Men on the Move-Nashville: Feasibility and Acceptability of a Technology-Enhanced Physical Activity Pilot Intervention for Overweight and Obese Middle and Older Age African American Men

Gender-sensitive community weight-loss programmes to address overweight and obesity in men: a scoping review

OBJECTIVES

To examine how gender-sensitive community weight-loss programmes have been used to address overweight and obesity in men and to identify what can be learnt from this rapidly evolving field.

DESIGN

Scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review checklist for reporting.

DATA SOURCES

A database search was conducted using EBSCOhost (Academic Search Complete, CINAHL Complete, Global Health, Health Source: Consumer Edition, Health Source: Nursing/Academic Edition and Medline Complete), Google, Google Scholar, Open Access Theses and Dissertations platform and Scopus.

ELIGIBILITY CRITERIA

All weight-loss programmes using a gender-sensitive approach to address men's overweight and obesity in community settings.

DATA EXTRACTION AND SYNTHESIS

Narrative synthesis was conducted based on the research questions and objectives. Primary outcomes include operationalisation, context and concept of the gender-sensitive approach. Information was reviewed and extracted to Microsoft Excel by two reviewers.

RESULTS

A total of 40 studies (28 quantitative, eight mixed methods and four qualitative) were identified from 4617 records. Gender-sensitive approaches were undertaken in a range of settings and contexts including professional sports clubs (n=21), non-professional sporting clubs (n=16), workplace-based (n=2) and commercial organisation-based (n=1). The most common analysis approaches were evaluating the effect of the programmes (n=31) where positive impact was predominantly shown (eg, up to 3.9 kg weight reduction at 3-month follow-up). Programmes (ie, Football Fans in Training) were short-term cost-effective (eg, the cost was £862-£2228 per 5% weight reduction at 12-month follow-up). Qualitative evidence highlights factors that influenced men's participation (eg, camaraderie) and identifies areas for improvement.

CONCLUSION

The findings demonstrate that gender-sensitive programmes for men's weight loss have been effectively applied using a range of different approaches and in a range of different contexts. Further evidence is needed to confirm the effectiveness of the programmes across diverse groups of men.

Tailor Made: A Pilot Virtual Weight Loss Intervention Individually Tailored for African American Men

This study tests the acceptability and feasibility of the first virtual weight loss study individually tailored for middle-aged African American men. Tailor Made is a 3-month randomized controlled pilot of a weight loss intervention that included 58 overweight or obese African American men (mean age of 50.4; SD = 7.9). Control group participants received a Fitbit activity tracker and Bluetooth-enabled scale and copies of the self-led Tailor Made curriculum. Intervention group participants received the same Fitbit, Bluetooth-enabled scale, and curriculum and also participated in weekly, 45-minute virtual small group, professional-led education sessions using the Tailor Made curriculum and received three SMS text messages weekly: (a) a message individually tailored on African American Manhood that links men's values, goals, and motivation to health-promoting behavior; (b) a goal-tracking message to monitor physical activity, healthier eating, and lifestyle changes; and (c) a reminder 24 hours before their session. Participation rates in weekly small group sessions, randomization, and attendance at the assessments suggest that Tailor Made was feasible and acceptable. Only among intervention group participants, we found a small and significant decrease in BMI between baseline and final. In addition, active minutes of physical activity decreased for the control group while active minutes for the intervention group remained steady throughout the intervention. In sum, we demonstrated that a virtual, individually tailored weight loss intervention is feasible and acceptable to African American men. Participants valued the convenience of a virtual intervention, but there were a number of ways we may be able to enhance the potential benefits of this approach.

Mighty Men: A Pilot Test of the Feasibility and Acceptability of a Faith-Based, Individually Tailored, Cluster-Randomized Weight Loss Trial for Middle-Aged and Older African American Men

Two in five African American men have obesity, but they are underrepresented in community-based weight loss interventions. This pilot effectiveness trial examines the acceptability and feasibility of the first weight loss study for African American men that includes randomization and individual tailoring. Using a community-based, cluster-randomized, longitudinal parallel group design, four churches were randomized to a control condition or a weight loss condition. Each church received physical activity equipment, a coordinator, and small group physical activity sessions. A total of 71 African American men (mean age: 58.5) enrolled and received a Fitbit, Bluetooth-enabled scale, a t-shirt, gift cards for participation, and 45 min of small group physical activity led by a certified personal trainer. Men in the weight loss condition also received 45 min of health education and individually tailored SMS text messages. Multiple metrics suggest that Mighty Men was feasible, yet the acceptability of the intervention components was mixed. Participants in both the weight loss and control conditions lost weight between zero and 6 months (p < .001), but body fat (p = .005) and visceral fat percentage (p = .001) of men in the weight loss condition decreased while men in the control condition did not (p < .05). An increase in physical activity was seen among men in the weight loss condition (p = .030) but not among men in the control condition (p < .05). It is acceptable and feasible to conduct a 6-month weight loss intervention with African American men that includes randomization and individually tailored text messages.

A qualitative study of ecological and motivational factors to inform weight management interventions for Black men in the rural South of the United States

RATIONALE AND OBJECTIVE

Black men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South.

METHODS

We conducted individual telephone interviews with 23 Black men (mean age 50 ± 14 years) with overweight or obesity living in rural South Carolina communities in 2020 and 2021. Interviews were audio recorded, professionally transcribed, and coded by two men's health researchers who achieved an intercoder reliability of 70%. Content analysis using QSR NVivo 12 was used to generate themes using deductive and inductive approaches.

RESULTS

Physical health and health behaviors were perceived as key determinants of overall health. Family, friends, and other social contacts often provided positive social support that increased motivation but also hindered motivation by engaging in behaviors men were trying to avoid. Younger participants had stronger views of rural environments not supporting healthy lifestyles, which compounded personal challenges such as time constraints and lack of motivation. Comfort was discussed as a critical program consideration, and gender concordance among program participants and facilitators was perceived as promoting comfort. Participants noted preferences and benefits of in-person, group programs emphasizing physical activity, and younger participants more strongly endorsed programs that incorporated sports and competition.

CONCLUSIONS

Findings from this study provide important evidence to inform the development of weight management interventions for Black men in the rural US South. Based on these findings, an innovative, competitive "football-themed" weight management program promoting peer support and integrating competitive physical activities is being evaluated for younger Black men in the rural South.

The combined effect of motivational interviewing and wearable fitness trackers on motivation and physical activity in inactive adults: A randomized controlled trial

Despite overwhelming adoption of wearable fitness trackers (WFT), it is unclear if they affect physical activity (PA) engagement or PA motivation. We hypothesized that combining a WFT with an effective intervention, motivational interviewing (MI), would positively influence both motivation and PA. A 12-week randomized controlled trial was conducted in 40 adults who did not meet PA recommendations. The four conditions were: a PA education (Educational control, n = 10), a WFT (WFT, n = 10), bi-weekly MI sessions (MI, n = 10), or both interventions (WFT+, n = 10). Motivation and PA were measured through an online survey and actigraphy pre- and post-intervention. Both the WFT+ and MI groups improved autonomous forms and decreased controlled forms of motivation. They also had higher basic psychological needs scores when compared to the Education group post-intervention. We detected no changes in PA. High autonomous motivation at baseline predicted higher post-intervention PA in the WFT+ group but predicted lower post-intervention PA in the WFT group. Results suggests that MI alone or with a WFT can improve basic psychological needs and autonomous forms of motivation for PA, but not PA participation. Individual differences in motivation at baseline may moderate the effect of a WFT on PA. This study was registered at clinicaltrials.gov (NCT490014).

Systematic realist synthesis of health-related and lifestyle interventions designed to decrease overweight, obesity and unemployment in adults

Background

Obesity and unemployment are complex social and health issues with underlying causes that are interconnected. While a clear link has been established, there is lack of evidence on the underlying causal pathways and how health-related interventions could reduce obesity and unemployment using a holistic approach.

Objectives

The aim of this realist synthesis was to identify the common strategies used by health-related interventions to reduce obesity, overweight and unemployment and to determine for whom and under what circumstances these interventions were successful or unsuccessful and why.

Methods

A realist synthesis approach was used. Systematic literature searches were conducted in Cochrane library, Medline, SocIndex, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PsychInfo. The evidence from included studies were synthesised into Context-Mechanism-Outcome configurations (CMOcs) to better understand when and how programmes work, for which participants and to refine the final programme theory.

Results

A total of 83 articles met the inclusion criteria. 8 CMOcs elucidating the contexts of the health-related interventions, underlying mechanisms and outcomes were identified. Interventions that were tailored to the target population using multiple strategies, addressing different aspects of individual and external environments led to positive outcomes for reemployment and reduction of obesity.

Conclusion

This realist synthesis presents a broad array of contexts, mechanisms underlying the success of health-related interventions to reduce obesity and unemployment. It provides novel insights and key factors that influence the success of such interventions and highlights a need for participatory and holistic approaches to maximise the effectiveness of programmes designed to reduce obesity and unemployment.

Trial registration

PROSPERO 2020 CRD42020219897.

Improving Recruitment, Retention, and Cultural Saliency of Health Promotion Efforts Targeting African American Men: A Scoping Review

BACKGROUND

When health promotion efforts intend to include African American men, they experience challenges with recruitment and retention, in addition to limited cultural saliency-interventions that do not align the cultural preferences and experiences of the target population produce less effective results.

PURPOSE

This scoping review provides an understanding of (a) how health promotion efforts among African American men are developed and implemented, in addition to the (b) main outcomes, (c) retention rates, and (d) methodological rigor of those efforts.

METHODS

The following databases were used: PubMed, EMBASE (Ovid), PsycINFO (EBSCO), CINAHL (EBSCO), Web of Science (Clarivate), and ProQuest. Included studies were restricted to those: (a) conducted among African American men and (b) reported the effects of a health promotion intervention. Interventions using single-group pre-post study, post-test-only study, non-randomized controlled trial, and randomized controlled trial (RCT) study designs were included.

RESULTS

The results indicate that varying degrees of customization in the design and implementation of health promotion efforts targeting African American can improve recruitment, retention, and health-related outcomes. Results draw attention to the need for community input when designing and implementing efforts targeting these men.

CONCLUSIONS

These results indicate that opportunities exist to innovate health promotion efforts among African American men, such as the intentional incorporation of the community's values, perspectives, and preferences in the effort (i.e., cultural saliency) and explicitly indicating how the efforts were culturally tailored to improve saliency. Opportunities also exist to innovate health promotion efforts among African American men based on literature-derived best practices.

Peer Group Support Intervention to Reduce Cardiovascular Disease Risk for African American Men According to Life's Simple 7 in Faith-Based Communities

BACKGROUND AND PURPOSE

Adverse cardiovascular health disparities persist for African American men. Although changing health behaviors is perhaps one of the most effective methods to prevent cardiovascular disease (CVD)-related deaths, previous behavior change programs targeting single or multiple CVD risk factors in target groups have had mixed success. The purpose of this pilot study was to determine whether a multi-faceted peer group intervention model based on American Heart Association's Life's Simple 7 was feasible, safe, acceptable, and efficacious in producing meaningful risk reduction for African American men.

METHODS

A convenience sample of 24 African American men with at least one CVD risk factor participated quasi-experimental study having peer intervention vs. nonequivalent comparison groups, with pretest-posttests at two church sites in Minneapolis, MN (MPLS) and Washington, D.C. (DC). Feasibility, safety, acceptability, and potential efficacy were assessed by examining completion of peer group sessions, adverse events, attendance, attrition, within and between-group changes in measures using nonparametric statistics.

RESULTS

All twenty-four men completed the study with no study-related adverse symptoms and medical events. The peer groups had moderate to high attendance, and the peer program evaluation was highly positive among participants. Between baseline and 6-months, there were significant differences between the intervention and the comparison group in cholesterol levels and weights (p = .041, p = .034, respectively) at one site (DC). There were no significant between-group changes at the other site (MPLS).

IMPLICATION FOR PRACTICE

The multi-faceted peer support intervention was feasible, acceptable, and shown to have potential efficacy to reduce CVD risk for highly motivated African American men. Future studies with a larger sample size are needed to test the effectiveness of this intervention model to reduce CVD risk among African American men.

Acceptability and feasibility of the TELEhealth BARIatric behavioural intervention to increase physical ACTIVity (TELE-BariACTIV): A single-case experimental study protocol (Preprint)

Background

Regular physical activity (PA) is recommended to optimize weight and health outcomes in patients who have undergone metabolic and bariatric surgery (MBS). However, >70% of patients have low PA levels before MBS that persist after MBS. Although behavioral interventions delivered face-to-face have shown promise for increasing PA among patients who have undergone MBS, many may experience barriers, preventing enrollment into and adherence to such interventions. Delivering PA behavior change interventions via telehealth to patients who have undergone MBS may be an effective strategy to increase accessibility and reach, as well as adherence.

Objective

This paper reports the protocol for a study that aims to assess the feasibility and acceptability of the protocol or methods and the Telehealth Bariatric Behavioral Intervention (TELE-BariACTIV). The intervention is designed to increase moderate-to-vigorous intensity PA (MVPA) in patients awaiting bariatric surgery and is guided by a multitheory approach and a patient perspective. Another objective is to estimate the effect of the TELE-BariACTIV intervention on presurgical MVPA to determine the appropriate sample size for a multicenter trial.

Methods

This study is a multicenter trial using a repeated (ABAB’A) single-case experimental design. The A phases are observational phases without intervention (A1=pre-MBS phase; A2=length personalized according to the MBS date; A3=7 months post-MBS phase). The B phases are interventional phases with PA counseling (B1=6 weekly pre-MBS sessions; B2=3 monthly sessions starting 3 months after MBS). The target sample size is set to 12. Participants are inactive adults awaiting sleeve gastrectomy who have access to a computer with internet and an interface with a camera. The participants are randomly allocated to a 1- or 2-week baseline period (A1). Protocol and intervention feasibility and acceptability (primary outcomes) will be assessed by recording missing data, refusal, recruitment, retention, attendance, and attrition rates, as well as via web-based acceptability questionnaires and semistructured interviews. Data collected via accelerometry (7-14 days) on 8 occasions and via questionnaires on 10 occasions will be analyzed to estimate the effect of the intervention on MVPA. Generalization measures assessing the quality of life, anxiety and depressive symptoms, and theory-based constructs (ie, motivational regulations for PA, self-efficacy to overcome barriers to PA, basic psychological needs satisfaction and frustration, PA enjoyment, and social support for PA; secondary outcomes for a future large-scale trial) will be completed via web-based questionnaires on 6-10 occasions. The institutional review board provided ethics approval for the study in June 2021.

Results

Recruitment began in September 2021, and all the participants were enrolled (n=12). Data collection is expected to end in fall 2023, depending on the MBS date of the recruited participants.

Conclusions

The TELE-BariACTIV intervention has the potential for implementation across multiple settings owing to its collaborative construction that can be offered remotely.

International Registered Report Identifier (IRRID)

DERR1-10.2196/39633

The Acceptability, Feasibility, and Effectiveness of Wearable Activity Trackers for Increasing Physical Activity in Children and Adolescents: A Systematic Review

Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined the acceptability, feasibility, and effectiveness of wearables and their potential mechanisms of action for increasing PA in 5 to 19-year-olds. A systematic search of six databases was conducted, including data from the start date of each database to December 2019 (PROSPERO registration: CRD42020164506). Thirty-three studies were included. Most studies (70%) included only adolescents (10 to 19 years). There was some-but largely mixed-evidence that wearables increase steps and moderate-to-vigorous-intensity PA and reduce sedentary behaviour. There were no apparent differences in effectiveness based on the number of BCTs used and between studies using a wearable alone or as part of a multi-component intervention. Qualitative findings suggested wearables increased motivation to be physically active via self-monitoring, goal setting, feedback, and competition. However, children and adolescents reported technical difficulties and a novelty effect when using wearables, which may impact wearables' long-term use. More rigorous and long-term studies investigating the acceptability, feasibility, and effectiveness of wearables in 5 to 19-year-olds are warranted.

Use of Fitbit Devices in Physical Activity Intervention Studies Across the Life Course: Narrative Review

BACKGROUND

Commercial off-the-shelf activity trackers (eg, Fitbit) allow users to self-monitor their daily physical activity (PA), including the number of steps, type of PA, amount of sleep, and other features. Fitbits have been used as both measurement and intervention tools. However, it is not clear how they are being incorporated into PA intervention studies, and their use in specific age groups across the life course is not well understood.

OBJECTIVE

This narrative review aims to characterize how PA intervention studies across the life course use Fitbit devices by synthesizing and summarizing information on device selection, intended use (intervention vs measurement tool), participant wear instructions, rates of adherence to device wear, strategies used to boost adherence, and the complementary use of other PA measures. This review provides intervention scientists with a synthesis of information that may inform future trials involving Fitbit devices.

METHODS

We conducted a search of the Fitabase Fitbit Research Library, a database of studies published between 2012 and 2018. Of the 682 studies available on the Fitabase research library, 60 interventions met the eligibility criteria and were included in this review. A supplemental search in PubMed resulted in the inclusion of 15 additional articles published between 2019 and 2020. A total of 75 articles were reviewed, which represented interventions conducted in childhood; adolescence; and early, middle, and older adulthood.

RESULTS

There was considerable heterogeneity in the use of Fitbit within and between developmental stages. Interventions for adults typically required longer wear periods, whereas studies on children and adolescents tended to have more limited device wear periods. Most studies used developmentally appropriate behavior change techniques and device wear instructions. Regardless of the developmental stage and intended Fitbit use (ie, measurement vs intervention tool), the most common strategies used to enhance wear time included sending participants reminders through texts or emails and asking participants to log their steps or synchronize their Fitbit data daily. The rates of adherence to the wear time criteria were reported using varying metrics. Most studies supplemented the use of Fitbit with additional objective or self-reported measures for PA.

CONCLUSIONS

Overall, the heterogeneity in Fitbit use across PA intervention studies reflects its relative novelty in the field of research. As the use of monitoring devices continues to expand in PA research, the lack of uniformity in study protocols and metrics of reported measures represents a major issue for comparability purposes. There is a need for increased transparency in the prospective registration of PA intervention studies. Researchers need to provide a clear rationale for the use of several PA measures and specify the source of their main PA outcome and how additional measures will be used in the context of Fitbit-based interventions.

Multilevel mobile health approach to improve cardiovascular health in resource-limited communities with Step It Up: a randomised controlled trial protocol targeting physical activity

INTRODUCTION

Although physical activity (PA) reduces cardiovascular disease (CVD) risk, physical inactivity remains a pressing public health concern, especially among African American (AA) women in the USA. PA interventions focused on AA women living in resource-limited communities with scarce PA infrastructure are needed. Mobile health (mHealth) technology can increase access to PA interventions. We describe the development of a clinical protocol for a multilevel, community-based, mHealth PA intervention for AA women.

METHODS AND ANALYSIS

An mHealth intervention targeting AA women living in resource-limited Washington, DC communities was developed based on the socioecological framework for PA. Over 6 months, we will use a Sequential Multi-Assignment, Randomized Trial approach to compare the effects on PA of location-based remote messaging (named 'tailored-to-place') to standard remote messaging in an mHealth intervention. Participants will be randomised to a remote messaging intervention for 3 months, at which point the intervention strategy will adapt based on individuals' PA levels. Those who do not meet the PA goal will be rerandomised to more intensive treatment. Participants will be followed for another 3 months to determine the contribution of each mHealth intervention to PA level. This protocol will use novel statistical approaches to account for the adaptive strategy. Finally, effects of PA changes on CVD risk biomarkers will be characterised.

ETHICS AND DISSEMINATION

This protocol has been developed in partnership with a Washington, DC-area community advisory board to ensure feasibility and acceptability to community members. The National Institutes of Health Intramural IRB approved this research and the National Heart, Lung, and Blood Institute provided funding. Once published, results of this work will be disseminated to community members through presentations at community advisory board meetings and our quarterly newsletter.

TRIAL REGISTRATION NUMBER

NCT03288207.

Overcoming barriers to physical activity in underserved populations

There is compelling evidence suggesting underserved populations, including racial/ethnic minorities and individuals with low socioeconomic status, are less likely to partake in sufficient amounts of physical activity (PA) at recommended levels. Communities of color and low-income individuals face institutional, societal, and environmental barriers that may prevent them from achieving adequate levels of PA. However, these communities also possess a wealth of knowledge, assets, and support that can be harnessed to help individuals meet PA guidelines. This paper outlines the barriers to PA and explores how to overcome them, drawing from case studies of successful, evidence-based interventions that use culturally- and linguistically- appropriate approaches to increase PA in underserved populations.

Effects of Motivational Interviewing and Wearable Fitness Trackers on Motivation and Physical Activity: A Systematic Review

OBJECTIVE

To systematically review the impacts of Wearable Fitness Trackers (WFTs), Motivational Interviewing (MI), and Self Determination Theory (SDT)-based interventions on physical activity (PA) and motivation for PA.

DATA SOURCE

Manuscripts published between 2008 and 2018 in PubMed, Web of Science, CABAbstracts, and SPORTDiscus database were reviewed.

STUDY INCLUSION AND EXCLUSION CRITERIA

Inclusion criteria were original pilot studies, randomized controlled trials (RCT), cross-sectional studies, qualitative assessments, prospective cohort studies, longitudinal observational studies, and pretest posttest designs published in peer-reviewed journals.

DATA EXTRACTION

Studies were evaluated by 2 independent researchers for inclusion.

DATA SYNTHESIS

Extracted data were synthesized in a tabular format and narrative summary.

RESULTS

Twenty-six studies met final inclusion criteria, 10 addressed WFT use and PA behavior, 4 investigated WFT use and its association with motivation for PA, and 10 examined SDT and/or MI and their effect on motivation for PA and/or PA behavior. Finally, 2 studies addressed SDT-based MI, WFT use, and the combined effect on PA behavior.

CONCLUSIONS

While SDT-based interventions and MI positively impact motivation for PA and PA behavior, WFTs revealed mixed results. Wearable Fitness Trackers prove effective among individuals not currently meeting PA guidelines but have little impact on other populations. Self Determination Theory, MI, and WFTs use provides a promising combination of interventions to increase PA among sedentary individuals, though research is limited.

Mighty men: A faith-based weight loss intervention to reduce cancer risk in African American men

According to the American Cancer Society's guidelines on nutrition and physical activity for cancer prevention, weight control, eating practices and physical activity are second only to tobacco use as modifiable determinants of cancer risk. However, no evidence-based interventions have been targeted to African American men or tailored to individual African American men's preferences, needs or identities. The goal of this chapter is to describe the rationale for the components, aims and setting of Mighty Men: A Faith-Based Weight Loss Intervention for African American Men. We begin by discussing the rationale for focusing on weight loss in the context of cancer prevention, and argue that obesity and obesogenic behaviors are important yet modifiable determinants of cancer risk. Next, we briefly review the scarce literature on interventions to promote healthy eating, physical activity and weight loss in our population of interest, and then discuss the rationale for conducting the intervention in faith- based organizations rather than other common settings for recruiting African American men. We conclude with a discussion of the conceptual foundations and components of Mighty Men, and discuss our focus and goals in the context of the larger literature in this area.

Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health

The Diabetes Prevention Program (DPP) landmark randomized trial demonstrated that participants with prediabetes could reduce their risk for type 2 diabetes by 58% if they achieved 5%-7% weight loss through healthy eating and increasing physical activity. The National DPP (NDPP) is a group intervention based on the DPP and has been widely disseminated by the Centers for Disease Control and Prevention (CDC) and many healthcare institutions. While data show that the program is effective in diverse populations, enrollment among men from low-income and minority communities is low. Thus, the study piloted a novel adaptation focused on men living in disadvantaged neighborhoods. The study approach to adaptation and implementation used characteristics of participatory research, including input from an expert panel of African American and Latino leaders, ongoing consultation with an Advisory Panel, and focus groups with members of the target population. Discussions with these groups focused on male perspectives regarding health promotion and barriers and facilitators to participation in health programming for men. There was general agreement when reviewing ongoing pilot program implementation that the adapted program should have male-only groups with male coaches, as the Advisory Panel had originally suggested. The pilot programs were implemented at five New York City Department of Parks and Recreation sites in Harlem, the Bronx, and Brooklyn in 2015-2016.

Power Up for Health: Pilot Study Outcomes of a Diabetes Prevention Program for Men from Disadvantaged Neighborhoods

There is a significant evidence base for the Diabetes Prevention Program, a lifestyle intervention to prevent onset of type 2 diabetes among high-risk individuals; however, translation of this intervention for men has been challenging. This report presents outcomes of the pilot study of an adapted 16-week diabetes prevention program entitled " Power Up for Health." The study goal was to better engage men of color with prediabetes from disadvantaged neighborhoods of New York City. It was implemented at five different recreation centers located in predominantly low-income neighborhoods across New York City. The curriculum was facilitated by male lifestyle coaches only; one group was conducted in Spanish. Primary outcome was weight loss from baseline to 16 weeks. Other measures included lifestyle activities, depressive symptoms, and self-reported health status. Men ( N = 47) were screened by telephone. Of the 29 eligible men who began the program, 25 attended at least 4 sessions (52% non-Latino Black, 32% Latino, mean age 51.7 ± SD 9.9 years, mean body mass index 35 ± SD 6.9 kg/m2). End of program outcomes ( n = 23) varied by site and included a mean weight loss of 3.8% (9.7 lbs); 3 of the 5 sites had a mean weight loss of 5.6%, meeting the national goal of 5%-7%. Men ( n = 23) attended a mean of 11.6 of 16 sessions. Improvement in depressive symptoms, healthy eating and exercise, and health status were also seen. While recruitment was challenging with many lessons learned, the adapted men's diabetes prevention program shows promise of success for participants and their coaches.

Physical Activity Interventions With African American or Latino Men: A Systematic Review

Relatively little is known about what helps increase physical activity in African American men, and even less is known about promoting physical activity among Latino men. This systematic review aimed to address the key questions: (a) what is the state of the evidence on health-related behavior change interventions targeting physical activity among African American or Latino men? and (b) What factors facilitate physical activity for these men? For this review, nine electronic databases were searched to identify peer-reviewed articles published between 2011–2017 that reported interventions to promote physical activity among African American or Latino men. Following PRISMA guidelines, nine articles representing seven studies that met our criteria were identified: six published studies that provided data for African American men, and one published study provided data for Latino men. Consistent with previous reviews, more research is needed to better understand how gender can be incorporated in physical activity interventions for African American and Latino men. Future interventions should explore how being an adult male and a man of color shapes motivations, attitudes, and preferences to be physically active. Studies should consider how race and ethnicity intersect with notions of masculinity, manhood and Machismo to enhance the effectiveness of physical activity interventions for these populations. Despite the health benefits of physical activity, rates of these behaviors remain low among African American and Latino men. It is essential to determine how best to increase the motivation and salience for these men to overcome the obesogenic environments and contexts in which they often live.

Together Eating & Activity Matters (TEAM): results of a pilot randomized-clinical trial of a spousal support weight loss intervention for Black men

Objectives

The objective of this study is to evaluate the feasibility, participation, preliminary efficacy and retention in a couples-based weight loss intervention among Black men.

Design setting participants

Two-arm pilot randomized clinical trial in an academic clinical setting. Forty self-identified Black men and their female cohabitating partners (n = 80) aged 18 to 65 years with body mass index from 25 to 45 kg/m2 were randomized using computer generated tables to allocate treatments.

Intervention

Participants were randomized to a standard behavioural weight loss (Standard) programme or the Standard programme plus partner involvement (Enhanced). Both interventions focused on calorie reduction, physical activity and self-monitoring to facilitate weight loss. Enhanced included couples skills training and couple's communication components.

Main outcome and measures

Changes in weight from baseline to 3 months among men. Partner weight loss (secondary).

Results

Forty Black couples (men mean [SD] age, 47.4[11] years; body mass index, 35.0[6.1]), were recruited. Retention was 100% of the men and 98% of female partners. Attendance at group sessions was 63-73%. Between groups, mean (SD) weight changes among men were -3.4[.04] and -4.7[5.9] kg (p = 0.57) and among women -0.23[4.46] and -2.47[3.62] kg (p = 0.09), in the standard and enhanced groups.

Conclusions

Weight losses from an intervention enhanced by partner involvement and an intervention with no partner involvement were not different. Treatment choice can be based on preference rather than outcome as both treatments are effective in producing clinically significant percent weight loss.Trial registration Clinical Trials NCT02458053.

Lessons Learned About Motivation From a Pilot Physical Activity Intervention for African American Men

African American men are less likely than White men to meet physical activity recommendations, and few physical activity interventions have focused on the unique needs of African American men. Because health is not more important to men than fulfilling the role of a provider or other socially important roles, one of the biggest challenges in creating interventions for African American men is helping them identify reasons that they should prioritize both health and life goals. In a recent pilot physical activity intervention for 30- to 70-year-old African American men, we used self-determination theory and motivational interviewing principles to create worksheets that helped men identify their core values and life goals and asked them to describe how their values and goals were related to health and physical activity. We used basic statistics and thematic analysis to identify and examine key sources of motivation for men to be healthier and more physically active. We found that being healthy, a good Christian, a good spouse/partner, disciplined, and successful were among men's most important life goals. This article highlights a strategy for identifying key sources of motivation in African American men's lives and key themes that can be used in to enhance future interventions.