaviour using self-reporting and motor fitness (strength, flexibility, coordination, speed and endurance) using the motor performance fitness test. Effectiveness of the interventions is evaluated by multilevel regression analysis. The process of co-creating interventions and the implemented interventions is continually evaluated during meetings of the Action Teams and with children participating in the interventions. Empowerment of children is evaluated during focus groups. Summaries and transcripts of meetings are coded and analysed to enrich children's findings. ETHICS AND DISSEMINATION The Medical Ethics Committee of the VU Medical Center approved the study protocol (2016.366). TRIAL REGISTRATION NUMBER TC=6604.
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Affiliation(s)
- Manou Anselma
- Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske Altenburg
- Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mai Chinapaw
- Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Melius J, Barr-Anderson DJ, Orekoya O. Consideration of Factors Influencing Weight Outcomes among U.S. Racial-Ethnic Minority Populations in the Social Work Literature. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:158-175. [PMID: 30767623 DOI: 10.1080/19371918.2019.1575309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study explores the social work profession's empirical contribution to addressing factors influencing overweight and obesity outcomes among racial-ethnic minority populations in the United States. The high prevalence of obesity in U.S. adults and children, particularly in racial/ethnic minority populations, continues to be an important public health issue. The African American Collaborative Obesity Research Network (AACORN) Expanded Obesity Research Paradigm was used to assess the studies. Constructs in this paradigm identify conceptual and multilevel influences on obesity offering social work practitioners a comprehensive understanding of obesity-related factors in populations of color: cultural and psychosocial processes, historical and social contexts, and physical and economic environments. METHODS A systematic search of obesity-related, social work studies providing data for U.S. racial/ethnic minority populations was conducted in March through July 2013 with updated searches in February 2016 and July 2017. FINDINGS Identified studies were mostly cross-sectional, offering only a snapshot of factors associated with obesity among racial-ethnic minority populations. Articles addressing factors contributing to overweight/obesity were more likely to discuss cultural and psychosocial features and provided limited information about health behaviors embedded in the daily lives of racial-ethnic groups affecting obesity. FUTURE DIRECTIONS Given that social workers' interactions with clients occur in a variety of social services settings, they are in a unique position to assist with developing strategies for facilitating obesity prevention integrating conceptual features outlined by the AACORN paradigm. Practice and policy implications are discussed for social work professionals employed in community settings.
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Affiliation(s)
- Janella Melius
- a Barbara Solomon School of Social Work , Walden University , Minneapolis , Minnesota , USA
| | - Daheia J Barr-Anderson
- b College of Education and Human Development, School of Kinesiology , University of Minnesota System , Minneapolis , Minnesota , USA
| | - Olubunmi Orekoya
- c Department of Pediatrics , Metropolitan Hospital Oregon , New York , New York , USA
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Yeary KHK, Moore PC, Gauss CH, Cornell C, Prewitt TE, Shakya S, Turner J, Scarbrough C, Porter G, Estabrooks PA. Reach and Adoption of a Randomized Weight Loss Maintenance Trial in Rural African Americans of Faith: The WORD (Wholeness, Oneness, Righteousness, Deliverance). Am J Health Promot 2018; 33:549-557. [PMID: 30309257 DOI: 10.1177/0890117118805065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE There is minimal information regarding the Reach and Adoption of evidence-based weight loss maintenance interventions for African Americans of faith. DESIGN The WORD (Wholeness, Oneness, Righteousness, Deliverance) was an 18-month, cluster randomized trial designed to reduce and maintain weight loss in African American adults of faith. Participants received the Diabetes Prevention Program adapted core weight loss program for 6 months, and churches were subsequently randomized to 12-month maintenance treatment or control. All participants underwent body weight and associated behavioral and psychosocial assessments at baseline, 6, 12, and 18 months. The current article focuses on assessing Reach and Adoption at baseline and 6 months using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. SETTING Lower Mississippi Delta. PARTICIPANTS Thirty churches, 61 WORD Leaders (WLs), and 426 participants. INTERVENTION Group delivered by trained community members (WLs). MEASURES Body mass index and percentage weight lost from baseline to 6-month follow-up were measured. Reach was assessed at participant, WL, and church levels through calculating participation rates and sociodemographics of each level. Adoption was assessed at church and WL levels. ANALYSIS Descriptive statistics summarized baseline characteristics of each level. Continuous and categorical end point comparisons were made. RESULTS Participants' participation rate was 0.84 (n = 437 agreed to participate, n = 519 eligible invited to participate); they were predominantly female, employed, and had a mean age of 49.8. Dropouts by 6 months were younger, had differential marital status, and religious attendance compared with retained participants. Church participation rate was 0.63 (n = 30 enrolled, n = 48 eligible approached) and the majority reported ≤100 active members. The WL participation rate was 0.61 (n = 61 implemented intervention, n = 100 eligible approached); they were primarily female and aged 53.9 (mean). CONCLUSION Recruitment, engagement, and delivery strategies employed by the WORD show promise of sustained engagement and adoption in other faith-based behavioral weight management programs for African Americans.
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Affiliation(s)
- Karen H Kim Yeary
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Page C Moore
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - C Heath Gauss
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Carol Cornell
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - T Elaine Prewitt
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Samjhana Shakya
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jerome Turner
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Catherine Scarbrough
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Gwenndolyn Porter
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Paul A Estabrooks
- 1 Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Family TXT: Feasibility and Acceptability of a mHealth Obesity Prevention Program for Parents of Pre-Adolescent African American Girls. CHILDREN-BASEL 2018; 5:children5060081. [PMID: 29921811 PMCID: PMC6025426 DOI: 10.3390/children5060081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 01/28/2023]
Abstract
Obesity prevalence is greater in African American girls than their non-Hispanic white peers. Obesity prevention programs are needed to help parents create an obesity-preventive home environment. This paper reports the feasibility and acceptability of a mHealth child obesity prevention program consisting of self-determination theory-grounded text messages promoting a healthy home food and activity environment to parents of 8–10-year-old African American girls. A one-group design with baseline and immediate post-intervention assessments was utilized. Mothers (n = 19) received 36 text messages over 12 weeks. Feasibility and acceptability were assessed through staff logs and post-intervention surveys and an interview. Feasibility and acceptability criteria were met. Mothers reported positive reactions to the intervention; they liked the program, used the information, and all but one gave it an A or B grade. The majority made changes and shared the text messages with others. This research provides evidence that a theoretically grounded mHealth child obesity prevention intervention is feasible and acceptable to parents of African American girls.
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Mechanisms underlying weight status and healthcare avoidance in women: A study of weight stigma, body-related shame and guilt, and healthcare stress. Body Image 2018; 25:139-147. [PMID: 29574257 DOI: 10.1016/j.bodyim.2018.03.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 11/22/2022]
Abstract
Studies show that women with high BMI are less likely than thinner women to seek healthcare. We aimed to determine the mechanisms linking women's weight status to their healthcare avoidance. Women (N = 313) were surveyed from a U.S. health-panel database. We tested a theory-driven model containing multiple stigma and body-related constructs linking BMI to healthcare avoidance. The model had a good fit to the data. Higher BMI was related to greater experienced and internalized weight stigma, which were linked to greater body-related shame. Internalized weight stigma was also related to greater body-related guilt, which was associated with higher body-related shame. Body-related shame was associated with healthcare stress which ultimately contributed to healthcare avoidance. We discuss recommendations for a Weight Inclusive Approach to healthcare and the importance of enhancing education for health professionals in weight bias in order to increase appropriate use of preventive healthcare in higher weight women.
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Shah SN, Digenis-Bury E, Russo ET, O'Malley S, Blanding N, McHugh A, Wada R. No-cost gym visits are associated with lower weight and blood pressure among non-Latino black and Latino participants with a diagnosis of hypertension in a multi-site demonstration project. Prev Med Rep 2018; 10:66-71. [PMID: 29520336 PMCID: PMC5842286 DOI: 10.1016/j.pmedr.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/22/2018] [Accepted: 02/05/2018] [Indexed: 01/07/2023] Open
Abstract
Well documented, persistent racial/ethnic health disparities in obesity and hypertension in the US demonstrate the continued need for interventions that focus on people of color who may be at higher risk. We evaluated a demonstration project funded by the CDC's Racial/Ethnic Approaches to Community Health (REACH) program at four federally qualified health centers (FQHC) and YMCA fitness and wellness centers in Boston. No-cost YMCA memberships were offered from June 2014 to June 2015 to non-Latino black and Latino adults with a diagnosis of hypertension. YMCA visit data were merged with health data for 224 participants (n = 1265 health center visits). We assessed associations between gym visit frequency and weight, body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) using longitudinal time-varying linear fixed-effects models. The total number of gym visits over the entire program duration was 5.5, while the conditional total number of visits (after the first gym visit has been made) was 17.3. Having visited the gym at least 10 times before an FQHC exam was, on average, associated with lower weight (1.19 kg, p = 0.01), lower BMI (0.43 kg/m2, p = 0.01) and reductions in SBP (-3.20 mm Hg, p = 0.01) and DBP (-2.06 mm Hg p = 0.01). Having visited the gym an average of 1.4 times per month (study average) was associated with reductions in weight, BMI, and DBP. No-cost gym visits were associated with improved weight and blood pressure in hypertensive non-Latino black and Latino adults in this program. Additional evaluation is necessary to assess the sustainability of these effects.
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Affiliation(s)
- Snehal N. Shah
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
- Department of Pediatrics, Boston University School of Medicine, 850 Harrison Ave, Boston, MA 02116, United States
| | - Eleni Digenis-Bury
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
| | - Elizabeth T. Russo
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
| | - Shannon O'Malley
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
| | - Nineequa Blanding
- Chronic Disease Prevention and Control Division, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
| | - Anne McHugh
- Chronic Disease Prevention and Control Division, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
| | - Roy Wada
- Research and Evaluation Office, Boston Public Health Commission, 1010 Massachusetts Ave, 6th Floor, Boston, MA 02118, United States
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Abstract
Effective health promotion among African American women requires knowledge and understanding of cultural influences and practices. This scoping review focused on rest, related concepts, and cultural perspectives and practices. We found a lack of conceptual distinction between fatigue and sleep and limited research on cultural meanings and practices of rest.
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Sutin AR, Boutelle K, Czajkowski SM, Epel ES, Green PA, Hunter CM, Rice EL, Williams DM, Young-Hyman D, Rothman AJ. Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Psychosocial Domain. Obesity (Silver Spring) 2018; 26 Suppl 2:S45-S54. [PMID: 29575781 PMCID: PMC7055940 DOI: 10.1002/oby.22160] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/02/2018] [Accepted: 02/12/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Within the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, the psychosocial domain addresses how psychosocial processes underlie the influence of obesity treatment strategies on weight loss and weight maintenance. The subgroup for the psychosocial domain identified an initial list of high-priority constructs and measures that ranged from relatively stable characteristics about the person (cognitive function, personality) to dynamic characteristics that may change over time (motivation, affect). OBJECTIVES This paper describes (a) how the psychosocial domain fits into the broader model of weight loss and weight maintenance as conceptualized by ADOPT; (b) the guiding principles used to select constructs and measures for recommendation; (c) the high-priority constructs recommended for inclusion; (d) domain-specific issues for advancing the science; and (e) recommendations for future research. SIGNIFICANCE The inclusion of similar measures across trials will help to better identify how psychosocial factors mediate and moderate the weight loss and weight maintenance process, facilitate research into dynamic interactions with factors in the other ADOPT domains, and ultimately improve the design and delivery of effective interventions.
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Affiliation(s)
- Angelina R Sutin
- Department of Behavioral Sciences & Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Kerri Boutelle
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
| | - Susan M Czajkowski
- National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Elissa S Epel
- Department of Psychiatry, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Paige A Green
- National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise L Rice
- National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - David M Williams
- Center for Health Equity Research, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
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Clark DO, Srinivas P, Bodke K, Keith N, Hood S, Tu W. Addressing people and place microenvironments in weight loss disparities (APP-Me): Design of a randomized controlled trial testing timely messages for weight loss behavior in low income Black and White Women. Contemp Clin Trials 2018; 67:74-80. [PMID: 29357313 PMCID: PMC5871572 DOI: 10.1016/j.cct.2018.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/12/2018] [Accepted: 01/18/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Behavioral interventions for weight loss have been less effective in lower income and black women. These poorer outcomes may in part be related to these women having more frequent exposures to social and physical situations that are obesogenic, i.e., eating and sedentary cues or situations. OBJECTIVES Working with obese, lower income Black and White Women, Addressing People and Place Microenvironments (APP-Me) was designed to create awareness of self-behavior at times and places of frequent eating and sedentary behavior. DESIGN APP-Me is being evaluated in a randomized controlled trial with 240 participants recruited from federally qualified health centers located in a single Midwestern city. All participants complete four weeks of ecological momentary assessments (EMA) of situations and behavior. At the end of the four weeks, participants are randomized to enhanced usual care (UC) or UC plus APP-Me. METHODS APP-Me is an automated short messaging system (SMS). Messages are text, image, audio, or a combination, and are delivered to participants' mobile devices with the intent of creating awareness at the times and places of frequent eating or sedentary behavior. The EMA data inform the timing of message deliveries. SUMMARY This project aims to create and test timely awareness messages in a subpopulation that has not responded well to traditional behavioral interventions for weight loss. Novel aspects of the study include the involvement of a low income population, the use of data on time and place of obesogenic behavior, and message delivery time tailored to an individual's behavioral patterns.
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Affiliation(s)
- Daniel O Clark
- Indiana University Center for Aging Research, Indianapolis, IN, United States; Regenstrief Institute, Inc., Indianapolis, IN, United States; Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, United States.
| | | | - Kunal Bodke
- Regenstrief Institute, Inc., Indianapolis, IN, United States
| | - NiCole Keith
- Indiana University Center for Aging Research, Indianapolis, IN, United States; Regenstrief Institute, Inc., Indianapolis, IN, United States
| | - Sula Hood
- Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States
| | - Wanzhu Tu
- Indiana University Center for Aging Research, Indianapolis, IN, United States; Regenstrief Institute, Inc., Indianapolis, IN, United States; Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States
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Cahill AG, Haire-Joshu D, Cade WT, Stein RI, Woolfolk CL, Moley K, Mathur A, Schechtman K, Klein S. Weight Control Program and Gestational Weight Gain in Disadvantaged Women with Overweight or Obesity: A Randomized Clinical Trial. Obesity (Silver Spring) 2018; 26:485-491. [PMID: 29464907 PMCID: PMC5826625 DOI: 10.1002/oby.22070] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/17/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of a home-based lifestyle intervention delivered through Parents as Teachers (PAT) to reduce excessive gestational weight gain (GWG). METHODS This was a single-blinded randomized controlled trial conducted as part of the LIFE-Moms consortium at a single university-based tertiary care institution from October 2012 to March 2016. There were 267 socioeconomically disadvantaged (SED) African American women with overweight or obesity (BMI 25.0-45.0 kg/m2 before pregnancy. Participants were randomized to therapy with standard PAT alone (n = 134) or PAT plus a lifestyle intervention program embedded within the standard PAT program (PAT+) (n = 133). Both interventions were delivered in 10 biweekly home visits during pregnancy. The primary outcome was the percentage of women whose GWG exceeded the Institute of Medicine guidelines, and secondary outcomes included both weekly and total GWG. RESULTS Compared with the standard PAT group in the intent-to-treat analysis, the PAT + group gained less weekly (0.4 kg vs. 0.5 kg/wk; P = 0.04) and total (8.0 kg vs. 9.6 kg; P = 0.02) weight during gestation. Fewer participants in the PAT + group had excessive total GWG (36.1% vs. 45.9%), but the difference between groups was not statistically significant (P = 0.11). CONCLUSIONS PAT + reduced the weekly and total GWG in SED African American women with overweight or obesity at the start of pregnancy.
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Affiliation(s)
- Alison G. Cahill
- Department of Obstetrics and Gynecology, Washington University in St. Louis, 4566 Scott Avenue, Campus Box 8064, St. Louis, Missouri, 63110
| | - Debra Haire-Joshu
- School of Public Health and Medicine, Washington University in St. Louis, One Bookings Drive, Campus Box 1196, St. Louis, Missouri, 63130
| | - W. Todd Cade
- Program in Physical Therapy, Washington University in St. Louis, 4444 Forest Park Avenue, Suite 1101, St. Louis, Missouri 63108
| | - Richard I. Stein
- Center for Human Nutrition, Washington University in St. Louis, 507 South Euclid Avenue, St. Louis, Missouri 63110
| | - Candice L. Woolfolk
- Department of Obstetrics and Gynecology, Washington University in St. Louis, 4566 Scott Avenue, Campus Box 8064, St. Louis, Missouri, 63110
| | - Kelle Moley
- Department of Obstetrics and Gynecology, Washington University in St. Louis, 4566 Scott Avenue, Campus Box 8064, St. Louis, Missouri, 63110
| | - Amit Mathur
- Department of Pediatrics, Washington University in St. Louis, 4566 Scott Avenue, Campus Box 8116, St. Louis, Missouri 63110
| | - Kenneth Schechtman
- Department of Biostatistics, Washington University in St. Louis, 4523 Clayton Road, St. Louis, Missouri 63110
| | - Samuel Klein
- Program in Physical Therapy, Washington University in St. Louis, 4444 Forest Park Avenue, Suite 1101, St. Louis, Missouri 63108
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Campbell-Voytal KD, Hartlieb KB, Cunningham PB, Jacques-Tiura AJ, Ellis DA, Jen KLC, Naar-King S. African American Adolescent-Caregiver Relationships in a Weight Loss Trial. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:835-842. [PMID: 29610562 PMCID: PMC5877412 DOI: 10.1007/s10826-017-0920-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Kimberly D Campbell-Voytal
- Department of Family Medicine & Public Health Sciences, Wayne State University School of Medicine, 3939 Woodward Avenue, #321, Detroit, MI 48201
| | | | | | | | - Deborah A Ellis
- Wayne State University School of Medicine, Detroit, Michigan
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Blackman Carr LT, Samuel-Hodge C, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Racial Differences in Weight Loss Mediated by Engagement and Behavior Change. Ethn Dis 2018; 28:43-48. [PMID: 29467565 DOI: 10.18865/ed.28.1.43] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective We set out to determine if a primarily Internet-delivered behavioral weight loss intervention produced differential weight loss in African American and non-Hispanic White women, and to identify possible mediators. Design Data for this analysis were from a randomized controlled trial, collected at baseline and 4-months. Setting The intervention included monthly face-to-face group sessions and an Internet component that participants were recommended to use at least once weekly. Participants We included overweight or obese African American and non-Hispanic White women (n=170), with at least weekly Internet access, who were able to attend group sessions. Intervention Monthly face-to-face group sessions were delivered in large or small groups. The Internet component included automated tailored feedback, self-monitoring tools, written lessons, video resources, problem solving, exercise action planning tools, and social support through message boards. Main Outcome Measure Multiple linear regression was used to evaluate race group differences in weight change. Results Non-Hispanic White women lost more weight than African American women (-5.03% vs.-2.39%, P=.0002). Greater website log-ins and higher change in Eating Behavior Inventory score in non-Hispanic White women partially mediated the race-weight loss relationship. Conclusions The weight loss disparity may be addressed through improved website engagement and adoption of weight control behaviors.
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Affiliation(s)
- Loneke T Blackman Carr
- The Samuel Dubois Cook Center on Social Equity at Duke University, Durham, North Carolina
| | - Carmen Samuel-Hodge
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Dianne Stanton Ward
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario
| | - Deborah F Tate
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Joseph RP, Coe K, Ainsworth BE, Hooker SP, Mathis L, Keller C. Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration. Front Public Health 2018; 5:367. [PMID: 29404317 PMCID: PMC5777534 DOI: 10.3389/fpubh.2017.00367] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/26/2017] [Indexed: 11/28/2022] Open
Abstract
Background African American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention. Methods A qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m2). Content analysis was used to analyze these focus group data. Results Three key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman’s hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants. Conclusion Findings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.
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Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Kathryn Coe
- Social and Behavioral Sciences Department, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Barbara E Ainsworth
- Exercise Science and Health Promotion Program, School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Steven P Hooker
- Exercise Science and Health Promotion Program, School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - LaTanya Mathis
- Previously Affiliated with Arizona State University, Phoenix, AZ, United States
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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Cassidy O, Eichen DM, Burke NL, Patmore J, Shore A, Radin RM, Sbrocco T, Shomaker LB, Mirza N, Young JF, Wilfley DE, Tanofsky-Kraff M. Engaging African American Adolescents and Stakeholders to Adapt Interpersonal Psychotherapy for Weight Gain Prevention. JOURNAL OF BLACK PSYCHOLOGY 2017. [DOI: 10.1177/0095798417747142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Developing culturally appropriate obesity prevention programs for African American (AA) adolescent girls that account for psychological risk factors is paramount to addressing health disparities. The current study was part of an investigation utilizing a community-based participatory research framework to gather qualitative data from urban AA girls, their caregivers, and community health liaisons to develop a novel obesity prevention program based on interpersonal psychotherapy for the prevention of excessive weight gain (IPT-WG). In the current study with urban AAs, data from seven focus groups (total sample size, N = 40) were analyzed using thematic analysis. Participants identified problematic eating behaviors, including binge or loss of control eating; highlighted the importance of interpersonal relationships, mood functioning, and eating; and supported the tenets of IPT-WG. While features of IPT-WG generally resonated with participants, culturally based modifications were suggested. These data will be used to inform the development of a culturally relevant IPT-WG program.
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Affiliation(s)
- Omni Cassidy
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Dawn M. Eichen
- Washington University School of Medicine, St. Louis, MO, USA
| | - Natasha L. Burke
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Allison Shore
- Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel M. Radin
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tracy Sbrocco
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Nazrat Mirza
- Children’s National Health System, Washington, DC, USA
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Yingling LR, Mitchell V, Ayers CR, Peters-Lawrence M, Wallen GR, Brooks AT, Troendle JF, Adu-Brimpong J, Thomas S, Henry J, Saygbe JN, Sampson DM, Johnson AA, Graham AP, Graham LA, Wiley KL, Powell-Wiley T. Adherence with physical activity monitoring wearable devices in a community-based population: observations from the Washington, D.C., Cardiovascular Health and Needs Assessment. Transl Behav Med 2017; 7:719-730. [PMID: 28097627 PMCID: PMC5684058 DOI: 10.1007/s13142-016-0454-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Wearable mobile health (mHealth) technologies offer approaches for targeting physical activity (PA) in resource-limited, community-based interventions. We sought to explore user characteristics of PA tracking, wearable technology among a community-based population within a health and needs assessment. In 2014-2015, we conducted the Washington, D.C., Cardiovascular Health and Needs Assessment in predominantly African-American churches among communities with higher obesity rates and lower household incomes. Participants received a mHealth PA monitor and wirelessly uploaded PA data weekly to church data collection hubs. Participants (n = 99) were 59 ± 12 years, 79% female, and 99% African-American, with a mean body mass index of 33 ± 7 kg/m2. Eighty-one percent of participants uploaded PA data to the hub and were termed "PA device users." Though PA device users were more likely to report lower household incomes, no differences existed between device users and non-users for device ownership or technology fluency. Findings suggest that mHealth systems with a wearable device and data collection hub may feasibly target PA in resource-limited communities.
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Grants
- HHSN268201400023C NHLBI NIH HHS
- ZIA HL006168 Intramural NIH HHS
- Division of Intramural Research, National Heart, Lung, and Blood Insitute, USA
- Division of Intramural Research, National Heart, Lung, and Blood Institute, USA
- Office of Intramural Training and Education, National Institutes of Health, USA
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Affiliation(s)
- Leah R Yingling
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Valerie Mitchell
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Colby R Ayers
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marlene Peters-Lawrence
- Office of the Clinical Director, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Gwenyth R Wallen
- Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alyssa T Brooks
- Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - James F Troendle
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joel Adu-Brimpong
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Samantha Thomas
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - JaWanna Henry
- Office of the National Coordinator for Health Information Technology, Washington, DC, USA
| | - Johnetta N Saygbe
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Dana M Sampson
- Office of Minority Health, U.S. Department of Health and Human Services, Rockville, MD, USA
| | - Allan A Johnson
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Avis P Graham
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Lennox A Graham
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Kenneth L Wiley
- Division of Genomic Medicine, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tiffany Powell-Wiley
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA.
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Hartz J, Yingling L, Powell-Wiley TM. Use of Mobile Health Technology in the Prevention and Management of Diabetes Mellitus. Curr Cardiol Rep 2017; 18:130. [PMID: 27826901 DOI: 10.1007/s11886-016-0796-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality globally, with diabetes being an independent risk factor. Adequate diabetes management has proven to be resource-intensive, requiring frequent lab work, primary care and specialist visits, and time-consuming record-keeping by the patient and care team. New mobile health (mHealth) technologies have enhanced how diabetes is managed and care is delivered. While more recent work has investigated mHealth devices as complementary tools in behavioral interventions for diabetes prevention and management, little is still known about the effectiveness of mHealth technology as stand-alone intervention tools for reducing diabetes risk. In addition, more work is needed to identify the role of mHealth technology in treating vulnerable populations to ameliorate cardiovascular health disparities. With advances in mobile health technology development for diabetes prevention and management, these modalities will likely play an increasingly prominent role in reducing cardiometabolic risk for the US population.
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Affiliation(s)
- Jacob Hartz
- Department of Cardiology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC, 20010, USA
| | - Leah Yingling
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10, 5-3330, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Tiffany M Powell-Wiley
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10, 5-3330, 10 Center Drive, Bethesda, MD, 20892, USA.
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Venditti EM. Behavioral lifestyle interventions for the primary prevention of type 2 diabetes and translation to Hispanic/Latino communities in the United States and Mexico. Nutr Rev 2017; 75:85-93. [PMID: 28049753 DOI: 10.1093/nutrit/nuw041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Lifestyle behaviors in overweight and obese individuals are closely linked to the development, course, and outcomes of type 2 diabetes and multiple comorbid health conditions. Behavior change theory and many randomized controlled studies offer strong support for screening and identifying adults at increased cardiometabolic risk and for providing early intervention to mitigate risk factors to prevent or delay the onset of disease. The current article reviews key lifestyle intervention efficacy and dissemination trials conducted with individuals deemed to be at increased risk for diabetes and describes the rationale for training teams of professionals and community health workers (e.g., promotores [in Spanish]) to implement comprehensive programs, with fidelity, in a variety of medical care and community settings. This evidence-based road map may be used to facilitate the design and implementation of strategies for structured behavioral diabetes risk reduction programs in the public and private healthcare sectors and other relevant community-based platforms serving individuals of Hispanic/Latino origin in the United States and Mexico.
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Affiliation(s)
- Elizabeth M Venditti
- E.M. Venditti is with the Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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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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Whitt-Glover MC, Goldmon MV, Gizlice Z, Heil DP, Karanja N. Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life: A Church-Based Physical Activity Intervention - Baseline Participant Characteristics. Ethn Dis 2017; 27:257-264. [PMID: 28811737 DOI: 10.18865/ed.27.3.257] [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: 11/18/2022] Open
Abstract
OBJECTIVE Physical activity (PA) is beneficial for health, yet most African American women do not achieve recommended levels. Successful, sustainable strategies could help to address disparities in health outcomes associated with low levels of PA. The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-based and a secular intervention for increasing PA with a self-guided control group. DESIGN SETTING AND PARTICIPANTS This cluster randomized, controlled trial was conducted from 2010 - 2011 in African American churches (n=31) in suburban North Carolina. Participants were 469 self-identified low active African American women. MEASURES Baseline data were collected on participant demographics, objective and self-reported PA, and constructs related to social ecological theory and social cognitive theory. RESULTS Complete baseline data were available for 417 participants who were aged 51.4 ± 12.9 years, with average BMI (kg/m2) 35.8 ± 9.9; 73% of participants were obese (BMI >30). Participants averaged 3,990 ± 1,828 pedometer-assessed daily steps and 23.9 ± 37.7 accelerometer-assessed minutes of daily moderate-to-vigorous PA, and self-reported 25.4 ± 45.4 minutes of weekly walking and moderate- and vigorous-intensity PA. Baseline self-reported religiosity and social support were high. CONCLUSIONS L.A.D.I.E.S. is one of the largest PA trials focused on individual behavior change in African American women. Baseline characteristics suggest participants are representative of the general population. Findings from the study will contribute toward understanding appropriate strategies for increasing PA in high-risk populations.
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Affiliation(s)
| | | | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniel P Heil
- Exercise Physiology, Montana State University, Bozeman, MT
| | - Njeri Karanja
- Center for Health Research, Kaiser Permanente, Portland, OR
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