1
|
Seguin-Fowler RA, Hanson KL, Villarreal D, Rethorst CD, Ayine P, Folta SC, Maddock JE, Patterson MS, Marshall GA, Volpe LC, Eldridge GD, Kershaw M, Luong V, Wang H, Kenkel D. Evaluation of a civic engagement approach to catalyze built environment change and promote healthy eating and physical activity among rural residents: a cluster (community) randomized controlled trial. BMC Public Health 2022; 22:1674. [PMID: 36058913 PMCID: PMC9441047 DOI: 10.1186/s12889-022-13653-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prior studies demonstrate associations between risk factors for obesity and related chronic diseases (e.g., cardiovascular disease) and features of the built environment. This is particularly true for rural populations, who have higher rates of obesity, cancer, and other chronic diseases than urban residents. There is also evidence linking health behaviors and outcomes to social factors such as social support, opposition, and norms. Thus, overlapping social networks that have a high degree of social capital and community cohesion, such as those found in rural communities, may be effective targets for introducing and maintaining healthy behaviors. METHODS This study will evaluate the effectiveness of the Change Club (CC) intervention, a civic engagement intervention for built environment change to improve health behaviors and outcomes for residents of rural communities. The CC intervention provides small groups of community residents (approximately 10-14 people) with nutrition and physical activity lessons and stepwise built environment change planning workshops delivered by trained extension educators via in-person, virtual, or hybrid methods. We will conduct process, multilevel outcome, and cost evaluations of implementation of the CC intervention in a cluster randomized controlled trial in 10 communities across two states using a two-arm parallel design. Change in the primary outcome, American Heart Association's Life's Simple 7 composite cardiovascular health score, will be evaluated among CC members, their friends and family members, and other community residents and compared to comparable samples in control communities. We will also evaluate changes at the social/collective level (e.g., social cohesion, social trust) and examine costs as well as barriers and facilitators to implementation. DISCUSSION Our central hypothesis is the CC intervention will improve health behaviors and outcomes among engaged citizens and their family and friends within 24 months. Furthermore, we hypothesize that positive changes will catalyze critical steps in the pathway to improving longer-term health among community residents through improved healthy eating and physical activity opportunities. This study also represents a unique opportunity to evaluate process and cost-related data, which will provide key insights into the viability of this approach for widespread dissemination. TRIAL REGISTRATION ClinicalTrials.gov: NCT05002660 , Registered 12 August 2021.
Collapse
Affiliation(s)
- Rebecca A. Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife, College Station, TX 77843 USA
| | - Karla L. Hanson
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Deyaun Villarreal
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Chad D. Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Priscilla Ayine
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Sara C. Folta
- grid.429997.80000 0004 1936 7531Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02155 USA
| | - Jay E. Maddock
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Megan S. Patterson
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Grace A. Marshall
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Leah C. Volpe
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Galen D. Eldridge
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Meghan Kershaw
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Vi Luong
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Hua Wang
- grid.5386.8000000041936877XJeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY 14853 USA
| | - Don Kenkel
- grid.5386.8000000041936877XJeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY 14853 USA
| |
Collapse
|
2
|
Baker BS, Miller K, Weitzel KJ, Duren DL, Gammon R, Mills-Gray S, Ball SD. Resistance Training Reduces Age- and Geography-Related Physical Function Discrepancies in Older Adults. Gerontol Geriatr Med 2021; 7:2333721421992251. [PMID: 33614831 PMCID: PMC7868454 DOI: 10.1177/2333721421992251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
Comorbidities affecting physical function increase with advanced-age and rural living. This study investigated the degree of benefit from resistance training (RT) in older adults based on age (50-89 years), location (urban vs. rural), and program duration (10 vs. 8-weeks). 260 participants completed pre- and post-program dynamic and static tasks and flexibility testing. Paired and independent t-tests and one-way and repeated measures ANOVAs were used to test group improvements. All ages improved performance (all p ≤ .002) but those in their 50's improved flexibility the most and those in their 60's improved 30STS more and tandem balance less than those in their 80's. Both rural and urban participants improved in all areas (all p ≤ .002), but rural participants reported greater improvements in tandem balance. Both 10- and 8-week classes improved performance (all p ≤ .001), but 8-week participants improved dynamic tasks and tandem balance more. RT can reduce functional discrepancies in older adults and rural residents.
Collapse
|
4
|
Cheong SM, Mohamad Nor NS, Ahmad MH, Manickam M, Ambak R, Shahrir SN, Aris T. Improvement of health literacy and intervention measurements among low socio-economic status women: findings from the MyBFF@home study. BMC WOMENS HEALTH 2018; 18:99. [PMID: 30066659 PMCID: PMC6069691 DOI: 10.1186/s12905-018-0596-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Health literacy (HL) consists of different components and associates with several health outcomes, including obesity. It is linked to an individual’s knowledge, motivation, competencies, behavior, and application to everyday life. The present study aimed to determine the change of HL scores and to investigate the difference of intervention outcomes at the weight loss (WL) intervention and WL maintenance phase between the HL groups. Methods A total of 322 participants from the MyBFF@home study completed the Newest Vital Sign (NVS) test at baseline. However, only data from 209 participants who completed the NVS test from baseline to WL intervention were used to determine the HL groups. Change of the NVS scores from baseline to WL intervention phase was categorized into two groups: those with HL improvement (increased 0.1 score and above) and those without HL improvement (no change or decreased 0.1 score and more). Independent variables in this study were change of energy intake, nutrient intake, physical activity, anthropometry measurements, and body composition measurements between baseline and WL intervention as well as between WL intervention and WL maintenance. An Independent sample t-test was used in the statistical analysis. Results In general, both intervention and control participants have low HL. The study revealed that the intervention group increased the NVS mean score from baseline (1.19 scores) to the end of the WL maintenance phase (1.51 scores) compared to the control group. There was no significant difference in sociodemographic characteristics between the group with HL improvement and the group without HL improvement at baseline. Most of the dietary intake measurements at WL intervention were significantly different between the two HL groups among intervention participants. Physical activity and body composition did not differ significantly between the two HL groups among both intervention and control groups. Conclusion There was an improvement of HL during the WL intervention and WL maintenance phase in intervention participants compared to control participants. HL shows positive impacts on dietary intake behavior among intervention participants. New research is suggested to explore the relationship between HL and weight loss behaviors in future obesity intervention studies.
Collapse
Affiliation(s)
- Siew Man Cheong
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Centre for Nutrition Epidemiology Research, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia.
| | - Noor Safiza Mohamad Nor
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Centre for Nutrition Epidemiology Research, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Mohamad Hasnan Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Centre for Nutrition Epidemiology Research, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Mala Manickam
- Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Sungai Besi, Kuala Lumpur, Malaysia
| | - Rashidah Ambak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Centre for Nutrition Epidemiology Research, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Siti Nurbaya Shahrir
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Centre for Nutrition Epidemiology Research, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| |
Collapse
|