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Williams LB, Moser DK, Gustafson A, Waters TM, Rayens MK, Karle ER, Kriska AM. Reaching high-risk Black adults for diabetes prevention programming during a pandemic: The design of Fit & Faithful a randomized controlled community trial. Contemp Clin Trials 2022; 123:106973. [PMID: 36334705 PMCID: PMC10155857 DOI: 10.1016/j.cct.2022.106973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 10/14/2022] [Accepted: 10/20/2022] [Indexed: 11/08/2022]
Abstract
Obesity is a key risk factor for Type 2 diabetes (T2D). Alarmingly, 87% of US adults have overweight or obesity, with non-Hispanic black adults having higher obesity and T2D prevalence than non-Hispanic white. The Diabetes Prevention Program (DPP) demonstrated the clinical benefits of lifestyle intervention (LI). While the DPP LI is effective, some participants don't achieve clinically significant weight loss in the current group-based translation paradigm. Black adults have the lowest adjusted weight loss (3.2%) among all racial/ethnic groups. Early intervention nonresponse defined as ≤1% weight loss at intervention week 4 is linked to lower probability of achieving weight loss goals. This paper describes the design and methods of a cluster randomized controlled trial among black weight loss nonresponders nested in 20 community sites (primarily churches). Descriptions of the adaptations made to transition the program to virtual format during the COVID-19 pandemic are also included. Trained community health workers deliver a group-based, 6-month long DPP over 18 sessions via Zoom. Additionally, nonresponders in the enhanced group receive weekly telephone support to provide individual-level intervention to help overcome weight loss barriers. Outcomes include weight, physical activity level, blood pressure, and dietary behaviors; these are compared between nonresponders in the enhanced intervention group and nonresponders in the active control group. Cost, mediators, and moderators are explored. If found to efficacious, these enhanced strategies could be standardized as a supplement for use with DPP nonresponders.
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Affiliation(s)
- Lovoria B Williams
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States.
| | - Debra K Moser
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States
| | - Alison Gustafson
- University of Kentucky, College of Agriculture, Department of Dietetics and Human Nutrition, 206g Funkhouser, Lexington, KY 40536, United States
| | - Teresa M Waters
- University of Kentucky, College of Public Health Department of Health Management and Policy, 111 Washington Avenue, Lexington, KY 40536, United States
| | - Mary Kay Rayens
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States; University of Kentucky, College of Public Health Department of Health Management and Policy, 111 Washington Avenue, Lexington, KY 40536, United States
| | - Erika R Karle
- University of Kentucky, College of Nursing, 751 Rose Street, Lexington, KY 40536, United States
| | - Andrea M Kriska
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, 130 Desoto Street, Pittsburgh, PA 15261, United States
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Reid R. Faith Community Nursing: Improving Self-Care in Minority Church Members Through Patient Activation. J Christ Nurs 2022; 39:E35-E40. [PMID: 35255040 DOI: 10.1097/cnj.0000000000000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Spirituality and faith, which are cornerstones of African American churches, also create a receptive setting for health improvement activities. This article presents participant responses to a health improvement intervention to promote church members' self-care. Using the Body & Soul program, the faith community nurse involved laypersons as health ministry team members to support urban African American churchgoers in learning and practicing healthier eating and self-care practices. The health intervention used the Patient Activation Measure (PAM) and incorporated Scripture into weekly sessions, revealing an increase in participants' self-care activation activities.
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Affiliation(s)
- Roxanne Reid
- Roxanne Reid, DNP, MSN-Ed, RN, is an associate professor in the College of Nursing, University of Missouri-St. Louis, teaching in undergraduate and graduate programs. She has 23 years of experience as a clinical nurse and nurse educator in institutional and academic settings
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Chopra S, Ranjan P, Malhotra A, Sarkar S, Kumari A, Kaloiya GS, Dwivedi SN, Siddhu A, Vikram NK. Identification of instruments for evaluation of behavioural and psychological parameters associated with obesity management: A systematic review with narrative synthesis of the findings. Diabetes Metab Syndr 2022; 16:102350. [PMID: 34920204 DOI: 10.1016/j.dsx.2021.102350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/31/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS To identify instruments used to evaluate the predictors of successful weight loss across weight loss trials. METHODS We searched PubMed, PsychInfo, Cochrane Reviews and Scopus for weight loss trials reporting instruments published in the last 16 years. RESULTS A total of 46 significant behavioral and psychological predictors were identified, of which 32 instruments were finally selected. SF-36 questionnaire and Obesity Related Problem Scale for psychosocial health, TREMORE scale for motivation, Social Support Scale for support, Weight Efficacy Lifestyle Scale for self-efficacy and Body Shape Questionnaire for body image had moderate quality. Barriers to healthy eating questionnaire scale and Dutch Eating Behavior also had moderate quality. CONCLUSION Use of uniform instruments with optimum quality can benefit clinical and community-based researchers to generate reliable datasets.
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Affiliation(s)
- Sakshi Chopra
- University of Delhi, Department of Home Science, New Delhi, India
| | - Piyush Ranjan
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India.
| | - Anita Malhotra
- Lakshmibai College, University of Delhi, Department of Home Science, New Delhi, India
| | - Siddharth Sarkar
- All India Institute of Medical Sciences, Department of Psychiatry, New Delhi, India
| | - Archana Kumari
- All India Institute of Medical Sciences, Department of Obstetrics and Gynaecology, New Delhi, India
| | | | - S N Dwivedi
- All India Institute of Medical Sciences, Department of Biostatistics, New Delhi, India
| | - Anupa Siddhu
- University of Delhi, Department of Home Science, New Delhi, India
| | - Naval K Vikram
- All India Institute of Medical Sciences, Department of Medicine, New Delhi, India
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Mama SK, Bhuiyan N, Chaoul A, Cohen L, Fagundes CP, Hoover DS, Strong LL, Li Y, Nguyen NT, McNeill LH. Feasibility and acceptability of a faith-based mind-body intervention among African American adults. Transl Behav Med 2021; 10:928-937. [PMID: 30476343 DOI: 10.1093/tbm/iby114] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Physical activity reduces cancer risk, yet African American adults remain insufficiently active, contributing to cancer health disparities. Harmony & Health (HH) was developed as a culturally adapted mind-body intervention to promote physical activity, psychosocial well-being, and quality of life among a church-based sample of overweight/obese, insufficiently active African American adults. Men and women were recruited to the study through an existing church partnership. Eligible participants (N = 50) were randomized to a movement-based mind-body intervention (n = 26) or waitlist control (n = 24). Participants in the intervention attended 16 mind-body sessions over 8 weeks and completed a physical assessment, questionnaires on moderate-to-vigorous physical activity (MVPA) and psychosocial factors, and accelerometry at baseline (T1), post-intervention (T2), and 6 week follow-up (T3). Eighty percent of participants (94% women, M age = 49.7 ± 9.4 years, M body mass index = 32.8 ± 5.2 kg/m2) completed the study, and 61.5% of intervention participants attended ≥10 mind-body sessions. Participants self-reported doing 78.8 ± 102.9 (median = 40.7, range: 0-470.7) min/day of MVPA and did 27.1 ± 20.7 (median = 22.0, range: 0-100.5) min/day of accelerometer-measured MVPA at baseline. Trends suggest that mind-body participants self-reported greater improvements in physical activity and psychosocial well-being from baseline to post-intervention than waitlist control participants. HH is feasible and acceptable among African American adults. Trends suggest that the mind-body intervention led to improvements in physical activity and psychosocial outcomes. This study extends the literature on the use of mind-body practices to promote physical and psychological health and reduce cancer disparities in African American adults.
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Affiliation(s)
- Scherezade K Mama
- Department of Kinesiology, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Nishat Bhuiyan
- Department of Kinesiology, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - Alejandro Chaoul
- Department of Palliative, Rehabilitation, and Integrative Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Diana S Hoover
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Larkin L Strong
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nga T Nguyen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorna H McNeill
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Blankinship LA, Rouse WA, Bernstein J, Kruk J, Aboul-Enein BH. A Narrative Review of Ethnic Minority Studies for Faith-Based Health Promotion Interventions with Special Reference to the Contemporary Christian Nurse. JOURNAL OF RELIGION AND HEALTH 2021; 60:1375-1387. [PMID: 33400145 DOI: 10.1007/s10943-020-01150-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
Heart disease, diabetes mellitus (DM) type 2, and obesity are three of the most prevalent diseases in the USA. Some obesity-related comorbidities are disproportionately higher within African-American and Hispanic communities. While governmental and local health programs offer educational opportunities encouraging long-term health behavior changes, the most accessible programs have been through faith-based communities. This narrative review investigates the outcomes of faith-based wellness programs on Latino and African-American populations with respect to general health and wellness, obesity management, DM type 2, and hypertension. Perceived authority of faith community nurses, faith leaders, and accountability and encouragement provided by faith communities are critical. Long-term behavior change is positively affected by elements faith-based organizations can provide: cultural appropriateness, community support, and self-efficacy.
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Affiliation(s)
- Lisa A Blankinship
- Department of Biology, University of North Alabama, 1 Harrison Plaza, Florence, AL, USA
| | - William A Rouse
- Anderson College of Nursing and Health Professions, University of North Alabama, Florence, AL, 35632, USA
| | - Joshua Bernstein
- College of Graduate Health Studies, A.T. Still University of Health Sciences, 800 W. Jefferson St., Kirksville, MO, 63501, USA
| | - Joanna Kruk
- Faculty of Physical Culture and Health Promotion, University of Szczecin, Al. Piastów 40b/6, 71-065, Szczecin, Poland
| | - Basil H Aboul-Enein
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
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Li JB, Qiu ZY, Liu Z, Zhou Q, Feng LF, Li JD, Zhang X. Gender Differences in Factors Associated with Clinically Meaningful Weight Loss among Adults Who Were Overweight or Obese: A Population-Based Cohort Study. Obes Facts 2021; 14:108-120. [PMID: 33352568 PMCID: PMC7983648 DOI: 10.1159/000512294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/25/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES The impact of heterogeneity on gender difference for achieving clinically meaningful weight loss (cmWL) remains unclear. Here, we explored the potential gender differences in factors associated with cmWL. METHODS A total of 60,668 participants with body mass index (BMI) ≥25 kg/m2 at study entry and available BMI values at follow-up were included in this study. cmWL was defined as a weight loss of ≥5% from the study entry to follow-up. The associations of social-demographic factors, personal history of chronic diseases, lifestyle behaviors, and history of BMI with cmWL were evaluated using logistic regression models. RESULTS During a median follow-up of 9.13 years, 26.6% of the participants had a cmWL (30.8% for females vs. 23.1% in males; p < 0.001). Participants with older age, obesity at study entry, being more physical activity compared to 10 years ago, being relapsed smokers or consistent current smokers, having a history of chronic diseases (i.e., diabetes, osteoporosis, and stroke), cancer diagnosis during the study period, and more than 10-year follow-up were more likely to achieve cmWL in both males and females (all p < 0.05). The new smoking quitters and participants with less active in physical activity compared to 10 years ago were less likely to achieve cmWL in both males and females (all p < 0.05). Specifically, males with a history of emphysema were more likely to reach cmWL, and for females, those being overweight at 20 years old and current drinkers were more likely to reach cmWL (p < 0.05). Sensitivity analyses demonstrated similar results. CONCLUSION Age, BMI status, physical activity, smoking status, family income, and health status were independent factors in males and females for weight management. However, further well-designed prospective studies are warranted to confirm our findings.
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Affiliation(s)
- Ji-Bin Li
- Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhi-Yu Qiu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhen Liu
- Department of Rehabilitation Medicine, The First People's Hospital of Foshan, Foshan, China
| | - Qian Zhou
- Clinical Research Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Li-Fen Feng
- Department of Statistics, Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, China
| | - Jun-Dong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- **Jun-Dong Li, Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Dong Feng East Road 651, Guangzhou 510060 (PR China),
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Xi Zhang, Clinical Research Unit, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Kejiao Building 233B, Shanghai 200092 (PR China),
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Fostering African-American Improvement in Total Health (FAITH!): An Application of the American Heart Association's Life's Simple 7™ among Midwestern African-Americans. J Racial Ethn Health Disparities 2016; 4:269-281. [PMID: 27059054 DOI: 10.1007/s40615-016-0226-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/17/2016] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE African-Americans have a strikingly low prevalence of ideal cardiovascular health metrics of the American Heart Association's Life's Simple 7 (LS7). This study was conducted to assess the impact of a community-based cardiovascular disease prevention intervention on the knowledge and achievement of cardiovascular health metrics among a marginalized African-American community. METHODS Adult congregants (n = 37, 70 % women) from three African-American churches in Rochester, MN, participated in the Fostering African-American Improvement in Total Health (FAITH!) program, a theory-based, culturally-tailored, 16-week education series incorporating the American Heart Association's LS7 framework. Feasibility testing included assessments of participant recruitment, program attendance, and retention. We classified participants according to definitions of ideal, intermediate, and poor cardiovascular health based on cardiac risk factors and health behaviors and calculated an LS7 score (range 0 to 14) at baseline and post-intervention. Knowledge of cardiac risk factors was assessed by questionnaire. Main outcome measures were changes in cardiovascular health knowledge and cardiovascular health components related to LS7 from baseline to post-intervention. Psychosocial measures included socioeconomic status, outlook on life, self-reported health, self-efficacy, and family support. RESULTS Thirty-six out of 37 recruited participants completed the entire program including health assessments. Participants attended 63.5 % of the education series and attendance at each session was, on average, 62 % of those enrolled. There was a statistically significant improvement in cardiovascular health knowledge (p < 0.02). A higher percentage of participants meeting either ideal or intermediate LS7 score categories and a lower percentage within the poor category were observed. Higher LS7 scores correlated with higher psychosocial measures ratings. CONCLUSIONS Although small, our study suggests that the FAITH! program is a feasible, community intervention promoting ideal cardiovascular health that has the potential to improve cardiovascular health literacy and LS7 among African-Americans.
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