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Campbell LE, Gomersall SR, Tsiamis M, Goode AD, Healy GN. Understanding diabetes risk in the Y Community of Greater Brisbane: Findings from a cross-sectional survey. Health Promot J Austr 2024. [PMID: 38866388 DOI: 10.1002/hpja.889] [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: 12/06/2023] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND This cross-sectional study aimed to understand the need and desire for a diabetes prevention program within the Y (formerly YMCA: Young Men's Christian Association) of the Greater Brisbane region, Queensland, Australia. METHODS An anonymous online survey was distributed (March-April 2023) by The Y Queensland targeting adults within the Greater Brisbane Y community. Data were collected on Y membership and branch attended, postcode, diabetes risk in the next 5 years (low, medium, or high), and interest in participation in a diabetes prevention program. Data were analysed via descriptives and cross tabulation with statistical significance considered at p < .05. RESULTS Respondents (n = 575) were primarily female (65%), attending a Y branch located in the outer city (51%), and aged under 55 years (68%). Twenty Y sites were represented, with a mix of inner-city, outer-city, and regional areas. Overall, 46% (n = 241/530) of respondents were at high diabetes risk, with those living in relatively socio-economically disadvantaged areas more likely (p < .001) to be at high-risk (57%) than intermediate (26%) or low-risk (18%). Most (68%) respondents were interested/potentially interested in program participation; those at high risk of developing diabetes in the next 5 years were most interested (55%). CONCLUSIONS The Y in Greater Brisbane may provide a suitable setting to host a community-based diabetes prevention program. Locations outside the inner city should be prioritised to target those who are relatively socio-economically disadvantaged to align with higher need and demand. SO WHAT?: Findings inform the implementation and prioritisation of a community-delivered diabetes prevention program.
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Affiliation(s)
- Lucy E Campbell
- The University of Queensland, School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research Innovation, Brisbane, Australia
| | - Sjaan R Gomersall
- The University of Queensland, School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research Innovation, Brisbane, Australia
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | | | - Ana D Goode
- The University of Queensland, School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research Innovation, Brisbane, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research Innovation, Brisbane, Australia
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2
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Hopkins SE, Orr E, Boyer BB, Thompson B. Culturally adapting an evidence-based intervention to promote a healthy diet and lifestyle for Yup'ik Alaska native communities. Int J Circumpolar Health 2023; 82:2159888. [PMID: 36544274 PMCID: PMC9788688 DOI: 10.1080/22423982.2022.2159888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Underserved populations are at increased risk for obesity and related cardiovascular disease, type 2 diabetes, and other chronic diseases. Lack of access to healthy foods, sedentary behaviour, and other social environmental factors contribute to disease risk. Yup'ik Alaska Native communities are experiencing lifestyle changes that are likely to affect their cardiometabolic risks. Barrera & Castro's Cultural Adaptation Framework was used to adapt an evidence-based intervention (EBI) originally designed for Latino communities for use in Yup'ik communities. Focus groups and key informant interviews were held in two Yup'ik communities. Major themes included causes of obesity, barriers and facilitators to healthy foods and physical activity, and intervention ideas. The adaptation process was guided by a Community Planning Group of Yup'ik women and included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. Two of the adapted educational modules were pilot tested. Involving community members as co-researchers in cultural adaptation is vital for an EBI to be effective in another population. Small group gatherings led by local lay health workers are culturally appropriate and may be an effective health promotion model in Yup'ik communities. Social environmental factors affecting healthy food availability and physical activity need further exploration.
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Affiliation(s)
- Scarlett E. Hopkins
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Eliza Orr
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Bert B. Boyer
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Beti Thompson
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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3
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The Role of Black Pastors in Disseminating COVID-19 Vaccination Information to Black Communities in South Carolina. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158926. [PMID: 35897301 PMCID: PMC9332625 DOI: 10.3390/ijerph19158926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
COVID-19 vaccination rates have increased since distribution began in December 2020. However, in some states, such as South Carolina, getting people to take the vaccine has been challenging; as of spring 2022, slightly less than 60% of the total population is fully vaccinated. Vaccine hesitancy among Black Americans may be explained by several factors, including lack of confidence in the medical establishment and vaccines in particular. Faith-based leaders, such as pastors, can make a difference. This study explores the communication strategies that pastors in predominantly Black churches use to increase COVID-19 vaccination rates among churchgoers and the surrounding community. We conducted semi-structured interviews with 10 pastors in South Carolina. The main themes that emerged are: (1) using various communication channels to ensure access; (2) representing a trusted source of information; (3) offering a role model for vaccination—leading by example; and (4) strengthening the commitment to health. As the need for COVID-19 vaccination continues, including booster vaccines, pastors can provide accurate information and community outreach to promote the health of Black communities.
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Schafer GL, Songer TJ, Arena VC, Kramer MK, Miller RG, Kriska AM. Participant food and activity costs in a translational Diabetes Prevention Program. Transl Behav Med 2021; 11:351-358. [PMID: 32298445 DOI: 10.1093/tbm/ibaa031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Diabetes Prevention Program (DPP) and its translational adaptations have been shown to be effective. However, individual-level economic impacts, such as the out-of-pocket costs borne by participants due to involvement in these programs have not been consistently and thoroughly evaluated. As cost is an important consideration that will impact the willingness of individuals to participate in such programs, this study examined direct monetary costs to participants in the Group Lifestyle Balance (GLB) DPP. Older adults (n = 134, mean age 62.8 years) with body mass index (BMI) ≥24 kg/m2 and prediabetes and/or metabolic syndrome participated in this GLB intervention, with two-thirds randomized to begin the intervention immediately and one-third functioning as a control for 6 months before receiving the entire intervention. Food and activity time and costs borne by participants were measured by self-report at baseline and after 6 months. Significant improvements in clinical metabolic measures, weight, and physical activity levels were achieved after 6 months in the intervention group compared both with baseline and the controls. Food costs did not increase among intervention participants. Costs related to physical activity did not change consistently over the course of the intervention. This DPP-GLB lifestyle intervention was effective in reducing risk factors for Type 2 diabetes mellitus among a diverse group of older participants without significantly increasing their out-of-pocket costs for food or physical activity over the course of the intervention. These results should help reduce concerns of individuals who are hesitant to participate in similar programs due to costs. The clinical trial registration number of this study is NCT01050205.
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Affiliation(s)
| | - Thomas J Songer
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Vincent C Arena
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - M Kaye Kramer
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.,Spark360, Cincinnati, OH, USA
| | - Rachel G Miller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Andrea M Kriska
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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Reed M, Wilbur J, Tangney CC, Miller AM, Schoeny ME, Webber-Ritchey KJ. Development and Feasibility of an Obesity Prevention Intervention for Black Adolescent Daughters and Their Mothers. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2021; 1:94-107. [PMID: 37789909 PMCID: PMC10544921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Black female adolescents and women have disproportionately higher rates of obesity than their racial/ethnic counterparts. There is an urgent need to address obesity prevention in Black adolescent females through interventions that enhance lifestyle physical activity and improve dietary behaviors. Middle adolescence presents an important opportunity to strengthen the daughter-mother bond and improve healthy behaviors such as physical activity and dietary intake. Because of the intersection of adolescent development, culture and structural racism, it is essential to include mothers; however, this approach is understudied in the literature. This pre-pilot proof of concept study, Black Girls Move, was conducted using a 12-week pre-post within-subjects design to assess feasibility of conducting and delivering the BGM intervention, program satisfaction, and ability to obtain outcome measures in Black ninth and tenth grade daughters and their mothers. Twenty-two dyads were recruited and 14 dyads completed baseline assessments; however, only eight daughters and their mothers attended the first session and remained for the entire study. All dyads had valid objective and self-reported physical activity data. However, two of eight daughters and one mother provided self-reported dietary data that were considered invalid. All individual sessions were rated highly. Excellent attendance, retention, and satisfaction among participants suggest that we succeeded in developing an accepted, culturally relevant intervention. This lifestyle intervention would be strengthened by modifications to recruitment and retention, as well as incorporation of a computerized dietary assessment tool, a tailored dietary app for self-monitoring, and increased photo-based and group homework activities.
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Berkley-Patton J, Bowe Thompson C, Bauer AG, Berman M, Bradley-Ewing A, Goggin K, Catley D, Allsworth JE. A Multilevel Diabetes and CVD Risk Reduction Intervention in African American Churches: Project Faith Influencing Transformation (FIT) Feasibility and Outcomes. J Racial Ethn Health Disparities 2020; 7:1160-1171. [PMID: 32329033 PMCID: PMC7581562 DOI: 10.1007/s40615-020-00740-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 12/30/2022]
Abstract
Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.
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Affiliation(s)
- Jannette Berkley-Patton
- Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Carole Bowe Thompson
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Alexandria G Bauer
- Department of Biomedical and Health Informatics, School of Medicine, and Psychology Department, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO, 64108, USA
| | - Marcie Berman
- The Institute for Community Research, Hartford, CT, USA
| | - Andrea Bradley-Ewing
- Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kathy Goggin
- Health Services and Outcomes Research, Children's Mercy Kansas City; Schools of Medicine and Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City; Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Jenifer E Allsworth
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
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Hurt TR, Francis SL, Seawell AH, Krisco MP, Flynn MH, O'Connor MC, Rudolph CS, Hill A. Revising Diabetes Programming for Black Men and Their Families. Glob Qual Nurs Res 2020; 7:2333393620960183. [PMID: 33088849 PMCID: PMC7545759 DOI: 10.1177/2333393620960183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022] Open
Abstract
Type-2 diabetes has increased 160% for African American males in the United States. This two-part study's purpose was to apply social marketing theory to understand the Type-2 diabetes education needs of men in Iowa. Study One was a preference assessment of Type-2 diabetes education strategies. Four African American men participated in a series of four focus groups and indicated that they were interested in diabetes prevention programming with their families but not in having it labeled as diabetes education. Participating men would rather increase their physical activity as opposed to tracking their food intake. As a follow-up to this study, nine other African American males took part in Study Two, which used cooking demonstrations and recipe taste-testing with the men to examine their relationship to food in the context of managing their Type-2 diabetes. The findings of both studies, which provided insight into these African American men's lifestyle as related to their Type-2 diabetes, could be useful for nursing professionals who have a critical role in navigating cultural, gender, and family norms while developing care plans, offering patient education, and promoting quality of life.
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Elgazzar R, Nolan TS, Joseph JJ, Aboagye-Mensah EB, Azap RA, Gray DM. Community-engaged and community-based participatory research to promote American Heart Association Life's Simple 7 among African American adults: A systematic review. PLoS One 2020; 15:e0238374. [PMID: 32870944 PMCID: PMC7462313 DOI: 10.1371/journal.pone.0238374] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in the United States and African Americans (AA) have a disproportionately greater burden of CVD as compared to Whites. The American Heart Association (AHA) Life's Simple 7 (LS7) framework outlines goals for attaining ideal cardiovascular health. Yet, there is a lack of evidence summarizing best practices to maximize LS7 attainment. The objective of the present study was to systematically review the extant peer-reviewed literature on community-engaged and community-based participatory research (CBPR) aimed at improving one or more LS7 metrics among AA. METHODS PubMed, CINAHL, and Embase databases were searched. We included articles that reported quantitative results for one or more of the following LS7 metrics: physical activity, diet, cholesterol, blood pressure, body mass index, smoking, and glycemia. We included analyses with a greater than 50% AA study population focused on adults (≥18 years of age). RESULTS Of the 1008 unique studies identified, 54 met inclusion criteria; 27 of which were randomized controlled trials. 50% of studies assessed more than one LS7 metric but only two studies evaluated all seven of the LS7 metrics. No studies had a high proportion of AA males. 40 studies improved at least one LS7 metric at the study end-point. Formative research was used in many studies to guide intervention design. Studies were of varying quality, but overall rated "fair" using a modified approach to the National Institute of Health quality assessment tool. CONCLUSION There is insufficient data to recommend a specific community-engaged or CBPR intervention to improve attainment of LS7 metrics among AA. Future studies using rigorous methodology with increased gender diversity and utilizing the AHA LS7 framework are required to establish a validated program to improve LS7 in AAs.
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Affiliation(s)
- Rana Elgazzar
- The Ohio State University College of Medicine, Columbus, OH, United States of America
| | - Timiya S. Nolan
- The Ohio State University College of Nursing, Columbus, OH, United States of America
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America
| | - Joshua J. Joseph
- The Ohio State University College of Medicine, Columbus, OH, United States of America
| | | | - Rosevine A. Azap
- The Ohio State University College of Medicine, Columbus, OH, United States of America
| | - Darrell M. Gray
- The Ohio State University College of Medicine, Columbus, OH, United States of America
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America
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9
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Aga F, Dunbar SB, Kebede T, Higgins MK, Gary R. Relationships of diabetes self-care behaviours to glycaemic control in adults with type 2 diabetes and comorbid heart failure. Nurs Open 2020; 7:1453-1467. [PMID: 32802365 PMCID: PMC7424468 DOI: 10.1002/nop2.517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/13/2020] [Accepted: 04/27/2020] [Indexed: 01/02/2023] Open
Abstract
Aim To describe the relationship between diabetes self-care behaviours and glycaemic control in patients with type 2 diabetes and comorbid heart failure. Design A cross-sectional, correlational study. Method A secondary analysis of 180 participants' baseline data from a clinical trial that tested a 6-month integrated self-care intervention was performed. Correlational and hierarchical linear regression analysis was used to assess the relationships between diabetes self-care behaviours and glycaemic control. Result The Summary of Diabetes Self-Care Activities general diet and Summary of Diabetes Self-Care Activities exercise were negatively associated with glycated haemoglobin (HbA1c), while Summary of Diabetes Self-Care Activities specific diet was positively associated. Diabetic end-organ failure, taking insulin only and taking both oral antiglycaemic and insulin, predicted higher HbA1c and fasting blood glucose. African American race and dyslipidaemia predicted higher HbA1c while taking higher total daily medication predicted higher fasting blood glucose. Longer years lived with heart failure, lower ventricular ejection fraction and exposure to chemotherapy predicted lower fasting blood glucose.
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Affiliation(s)
- Fekadu Aga
- School of Nursing & MidwiferyCollege of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia
| | - Sandra B. Dunbar
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGAUSA
| | - Tedla Kebede
- Diabetes & Endocrinology UnitDepartment of Internal MedicineSchool of MedicineCollege of Health SciencesTikur Anbessa Specialized HospitalAddis Ababa UniversityAddis AbabaEthiopia
| | | | - Rebecca Gary
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGAUSA
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Gittelsohn J, Anderson Steeves ET, Ho JJ, Shin A, Farner H, Summers A. A Church-Based Diabetes Risk Factor Prevention Program Improves Psychosocial Factors and Food-Related Behaviors. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2018.1564720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Joel Gittelsohn
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | | | - Jessica J Ho
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | - Ahyoung Shin
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | - Harmony Farner
- Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, USA
| | - Amber Summers
- Center for Communication Programs, Johns Hopkins School of Public Health, USA
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Flórez KR, Payán DD, Palar K, Williams MV, Katic B, Derose KP. Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review. Nutr Rev 2020; 78:304-322. [PMID: 31539069 PMCID: PMC8453621 DOI: 10.1093/nutrit/nuz046] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
CONTEXT Multilevel church-based interventions may help address racial/ethnic disparities in obesity in the United States since churches are often trusted institutions in vulnerable communities. These types of interventions affect at least two levels of socio-ecological influence which could mean an intervention that targets individual congregants as well as the congregation as a whole. However, the extent to which such interventions are developed using a collaborative partnership approach and are effective with diverse racial/ethnic populations is unclear, and these crucial features of well-designed community-based interventions. OBJECTIVE The present systematic literature review of church-based interventions was conducted to assess their efficacy for addressing obesity across different racial/ethnic groups (eg, African Americans, Latinos). DATA SOURCES AND EXTRACTION In total, 43 relevant articles were identified using systematic review methods developed by the Center for Disease Control and Prevention (CDC)'s Task Force on Community Preventive Services. The extent to which each intervention was developed using community-based participatory research principles, was tailored to the particular community in question, and involved the church in the study development and implementation were also assessed. DATA ANALYSIS Although 81% of the studies reported significant results for between- or within-group differences according to the study design, effect sizes were reported or could only be calculated in 56% of cases, and most were small. There was also a lack of diversity among samples (eg, few studies involved Latinos, men, young adults, or children), which limits knowledge about the ability of church-based interventions to reduce the burden of obesity more broadly among vulnerable communities of color. Further, few interventions were multilevel in nature, or incorporated strategies at the church or community level. CONCLUSIONS Church-based interventions to address obesity will have greater impact if they consider the diversity among populations burdened by this condition and develop programs that are tailored to these different populations (eg, men of color, Latinos). Programs could also benefit from employing multilevel approaches to move the field away from behavioral modifications at the individual level and into a more systems-based framework. However, effect sizes will likely remain small, especially since individuals only spend a limited amount of time in this particular setting.
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Affiliation(s)
- Karen R Flórez
- CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Denise D Payán
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, California, USA
- RAND Corporation, Santa Monica, California, USA
| | - Kartika Palar
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | | | - Bozena Katic
- CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
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Kim Yeary KH, Cornell CE, Moore PC, Gauss CH, Prewitt TE, Turner J. The WORD: Outcomes of a Behavioral Weight Loss Maintenance Effectiveness Trial in Rural Black Adults of Faith. Obesity (Silver Spring) 2020; 28:510-520. [PMID: 31984668 PMCID: PMC7042080 DOI: 10.1002/oby.22717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/21/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Rural black communities bear a disproportionate burden of obesity. To increase reach among underserved groups, community-based weight loss and maintenance interventions are crucial. METHODS The Diabetes Prevention Program (DPP) was adapted for rural black adults of faith to create The Wholeness, Oneness, Righteousness, Deliverance (WORD) trial, a group-based, community health worker-delivered weight loss intervention. A Weight Loss Only arm (16 sessions) was compared with a Weight Loss + Maintenance arm (16 + 12 sessions) in a cluster randomized controlled trial of 31 churches (n = 440). Weight and related behaviors were assessed at 0, 6, 12, and 18 months. RESULTS The WORD produced weight loss from baseline to 6 months (percentage body weight change -2.47 [-3.13 to -1.80]). Among those who lost 5% of their baseline weight, there was a statistical trend of lower weight regain in the Weight Loss + Maintenance arm compared with control. Maintenance arm participants reported higher activity at 12 months. There were no between-arm differences at 18 months. CONCLUSIONS The WORD produced weight loss from baseline to 6 months on par with that produced by other DPP adaptations for black communities, including adaptations using health professionals. Weight regain was also consistent with that reported in prior literature. Continuing sessions as part of the church's mission may foster adoption of DPP-based weight loss programs.
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Affiliation(s)
| | - Carol E. Cornell
- University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | | | - C. Heath Gauss
- University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | | | - Jerome Turner
- Boys, Girls, Adults Community Development Center (BGACDC), Marvell, AR 72366
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13
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Driver S, Reynolds M, Woolsey A, Callender L, Prajapati PK, Bennett M, Kramer K. Impact of a Community-Based Healthy Lifestyle Program on Individuals With Traumatic Brain Injury. J Head Trauma Rehabil 2018; 33:E49-E58. [DOI: 10.1097/htr.0000000000000372] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Shahim B, Hasselberg S, Boldt-Christmas O, Gyberg V, Mellbin L, Rydén L. Effectiveness of different outreach strategies to identify individuals at high risk of diabetes in a heterogeneous population: a study in the Swedish municipality of Södertälje. Eur J Prev Cardiol 2018; 25:1990-1999. [PMID: 30289273 DOI: 10.1177/2047487318805582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Identifying type 2 diabetes mellitus (T2DM) is a prerequisite for the institution of preventive measures to reduce future micro and macrovascular complications. Approximately 50% of people with T2DM are undiagnosed, challenging the assumption that a traditional primary healthcare setting is the most efficient way to reach people at risk of T2DM. A setting of this kind may be even more suboptimal when it comes to reaching immigrants, who often appear to have inferior access to healthcare and/or are less likely to attend routine health checks at primary healthcare centres. OBJECTIVES The objective of this study was to identify the best strategy to reach individuals at high risk of T2DM and thereby cardiovascular disease in a heterogeneous population. METHODS All 18-65-year-old inhabitants in the Swedish municipality of Södertälje ( n∼51,000) without known T2DM and cardiovascular disease were encouraged to complete the Finnish Diabetes Risk Score (FINDRISC: score > 15 indicating a high and > 20 a very high risk of future T2DM and cardiovascular disease) through the following communication channels: primary care centres, workplaces, Syrian orthodox churches, pharmacies, crowded public places, mass media, social media and mail. Data collection lasted for six weeks. RESULTS The highest response rate was obtained through workplaces (27%) and the largest proportion of respondents at high/very high risk through the Syrian orthodox churches (18%). The proportion reached through primary care centres was 4%, of whom 5% were at elevated risk. The cost of identifying a person at elevated risk through the Syrian orthodox church was €104 compared with €8 through workplaces and €112 through primary care centres. CONCLUSIONS The choice of communication channels was important to reach high/very high-risk individuals for T2DM and for screening costs. In this immigrant-dense community, primary care centres were inferior to strategies using workplaces and churches in terms of both the proportion of identified at-risk individuals and costs.
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Affiliation(s)
- Bahira Shahim
- 1 Department of Medicine Solna, Karolinska Institutet, Sweden
| | - Sofia Hasselberg
- 2 McKinsey & Company, Stockholm, Sweden.,3 Getinge AB, Gothenburg, Sweden
| | | | - Viveca Gyberg
- 1 Department of Medicine Solna, Karolinska Institutet, Sweden.,4 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - Linda Mellbin
- 1 Department of Medicine Solna, Karolinska Institutet, Sweden
| | - Lars Rydén
- 1 Department of Medicine Solna, Karolinska Institutet, Sweden
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Johnston JA, Konda K, Ablah E. Building Capacity Among Laity: A Faith-Based Health Ministry Initiative. JOURNAL OF RELIGION AND HEALTH 2018; 57:1276-1284. [PMID: 28689271 DOI: 10.1007/s10943-017-0445-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A systematic review of topic-specific faith-based health programs determined that health outcomes can be improved though faith-based health interventions. A university research team, in partnership with the Kansas United Methodist Church and a United Methodist philanthropy, facilitated planning and development of a statewide initiative to increase the capacity of laity-led health ministry teams. The purpose of this paper is to describe the processes utilized to design and implement an initiative to increase capacity for laity-led comprehensive health ministry among Kansas United Methodist Church congregations and to share the key elements of the initiative.
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Affiliation(s)
- Judy A Johnston
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kanas St., Wichita, KS, 67214-3199, USA.
| | - Kurt Konda
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kanas St., Wichita, KS, 67214-3199, USA
| | - Elizabeth Ablah
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kanas St., Wichita, KS, 67214-3199, USA
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16
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Walker JA, Hashim Y, Oranye N. Impact of Muslim opinion leaders' training of healthcare providers on the uptake of MNCH services in Northern Nigeria. Glob Public Health 2018; 14:200-213. [PMID: 29764294 DOI: 10.1080/17441692.2018.1473889] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Expanding access to maternal, newborn and child health (MNCH) services in traditional societies is a public health challenge, often complicated by cultural and religious beliefs about what is permitted or not permitted within a faith group. This is particularly true in the Muslim majority North of Nigeria, where deep suspicions of Western public health programmes, coupled with failing and underfunded health system, have led to the emergence of a new generation of Muslim Opinion Leaders (MOLs) with counter-narratives against family planning, immunisation and nutrition programmes. This paper reports on an innovative project implemented under the Saving Lives at Birth global partnership programme, where conservative MOLs transformed as champions were engaged as health communicators to train health providers on correct religious precepts related to MNCH. A matched subject type of study design was used to compare healthcare providers' performance in control and intervention health facilities. The result indicates a significant difference both in perception and in practices between healthcare providers in intervention and control facilities, with respect to MNCH uptake. This paper highlights the need for renewed focus on engaging faith leaders and organisations in health communication and service delivery and presents a model of sustainable engagement of champions in MNCH.
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Affiliation(s)
| | - Yahaya Hashim
- a Development Research and Projects Centre , Kano , Nigeria
| | - Nelson Oranye
- b College of Rehabilitation Sciences , University of Manitoba , Winnipeg , Canada
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Roy S, Hansen AR, Ross L, Larson R. A Qualitative Study to Assess Barber Perceptions of the Feasibility of the Employer as a Health Advisor for Obesity Prevention. Am J Mens Health 2018; 12:1450-1462. [PMID: 29658399 PMCID: PMC6142171 DOI: 10.1177/1557988318768586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Obesity has become a serious issue affecting millions of Americans, especially in the southern United States. One avenue for addressing obesity is the workplace setting. This formative research study examined the feasibility of an obesity prevention worksite intervention in the barbershop for African American barbershop owners (employers) and barbers (employees). The study proposes an intervention where the owner of the barbershop would be trained to educate his barbers about obesity prevention. Twenty in-depth interviews were conducted with the owners (n = 5) and barbers (n = 15) of five barbershops in Statesboro, Georgia, to determine the feasibility of the intervention. The results of this study indicated that the owners and barbers all felt that the intervention was feasible and could be implemented in the barbershop. The owners and barbers felt that obesity was an important issue in their community. Additional themes identified include program benefits, empowerment of owners and barbers, and motivational components to help produce healthy habits. The owners felt comfortable educating their barbers about obesity prevention, and the barbers were receptive toward the idea of being educated by their employer. In order for this intervention to be implemented and effective, it must be tailored to fit within the barbershop environment. This intervention addresses known health disparities that exist in the African American community and underscores the need for additional worksite health promotion programs in medically underserved communities.
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Affiliation(s)
| | - Andrew R Hansen
- 2 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Levi Ross
- 3 The University of Alabama, Tuscaloosa, AL, USA
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Morales-Alemán MM, Moore A, Scarinci IC. Development of a Participatory Capacity-Building Program for Congregational Health Leaders in African American Churches in the US South. Ethn Dis 2018; 28:11-18. [PMID: 29467561 PMCID: PMC5794442 DOI: 10.18865/ed.28.1.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
African Americans are disproportionately affected by diabetes and colorectal cancer. Although studies have shown the effectiveness of spiritually based health interventions delivered by community health workers to African Americans, few have described the development of the capacity-building component. This article describes this process. The development of the Healthy Congregations Healthy Communities Program (HCHC) was guided through a community-based participatory research lens and included: 1) establishment of a community coalition; 2) identification by coalition members of churches as the best venues for health promotion strategies among African Americans; 3) recruitment of churches; 4) development of a training manual; 5) recruitment and training of congregational health leaders (CHLs); and 6) "Passing of the torch" from the coalition to the CHLs who implemented the intervention in their congregations. We trained 35 CHLs to promote awareness about diabetes and colorectal cancer using a culturally relevant, spiritually based curriculum. Pre- and post-test paired t-tests showed significant increases in CHLs' knowledge of wellness (P<.001), colorectal cancer (P<.002), nutrition (P<.004), and lifestyle changes (P<.005). The community-academic partnership was successful in developing a culturally relevant, spiritually based capacity-building program for African American CHLs to implement health promotion strategies in their congregations and communities.
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Affiliation(s)
| | - Artisha Moore
- Division of Preventive Medicine, University of Alabama at Birmingham
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19
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Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP). BMC Public Health 2018; 17:974. [PMID: 29298703 PMCID: PMC6389141 DOI: 10.1186/s12889-017-4986-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 12/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is now one of the leading causes of disease-related deaths globally. India has the world's second largest number of individuals living with diabetes. Lifestyle change has been proven to be an effective means by which to reduce risk of T2DM and a number of "real world" diabetes prevention trials have been undertaken in high income countries. However, systematic efforts to adapt such interventions for T2DM prevention in low- and middle-income countries have been very limited to date. This research-to-action gap is now widely recognised as a major challenge to the prevention and control of diabetes. Reducing the gap is associated with reductions in morbidity and mortality and reduced health care costs. The aim of this article is to describe the adaptation, development and refinement of diabetes prevention programs from the USA, Finland and Australia to the State of Kerala, India. METHODS The Kerala Diabetes Prevention Program (K-DPP) was adapted to Kerala, India from evidence-based lifestyle interventions implemented in high income countries, namely, Finland, United States and Australia. The adaptation process was undertaken in five phases: 1) needs assessment; 2) formulation of program objectives; 3) program adaptation and development; 4) piloting of the program and its delivery; and 5) program refinement and active implementation. RESULTS The resulting program, K-DPP, includes four key components: 1) a group-based peer support program for participants; 2) a peer-leader training and support program for lay people to lead the groups; 3) resource materials; and 4) strategies to stimulate broader community engagement. The systematic approach to adaptation was underpinned by evidence-based behavior change techniques. CONCLUSION K-DPP is the first well evaluated community-based, peer-led diabetes prevention program in India. Future refinement and utilization of this approach will promote translation of K-DPP to other contexts and population groups within India as well as other low- and middle-income countries. This same approach could also be applied more broadly to enable the translation of effective non-communicable disease prevention programs developed in high-income settings to create context-specific evidence in rapidly developing low- and middle-income countries. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry: ACTRN12611000262909 . Registered 10 March 2011.
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Whitney E, Kindred E, Pratt A, O'Neal Y, Harrison RCP, Peek ME. Culturally Tailoring a Patient Empowerment and Diabetes Education Curriculum for the African American Church. DIABETES EDUCATOR 2017; 43:441-448. [PMID: 28793835 DOI: 10.1177/0145721717725280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The African American church has long been recognized as a valuable partner for health interventions in the community. While an extensive literature exists documenting the potential efficacy of diabetes education programs in church settings, there has yet to be an effort to leverage spiritual beliefs and practices to promote diabetes self-management and shared decision making within a faith-based framework that is culturally tailored to the African American church. The purpose of this article is to describe the translation of a clinic-based diabetes education program into faith-based education curriculum tailored for use in the African American church. Conclusions Themes extracted from focus groups and input from a faith-based community partner provided a methodical and patient-informed foundation for culturally tailoring and piloting a diabetes self-management curriculum for the African American church setting. This study illustrates how spirituality can be incorporated into interventions to enhance health promotion and behavioral change among African Americans with diabetes. Participants in our study described how religious beliefs play an active role in many aspects of diabetes care, including self-management behaviors, coping strategies, and patient/provider communication. In addition, this intervention can serve as a model for the development of patient-centered health interventions.
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Affiliation(s)
- Eric Whitney
- The Pritzker School of Medicine, The University of Chicago, Chicago, Illinois (Mr Whitney, Dr Pratt)
| | - Elijah Kindred
- The University of Chicago, Divinity School, Chicago, Illinois (Mr Kindred)
| | - Abdullah Pratt
- The Pritzker School of Medicine, The University of Chicago, Chicago, Illinois (Mr Whitney, Dr Pratt).,Department of Emergency Medicine, The University of Chicago Medical Center, Chicago, Illinois (Dr Pratt)
| | - Yolanda O'Neal
- The University of Chicago, Section of General Internal Medicine, Chicago, Illinois (Mrs O'Neal, Dr Peek)
| | - Rev Chauncey P Harrison
- New Beginnings Church of Chicago, Chicago, Illinois (Mr Harrison).,Trinity United Church of Christ, Chicago, Illinois (Mr Harrison)
| | - Monica E Peek
- The University of Chicago, Section of General Internal Medicine, Chicago, Illinois (Mrs O'Neal, Dr Peek)
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Saunders DM, Leak J, Carver ME, Smith SA. Application of a faith-based integration tool to assess mental and physical health interventions. JOURNAL OF THE GEORGIA PUBLIC HEALTH ASSOCIATION 2017; 7:26-38. [PMID: 29354795 PMCID: PMC5771442 DOI: 10.21633/jgpha.7.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Methods Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. Results The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Conclusions Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed.
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Affiliation(s)
| | - Jean Leak
- Refreshing Springs Outreach Sykesville, MD
| | | | - Selina A Smith
- Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, GA
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Hurt TR, Seawell AH, Cutrona C, O'Connor MC, Camp RD, Duran R, Elderts R, Green C, Hara V, Pattee J. Black Women's Recommendations for Developing Effective Type 2 Diabetes Programming. Glob Qual Nurs Res 2017; 4:2333393617715335. [PMID: 28804746 PMCID: PMC5484429 DOI: 10.1177/2333393617715335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 05/13/2017] [Accepted: 05/22/2017] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to learn from 29 Black women how to develop effective Type 2 diabetes programming. Three focus groups were held in Des Moines, Iowa, during fall 2012. Results highlighted themes related to diabetes knowledge, diabetes management and prevention, physical activity, diet, and diabetes management programming. Opinions were shared as to whether family members should be included in programs for supporting those diagnosed with diabetes. These results provided guidance and ideas to scholars and health care professionals aiming to improve effectiveness of diabetes programs for Black women and families.
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Coughlin SS, Smith SA. Community-Based Participatory Research to Promote Healthy Diet and Nutrition and Prevent and Control Obesity Among African-Americans: a Literature Review. J Racial Ethn Health Disparities 2017; 4:259-268. [PMID: 27059053 PMCID: PMC5055839 DOI: 10.1007/s40615-016-0225-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/16/2016] [Accepted: 03/18/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The literature on community-based participatory research (CBPR) approaches for promoting healthy diet and nutrition and preventing and controlling obesity in African-American communities was systematically reviewed as part of the planning process for new research. METHODS CBPR studies of diet, nutrition, and weight management among African-Americans were identified from 1989 through October 31, 2015, using PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases and MeSH term and keyword searches. RESULTS A total of 16 CBPR studies on healthy diet, nutrition, and weight management among African-Americans were identified; outcome evaluation results were available for all but two. Of the remaining 14 studies, 11 focused on adults, 1 on children, and 2 on both children and adults. Eight studies employed CBPR methods to address diet, nutrition, and weight management in church settings. Four had a cluster-randomized controlled design. Others had a pre-post test, quasi-experimental, or uncontrolled design. Only one study addressed four levels of the socioecological model; none addressed all five levels of the model. The studies identified in this review indicate that CBPR approaches can be effective for promoting healthy diet, nutrition, and weight management among African-American adults, but there is a need for additional studies with rigorous study designs that overcome methodologic limitations of many existing studies. There is only limited evidence for the effectiveness of CBPR approaches for promoting healthy eating and weight control among African-American children and adolescents. CONCLUSION To address health disparities, additional CBPR studies are needed to promote healthy diet, nutrition, and weight management in African-American communities. Of particular interest are multilevel CBPR studies that include interventions aimed at multiple levels of the socioecological model.
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Affiliation(s)
- Steven S Coughlin
- Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, One University Avenue, Kitson Hall 313A, Lowell, MA, 01854, USA.
| | - Selina A Smith
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
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24
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A Feasibility Study of Taste & See: A Church Based Programme to Develop a Healthy Relationship with Food. RELIGIONS 2017. [DOI: 10.3390/rel8020029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hardison-Moody A, Edwards MB, Bocarro JN, Stein A, Kanters MA, Sherman DM, Rhew LK, Stallings WM, Bowen SK. Shared Use of Physical Activity Facilities Among North Carolina Faith Communities, 2013. Prev Chronic Dis 2017; 14:E11. [PMID: 28152362 PMCID: PMC5303649 DOI: 10.5888/pcd14.160393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Shared use of recreational facilities is a promising strategy for increasing access to places for physical activity. Little is known about shared use in faith-based settings. This study examined shared use practices and barriers in faith communities in North Carolina. Methods Faith communities in North Carolina (n = 234) completed an online survey (October–December 2013) designed to provide information about the extent and nature of shared use of recreational facilities. We used binary logistic regression to examine differences between congregations that shared use and those that did not share use. Results Most of the faith communities (82.9%) that completed the survey indicated that they share their facilities with outside individuals and organizations. Formal agreements were more common when faith communities shared indoor spaces such as gymnasiums and classroom meeting spaces than when they shared outdoor spaces such as playgrounds or athletic fields. Faith communities in the wealthiest counties were more likely to share their spaces than were faith communities in poorer counties. Faith communities in counties with the best health rankings were more likely to share facilities than faith communities in counties that had lower health rankings. The most frequently cited reasons faith communities did not share their facilities were that they did not know how to initiate the process of sharing their facilities or that no outside groups had ever asked. Conclusion Most faith communities shared their facilities for physical activity. Research is needed on the relationship between shared use and physical activity levels, including the effect of formalizing shared-use policies.
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Affiliation(s)
- Annie Hardison-Moody
- Department of Agricultural and Human Sciences, North Carolina State University, Campus Box 7606, Raleigh, NC 27695-7606.
| | | | | | - Anna Stein
- North Carolina Division of Public Health, Raleigh, North Carolina
| | | | | | - Lori K Rhew
- North Carolina Division of Public Health, Raleigh, North Carolina
| | - Willona Marie Stallings
- Partners in Health and Wholeness, North Carolina Council of Churches, Raleigh, North Carolina
| | - Sarah K Bowen
- North Carolina State University, Raleigh, North Carolina
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Brewer LC, Morrison EJ, Balls-Berry JE, Dean P, Lackore K, Jenkins S, Cohen C, Johnson J, Ellis F, Mangum DC, Hayes SN, Patten C. Preventing cardiovascular disease: Participant perspectives of the FAITH! Program. J Health Psychol 2017; 24:1710-1723. [PMID: 28810418 DOI: 10.1177/1359105317695878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Striking cardiovascular health disparities exist among African-Americans in Minnesota compared to Whites; however, community-based interventions to address cardiovascular disease risk are lacking. This study explored participant perceptions of a culturally tailored, cardiovascular disease prevention program developed using a community-based participatory research process. Research participation perceptions, program benefits, and program satisfaction/acceptability were analyzed using a mixed-methods approach. Overall, acceptability was high. Findings highlight the favorable inclusion of African-Americans (research perception), knowledge gained about healthy lifestyle practices (benefits), and quality of the curriculum/speakers (satisfaction). Community-based participatory research may be useful in fostering the acceptability of behavior change interventions among marginalized African-American communities.
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Lagisetty PA, Priyadarshini S, Terrell S, Hamati M, Landgraf J, Chopra V, Heisler M. Culturally Targeted Strategies for Diabetes Prevention in Minority Population. THE DIABETES EDUCATOR 2017; 43:54-77. [PMID: 28118127 PMCID: PMC5408505 DOI: 10.1177/0145721716683811] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose The purpose of this study is to (a) assess the effectiveness of culturally tailored diabetes prevention interventions in minority populations and (b) develop a novel framework to characterize 4 key domains of culturally tailored interventions. Prevention strategies specifically tailored to the culture of ethnic minority patients may help reduce the incidence of diabetes. Methods We searched PubMed, EMBASE, and CINAHL for English-language, randomized controlled trials (RCTs) or quasi-experimental (QE) trials testing culturally tailored interventions to prevent diabetes in minority populations. Two reviewers independently extracted data and assessed risk of bias. Inductive thematic analysis was used to develop a framework with 4 domains (FiLLM: Facilitating [ie, delivering] Interventions Through Language, Location, and Message). The framework was used to assess the overall effectiveness of culturally tailored interventions. Results Thirty-four trials met eligibility criteria. Twelve studies were RCTs, and 22 were QE trials. Twenty-five out of 34 studies (74%) that used cultural tailoring demonstrated significantly improved A1C, fasting glucose, and/or weight loss. Of the 25 successful interventions, 21 (84%) incorporated at least 3 culturally targeted domains. Seven studies used all 4 domains and were all successful. The least utilized domain was delivery (4/34) of the intervention's key educational message. Conclusions Culturally tailoring interventions across the 4 domains of facilitators, language, location, and messaging can be effective in improving risk factors for progression to diabetes among ethnic minority groups. Future studies should evaluate how specific tailoring approaches work compared to usual care as well as comparative effectiveness of each tailoring domain.
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Affiliation(s)
- Pooja A Lagisetty
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Dr Lagisetty, Dr Heisler)
| | - Shubadra Priyadarshini
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Stephanie Terrell
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Mary Hamati
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Jessica Landgraf
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Vineet Chopra
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
| | - Michele Heisler
- Department of General Internal Medicine, University of Michigan, Ann Arbor, Michigan (Dr Lagisetty, Ms Priyadarshini, Ms Terrell, Ms Hamati, Ms Landgraf, Dr Chopra, Dr Heisler)
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan (Dr Lagisetty, Dr Heisler)
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A diagnosis of chronic kidney disease: despite fears patients want to know early. Clin Nephrol 2017; 86:78-86. [PMID: 27345185 PMCID: PMC5012189 DOI: 10.5414/cn108831] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2016] [Indexed: 12/13/2022] Open
Abstract
Aims: We elicited input from patients on their experience getting a chronic kidney disease (CKD) diagnosis to use for optimizing current CKD education interventions. Methods: We performed structured one-on-one patient interviews. Interviews were recorded, transcribed, and coded using modified grounded theory. Participants had CKD, were not on dialysis, and were recruited from general nephrology practices. Results: 49 patients enrolled from January to October 2014. Interviews revealed four major themes: 1. Reaction to diagnosis – patients described emotional reactions and subsequent behavior changes (152 statements); 2. Timing of diagnosis – patients described how they were told about their diagnosis and expectations of when a person should be told (149 statements); 3. Mediators in diagnosis delivery – patients discussed things that helped or hindered understanding and acceptance of their diagnosis (64 statements), and 4. Perceptions of diagnosis terminology – patients discussed perceptions about diagnostic terms (e.g., “chronic kidney disease”) (91 statements). Cross-sectional study design and setting limit interpretation of causality and generalizability. Conclusions: Patients experience fear but prefer early diagnosis communication. More work is needed to define evidence-based guidelines for diagnosis messaging across the spectrum of care.
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Batada A, Grier-McEachin J, Avery K. Partnering on the PRAISE Program: Putting Health Equity into Practice. Health Equity 2017; 1:7-14. [PMID: 30283830 PMCID: PMC6071877 DOI: 10.1089/heq.2016.0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: The purpose of Preventive Health Education Resulting in Action Inspiring Success for Everyone (PRAISE) was to develop a community-driven program to encourage and support churches in sustainable health promotion and assessment efforts to improve African Americans' health knowledge and behaviors in Asheville, North Carolina. Methods: The PRAISE program provided technical support toward gaining recognition and an award for health promotion activities to 10 churches in year 1 and 5 additional churches in year 2. The Results-Based Accountability© (RBA) framework involved documentation of church health promotion activities and surveys of a convenience sample of congregants at nine churches before (presurvey, n=270) and after (postsurvey, n=241) the intervention. Differences in frequency of conduct of and participation in church health promotion activities and in congregant health knowledge and behaviors were assessed in 2015 and 2016. Results: Fourteen of the churches engaged in at least one health promotion activity and more than half offered healthier foods at gatherings, offered exercise opportunities, and held at least three health education activities. Seventy-two percent of congregants reported participating in at least one church health activity at postsurvey compared with 58% at presurvey. The proportion of congregants who had personal health knowledge and the proportion that rated their health as good or better were higher at postsurvey. Conclusion: Building on years of trust and collaboration among churches, local community organizations, and an academic partner, PRAISE in its first 2 years suggests that a community-driven approach can support health promotion and healthy behaviors, advancing health equity efforts.
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Affiliation(s)
- Ameena Batada
- Department of Health and Wellness, University of North Carolina Asheville, Asheville, North Carolina
| | - JeWana Grier-McEachin
- Asheville Buncombe Institute of Parity Achievement (ABIPA), Asheville, North Carolina
| | - Kathey Avery
- Asheville Buncombe Institute of Parity Achievement (ABIPA), Asheville, North Carolina
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Yoga for Risk Reduction of Metabolic Syndrome: Patient-Reported Outcomes from a Randomized Controlled Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3094589. [PMID: 27847524 PMCID: PMC5101386 DOI: 10.1155/2016/3094589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/08/2016] [Accepted: 10/05/2016] [Indexed: 11/18/2022]
Abstract
Lifestyle change is recommended as treatment for adults at risk for metabolic syndrome (MetS), although adoption of new behavioral patterns is limited. In addition, most existing lifestyle interventions do not address psychological stress or quality of life, both of which impact the burden of MetS. Yoga, a form of physical activity that incorporates psychological components (e.g., maintaining attention, relaxation), is a promising intervention for improving the burden of MetS. This randomized controlled trial assessed the feasibility and preliminary efficacy of a 12-week yoga program coupled with an evidence-based health education program (HED) compared to HED alone. A secondary, exploratory aim examined perceived stress, quality of life, and related psychological outcomes (mindfulness, perceived health competence, and mood). Sixty-seven adults at risk for MetS enrolled (mean age [SD]: 58 [10] years; 50% male; 79% non-Hispanic White). Preliminary results revealed significantly larger improvements in two quality of life domains (role-physical and general health perceptions) in the HED plus yoga group versus HED alone (ps < 0.05). This is the first study that implemented lifestyle education along with yoga to evaluate the potential unique effects of yoga on participants at risk for MetS. A larger clinical trial is warranted to further investigate these promising patient-reported outcomes.
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Doucet-Battle J. Sweet Salvation: One Black Church, Diabetes Outreach, and Trust. TRANSFORMING ANTHROPOLOGY 2016. [DOI: 10.1111/traa.12073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- James Doucet-Battle
- Sociology; University of California Santa Cruz; 1156 High Street Santa Cruz CA 95064
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Sutton SM, Magwood GS, Nemeth LS, Jenkins CM. Conceptual Model of Weight Management in Overweight and Obese African-American Females. Nurs Forum 2016; 52:73-87. [PMID: 27309975 DOI: 10.1111/nuf.12165] [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] [Received: 09/19/2015] [Revised: 11/23/2015] [Accepted: 12/13/2015] [Indexed: 11/26/2022]
Abstract
PROBLEM Weight management of overweight and obese (OWO) African-American females (AAFs) is a poorly defined concept, leading to ineffective treatment of overweight and obesity, prevention of health sequelae, and risk reduction. METHODS A conceptual model of the phenomenon of weight management in OWO AAFs was developed through dimensional analysis of the literature. Constructs were identified and sorted into the dimensions of perspective, context, conditions, process, and consequences and integrated into an explanatory matrix. FINDINGS Through dimensional analysis, weight management in OWO AAFs was characterized as a multidimensional concept, defined from the perspective of weight loss in community-dwelling AAFs. Behaviors associated with weight management are strongly influenced by intrinsic factors and extrinsic conditions, which influence engagement in the processes and consequences of weight management. CONCLUSIONS The resulting conceptual model of weight management in OWO AAFs provides a framework for research interventions applicable in a variety of settings.
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Affiliation(s)
- Suzanne M Sutton
- Suzanne M. Sutton, MSN, RN, is PhD Student, College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Gayenell S Magwood
- Gayenell S. Magwood, PhD, RN, is Associate Professor, College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Lynne S Nemeth
- Lynne S. Nemeth, PhD, RN, FAAN, is Professor, College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Carolyn M Jenkins
- Carolyn M. Jenkins, DrPH, MSN, RD, LD, FAAN, is Professor and Ann Darlington Edwards Endowed Chair, College of Nursing, Medical University of South Carolina, Charleston, SC
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Sutton SM, Magwood GS, Jenkins CH, Nemeth LS. A Scoping Review of Behavioral Weight Management Interventions in Overweight/Obese African American Females. West J Nurs Res 2016; 38:1035-66. [DOI: 10.1177/0193945916635160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
African American females are adversely affected by overweight and obesity and accompanying physical, psychosocial, and economic consequences. Behavioral weight management interventions are less effective in addressing the needs of overweight and obese African American females. The objective of this scoping review was to explore weight management research in this population to identify key concepts, gaps in the literature, and implications for future research. Analyses revealed a broad array in purpose, theoretical frameworks, settings, study designs, interventions, intervention strategies, and outcome variables, making comparison difficult. Many of the articles included in this review did not provide a rich description of methods, which hinder their use in the development of future studies. Consistent application of a combined theory may address the gaps identified in this review by providing a reliable method for assessing needs, developing interventions, and evaluating the effectiveness and fidelity of behavioral weight management interventions in overweight and obese African American females.
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Neamah HH, Sebert Kuhlmann AK, Tabak RG. Effectiveness of Program Modification Strategies of the Diabetes Prevention Program: A Systematic Review. DIABETES EDUCATOR 2016; 42:153-65. [PMID: 26879459 DOI: 10.1177/0145721716630386] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE The purpose of this study is to review the effectiveness of commonly used program modifications classified under cultural adaptation and program translational strategies for the Diabetes Prevention Program (DPP) in terms of risk reduction for type 2 diabetes. METHODS Authors extracted data about weight, body mass index (BMI), and 5 areas of program modification strategies from 28 interventions and analyzed them in SPSS software. Bivariate analyses examined the odds of achieving a significant reduction in outcomes by each modification of the DPP and by presence of a maintenance component, as well as the mean reduction of weight and BMI by more versus fewer modifications and by the presence of a maintenance component. RESULTS There were no statistically significant differences in achieving a significant reduction in weight or BMI by any type of modification or by the presence of a maintenance component. Programs with fewer modifications reported significantly greater reduction in mean weight at 12 months postintervention and the furthest time point extracted. Programs with a maintenance component achieved significantly greater reduction in mean weight measured at the furthest time point extracted. CONCLUSIONS The DPP appears to be programmatically robust to a variety of cultural adaptation and translational strategies. Potentially cost-saving modifications do not seem to reduce effectiveness, which should encourage implementation on a broader scale. Program planners should, however, make efforts to include maintenance components because they appear to significantly reduce risk for acquiring type 2 diabetes.
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Affiliation(s)
- Hind H Neamah
- Brown School, Washington University in St Louis, St Louis, Missouri, USA (Dr Neamah, Dr Sebert Kuhlmann)
| | - Anne K Sebert Kuhlmann
- Brown School, Washington University in St Louis, St Louis, Missouri, USA (Dr Neamah, Dr Sebert Kuhlmann),Behavioral Sciences and Health Education, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri, USA (Dr Sebert Kuhlmann)
| | - Rachel G Tabak
- Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St Louis, Missouri, USA (Dr Tabak)
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Process Evaluation of the Nationwide Implementation of a Lifestyle Intervention in the Construction Industry. J Occup Environ Med 2015; 58:e6-14. [PMID: 26716860 DOI: 10.1097/jom.0000000000000628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to monitor the national scale up of the effective lifestyle intervention Health Under Construction in the Dutch construction industry. METHODS Data were collected on seven process indicators, ie, reach, dose delivered, dose received, fidelity, competence, satisfaction, and barriers. RESULTS The intervention reached 2.4% of the target group. Thirty-eight percent of the participants received five to seven consultations and 41% discussed all six intervention components. None of the counselors attained motivational interviewing proficiency. Participants perceived their counselor as competent and were satisfied with the intervention. Counselors were moderately satisfied with the intervention and experienced various barriers. CONCLUSIONS Even though important conditions for scale up were met, the implementation was characterized by a low reach, a high drop-out rate, and a low quality of the counseling technique.
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Stoutenberg M, Stanzilis K, Falcon A. Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings. Int J Behav Med 2015; 22:312-27. [PMID: 25200447 DOI: 10.1007/s12529-014-9438-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Lifestyle modification programs (LMPs) can provide individuals with behavioral skills to sustain long-term changes to their physical activity (PA) levels and dietary habits. Yet, there is much work to be done in the translation of these programs to community settings. PURPOSE This review identified LMPs that focused on changing both PA and dietary behaviors and examined common features and barriers faced in their translation to community settings. METHODS A search of multiple online databases was conducted to identify LMPs that included participants over the age of 18 who enrolled in LMPs, offered in community settings, and had the goal of improving both PA and dietary behaviors. Data were extracted on participant demographics, study design characteristics, and study outcome variables including changes in PA, dietary habits, body weight, and clinical outcomes. RESULTS We identified 27 studies that met inclusion criteria. Despite high levels of retention and adherence to the interventions, varying levels of success were observed in increasing PA levels, improving dietary habits, reducing body weight, and improving clinic outcomes. CONCLUSION LMPs addressing issues of PA and dietary habits can be successfully implemented in a community setting. However, inconsistent reporting of key components in the translation of these studies (participant recruitment, utilization of behavioral strategies) may limit their replication and advancement of future programs. Future efforts should better address issues such as identifying barriers to participation and program implementation, utilization of community resources, and evaluating changes across multiple health behaviors.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA,
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Hurt TR, Seawell AH, O'Connor MC. Developing Effective Diabetes Programming for Black Men. Glob Qual Nurs Res 2015; 2:2333393615610576. [PMID: 28462319 PMCID: PMC5342290 DOI: 10.1177/2333393615610576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 08/29/2015] [Accepted: 09/04/2015] [Indexed: 12/18/2022] Open
Abstract
The purpose of this study is to obtain feedback from 20 men on developing effective programming to reduce the impact of diabetes (t2dm) among Black men. Three focus groups were convened in Des Moines, Iowa. Men were recruited, all either diagnosed with t2dm (n = 10), pre-diabetic (n = 1), or experienced t2dm through family and friends (n = 9). The results highlighted themes related to t2dm knowledge, masculinity, and behavioral health; gender-centered diabetes management education; and family support and functioning. Men provided recommendations for program format and content, desirable facilitator characteristics, and whether to include spouses/partners, relatives, and friends. These results provide guidance and ideas to nurses wishing to enhance t2dm education and patient outcomes for Black men.
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A review of diabetes prevention program translations: use of cultural adaptation and implementation research. Transl Behav Med 2015; 5:401-14. [PMID: 26622913 DOI: 10.1007/s13142-015-0341-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The Diabetes Prevention Program (DPP) has been shown to prevent type 2 diabetes through lifestyle modification. The purpose of this study was to describe the literature on DPP translation, synthesizing studies using cultural adaptation and implementation research. A systematic search was conducted. Original studies evaluating DPP implementation and/or cultural adaptation were included. Data about cultural adaptation, implementation outcomes, and translation strategies was abstracted. A total of 44 were included, of which 15 reported cultural adaptations and 38 explored implementation. Many studies shortened the program length and reported a group format. The most commonly reported cultural adaptation (13 of 15) was with content. At the individual level, the most frequently assessed implementation outcome (n = 30) was adoption. Feasibility was most common (n = 32) at the organization level. The DPP is being tested in a variety of settings and populations, using numerous translational strategies and cultural adaptations. Implementation research that identifies, evaluates, and reports efforts to translate the DPP into practice is crucial.
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Evaluation of physical activity reporting in community Diabetes Prevention Program lifestyle intervention efforts: A systematic review. Prev Med 2015; 77:191-9. [PMID: 26051204 DOI: 10.1016/j.ypmed.2015.05.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/29/2015] [Accepted: 05/30/2015] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The Diabetes Prevention Program (DPP) lifestyle intervention has been translated to community settings using the DPP goals of 7% weight loss and 150min of moderate physical activity (PA) per week. Given that PA is a primary lifestyle goal and has been linked to improvements in metabolic health in the DPP, it is important to understand the role that PA plays in translation effort success. The purpose of this review is to thoroughly evaluate the reporting of PA methodology and results in DPP-based translations in order to guide future prevention efforts. METHODS PubMed and Ovid databases were searched to identify peer-reviewed original research articles on DPP-based translations for adults at-risk for developing diabetes or cardiovascular disease, limited to English language publications from January 2002-March 2015. RESULTS 72 original research articles describing 57 translation studies met eligibility criteria. All 57 study interventions included a PA goal, 47 studies (82%) collected participant PA information, and 34 (60%) provided PA results. CONCLUSIONS Despite PA being a primary intervention goal, PA methodology and results are under-reported in published DPP translation studies. This absence and inconsistency in reporting PA needs addressed in order to fully understand translation efforts' impact on participant health.
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Newlin Lew K, Arbauh N, Banach P, Melkus G. Diabetes: Christian worldview, medical distrust and self-management. JOURNAL OF RELIGION AND HEALTH 2015; 54:1157-1172. [PMID: 25735754 PMCID: PMC4673985 DOI: 10.1007/s10943-015-0022-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To inform the development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N = 44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical distrust and self-management as prominent themes. Findings suggest that diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African-American community to improve health outcomes.
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Seawell AH, Hurt TR, Shirley MC. The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men: A Qualitative Analysis. Am J Mens Health 2015; 10:149-56. [PMID: 25862692 DOI: 10.1177/1557988315580132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study used focus-group methodology to seek understanding about the unique influence of stress, gender, and culture on type 2 diabetes mellitus (t2dm) prevention and management among Black men. Twenty men from Iowa were recruited from a larger longitudinal study on Black families; each of these men participated in one of three focus groups. Ninety-five percent of the men in the sample were Black and all were either diagnosed with t2dm (n = 10), were prediabetic (n = 1), or had experience with t2dm through family and friends (n = 9). Our results revealed the existence of significant stress and some pessimism with respect to perceived ability to prevent and manage t2dm. The participants made it clear that, while their families are primary sources of support for managing stress, including t2dm, they can also be a source of stress, particularly with respect to parenting. Black men had mixed opinions on their relationships with respect to their health care providers; some had positive, long-standing relationships while others reported little or no relationship with their providers. In response to life stress, Black men reported experiencing inadequate and disrupted sleep as well as consuming too much alcohol at times. Some of the participants reported engaging in physical activity to manage their stress. The study concluded that, as researchers develop t2dm prevention and management programs, they should continue to consider the unique role that stress in its various forms, plays in the lives of Black men.
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Kramer MK, Molenaar DM, Arena VC, Venditti EM, Meehan RJ, Miller RG, Vanderwood KK, Eaglehouse Y, Kriska AM. Improving employee health: evaluation of a worksite lifestyle change program to decrease risk factors for diabetes and cardiovascular disease. J Occup Environ Med 2015; 57:284-91. [PMID: 25742535 PMCID: PMC4351781 DOI: 10.1097/jom.0000000000000350] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine whether an evidence-based, behavioral lifestyle intervention program delivered at a worksite setting is effective in improving type 2 diabetes and cardiovascular disease risk factors. METHODS A randomized 6-month delayed control design was utilized, with two thirds of the participants assigned to begin intervention immediately, and one third beginning 6 months later. The year-long program (weekly for 3 months transitioning to monthly) focused on weight loss and increasing physical activity. RESULTS The immediate intervention group had greater mean weight loss (-10.4 lb, 5.1%, vs -2.3 lb, 1%; P = 0.0001) than the delayed control group at 6 months and relatively greater improvements in activity, HbA1c, and other risk factors. The delayed group experienced similar improvements after completing the intervention program. CONCLUSIONS A worksite behavioral lifestyle intervention is feasible and effective in significantly improving risk factors for type 2 diabetes and cardiovascular disease.
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Affiliation(s)
- M Kaye Kramer
- From the Department of Epidemiology (Drs Kramer, Kriska, and Vanderwood, Ms Meehan, Ms Miller, and Ms Eaglehouse), University of Pittsburgh Graduate School of Public Health, Pa; Department of Medicine (Dr Molenaar), Veterans Health Administration, Minneapolis, Minn; Department of Biostatistics (Dr Arena), University of Pittsburgh Graduate School of Public Health; and Western Psychiatric Institute and Clinic (Dr Venditti), Pittsburgh, Pa
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Dodani S, Beayler I, Lewis J, Sowders LA. HEALS Hypertension Control Program: Training Church Members as Program Leaders. Open Cardiovasc Med J 2015; 8:121-7. [PMID: 25685245 PMCID: PMC4323768 DOI: 10.2174/1874192401408010121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/26/2014] [Accepted: 06/29/2014] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Health disparities related to cardiovascular diseases (CVDs) including stroke have remained higher in the African-Americans (AAs) than in other populations. HEALS is a faith-based hypertension (HTN) control program modified according to AA community needs, and delivered by the church-lay members called church health advisors (CHAs). This study examined the feasibility and acceptability of training CHAs as HEALS program leaders. DESIGN Four CHAs completed a 10-hour HEALS program training workshop at the Church, conducted by the nutrition experts. Workshop was evaluated by CHAs on their level of satisfaction, clarity of contents covered and comfort in delivery the program to the church congregation. RESULTS The overall six main HEALS curriculum components were completed. Workshop was highly evaluated by CHAs on length of training, balance between content and skills development, and level of satisfaction with program delivery. CONCLUSION Church-based culturally modified health promotion interventions conducted by the community lay members may be a way to reduce health disparities in ethnic minorities.
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Affiliation(s)
- Sunita Dodani
- University of Florida College of Medicine, Jacksonville, Florida, USA
| | | | - Jennifer Lewis
- Duval County Department of Health, Jacksonville, Florida, USA
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Rivera-Hernandez M. The role of religious leaders in health promotion for older Mexicans with diabetes. JOURNAL OF RELIGION AND HEALTH 2015; 54:303-315. [PMID: 24493233 PMCID: PMC4758818 DOI: 10.1007/s10943-014-9829-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Clergy in the Mexico play a major role in addressing the health care needs of their congregants. With qualitative semi-structured key-informant interviews, this study explored the views of ten male Mexican religious leaders (mostly Catholic) about their understanding of their role in diabetes health promotion. The major themes from the qualitative interviews emphasized the importance of open communication between church leaders and their parishioners, the role of the church in diabetes programs, and the unique position of religious institutions as a link between physical and spiritual aspects of health. Implications for diabetes interventions are discussed.
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Affiliation(s)
- Maricruz Rivera-Hernandez
- Center for Gerontology and HealthCare Research, School of Public Health, Brown University, Box G-S121 (6), 121 South Main Street, Providence, RI, 02912, USA,
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Samuel-Hodge CD, Johnson CM, Braxton DF, Lackey M. Effectiveness of Diabetes Prevention Program translations among African Americans. Obes Rev 2014; 15 Suppl 4:107-24. [PMID: 25196409 DOI: 10.1111/obr.12211] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 06/13/2014] [Accepted: 06/14/2014] [Indexed: 01/01/2023]
Abstract
The Diabetes Prevention Program (DPP) demonstrated risk reduction for incident diabetes through weight loss among all participants, including African Americans. Several DPP translations have been conducted in less controlled settings, including primary care practices and communities; however, there is no detailed compilation of how effective these translations have been for African Americans. This systematic literature review evaluated DPP translations from 2003 to 2012. Eligible records were retrieved using a search strategy of relevant databases and gray literature. Retrieved records (n=1,272) were screened using a priori criteria, which resulted in 21 full-text studies for review. Seventeen studies were included in the full-text qualitative synthesis. Seven studies had 100% African American samples and 10 studies had mixed samples with African American subgroups. African American participants' average weight loss was roughly half of that achieved in the DPP intervention. However, with few higher-quality studies, small sample sizes and differences in intervention designs and implementation, comparisons across interventions were difficult. The suboptimal effectiveness of DPP translations among African American adults, particularly women, signals the need for enhancements to existing evidence-based interventions and more high-quality research that includes other at-risk African American subgroups such as men and younger adults of lower socioeconomic status.
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Affiliation(s)
- C D Samuel-Hodge
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, NC, USA
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Lancaster KJ, Carter-Edwards L, Grilo S, Shen C, Schoenthaler AM. Obesity interventions in African American faith-based organizations: a systematic review. Obes Rev 2014; 15 Suppl 4:159-76. [PMID: 25196412 DOI: 10.1111/obr.12207] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 01/14/2023]
Abstract
African Americans, especially women, have higher obesity rates than the general US population. Because of the importance of faith to many African Americans, faith-based organizations (FBOs) may be effective venues for delivering health messages and promoting adoption of healthy behaviours. This article systematically reviews interventions targeting weight and related behaviours in faith settings. We searched literature published through July 2012 for interventions in FBOs targeting weight loss, diet and/or physical activity (PA) in African Americans. Of 27 relevant articles identified, 12 were randomized controlled trials; seven of these reported a statistically significant change in an outcome. Four of the five quasi-experimental and single-group design studies reported a statistically significant outcome. All 10 pilot studies reported improvement in at least one outcome, but most did not have a comparison group. Overall, 70% of interventions reported success in reducing weight, 60% reported increased fruit and vegetable intake and 38% reported increased PA. These results suggest that interventions in African American FBOs can successfully improve weight and related behaviours. However, not all of the findings about the success of certain approaches were as expected. This review identifies gaps in knowledge and recommends more rigorous studies be conducted to strengthen the comparative methodology and evidence.
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Affiliation(s)
- K J Lancaster
- Steinhardt School of Culture, Education, and Human Development, Department of Nutrition, Food Studies and Public Health, New York University, New York, NY, USA
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Kumanyika SK, Whitt-Glover MC, Haire-Joshu D. What works for obesity prevention and treatment in black Americans? Research directions. Obes Rev 2014; 15 Suppl 4:204-12. [PMID: 25196414 DOI: 10.1111/obr.12213] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 06/13/2014] [Accepted: 06/14/2014] [Indexed: 12/01/2022]
Abstract
Obesity prevalence in black/African American children and adults of both sexes is high overall and compared with US whites. What we know, and do not know, about how to enhance the effectiveness of obesity prevention and treatment interventions in African Americans is the focus of the 10 articles in this special issue of Obesity Reviews. The evidence base is limited in quantity and quality and insufficient to provide clear guidance. With respect to children, there is relatively consistent, but not definitive support for prioritizing the systematic implementation and evaluation of child-focused interventions in pre-school and school settings and outside of school time. For adults or all ages, developing and refining e-health approaches and faith-based or other culturally and contextually relevant approaches, including translation of the Diabetes Prevention Program intervention to community settings is indicated. Major evidence gaps were identified with respect to interventions with black men and boys, ways to increase participation and retention of black adults in lifestyle behaviour change programmes, and studies of the impact of environmental and policy changes on eating and physical activity in black communities. Bold steps related to research funding priorities, research infrastructure and methodological guidelines are recommended to improve the quantity and quality of research in this domain.
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Affiliation(s)
- S K Kumanyika
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Hosler AS, Michaels IH. Spatial Access to Faith-based Diabetes Intervention for Guyanese Adults in Schenectady, New York. DIABETES EDUCATOR 2014; 40:526-532. [PMID: 25049372 DOI: 10.1177/0145721714533828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this study is to examine whether travel distance would pose a barrier to participation in proposed diabetes intervention programs for Guyanese immigrants at faith-based organizations (FBOs). This study also suggests the most collectively accessible set of FBOs that could serve as intervention sites. METHODS Data were extracted from a cross-sectional health interview survey conducted in Schenectady, New York, in 2011. The shortest driving distances from homes to FBOs and to the city's only diabetes education center (DEC) were analyzed among Guyanese and non-Guyanese adults with diabetes and prediabetes (n = 238), using spatial algorithms and Geographic Information System resources. RESULTS The Guyanese were more likely to belong to a FBO than the non-Guyanese (77.8% vs 61.2%). The mean driving distance to FBO was 1.19 miles (95% CI, 0.98-1.39) for the Guyanese, which was significantly shorter than that for the non-Guyanese (2.87 miles, 95% CI, 1.93-3.82). The Guyanese had uniformly shorter mean and median driving distances in all sociodemographic and health status subcategories as well. Moreover, a higher percentage of the Guyanese lived closer to FBO than to DEC compared to non-Guyanese (52.2% vs 34.7%). It was found that having diabetes intervention at the 4 most popular FBOs (2 Hindu temples and 2 Christian churches) and DEC would provide the most collectively accessible arrangement for the Guyanese. CONCLUSIONS The results suggest that the short driving distance to FBO is a likely enabler that can encourage regular utilization of the faith-based intervention for the Guyanese.
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Affiliation(s)
- Akiko S Hosler
- Department of Epidemiology and Biostatistics, University at Albany (SUNY) School of Public Health, Rensselaer, New York(Dr Hosler, Mr Michaels)
| | - Isaac H Michaels
- Department of Epidemiology and Biostatistics, University at Albany (SUNY) School of Public Health, Rensselaer, New York(Dr Hosler, Mr Michaels)
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49
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Islam NS, Zanowiak JM, Wyatt LC, Kavathe R, Singh H, Kwon SC, Trinh-Shevrin C. Diabetes prevention in the New York City Sikh Asian Indian community: a pilot study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:5462-86. [PMID: 24852392 PMCID: PMC4053907 DOI: 10.3390/ijerph110505462] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 05/06/2014] [Accepted: 05/09/2014] [Indexed: 12/19/2022]
Abstract
India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious.
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Affiliation(s)
- Nadia S Islam
- Health Promotion and Prevention Research Center, Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA.
| | - Jennifer M Zanowiak
- Health Promotion and Prevention Research Center, Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA.
| | - Laura C Wyatt
- Center for the Study of Asian American Health, Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA.
| | - Rucha Kavathe
- UNITED SIKHS, Community Education & Empowerment Directorate, New York, NY 10116, USA.
| | - Hardayal Singh
- UNITED SIKHS, Community Education & Empowerment Directorate, New York, NY 10116, USA.
| | - Simona C Kwon
- Health Promotion and Prevention Research Center, Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA.
| | - Chau Trinh-Shevrin
- Health Promotion and Prevention Research Center, Department of Population Health, School of Medicine, New York University, New York, NY 10016, USA.
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50
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Williams TT, Pichon LC, Latkin CA, Davey-Rothwell M. Practicing What is Preached: The Relationship between Congregational Support and HIV Prevention Behaviors among Black Women. JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 42:365-378. [PMID: 25435597 PMCID: PMC4243173 DOI: 10.1002/jcop.21615] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Through the current analysis, we aimed to better understand the relationship between congregational support and HIV prevention behaviors among a sample of high risk, HIV negative Black women. Participants were 434 Black women who were at high risk for contracting HIV through heterosexual sex. They were recruited from a city in the Mid Atlantic Region. Data were collected through face-to-face interviews and Audio-Computer-Assisted Self-Interviews (ACASI). Results revealed three congregational characteristics were important for Black women's comfort level discussing HIV and their likelihood of returning for their HIV test results: feeling loved by their congregation, having ministries that helped people with their problems and feeling listened to by their congregation. Thus, religious congregational support was a significant correlate of Black women's comfort discussing HIV prevention and treatment as well as their motivation to return to get their HIV test results.
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Affiliation(s)
| | | | - Carl A. Latkin
- Johns Hopkins Bloomberg School of Public Health,
Baltimore, Maryland
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