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OBJECTIVE: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. METHODS: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. RESULTS: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P < 0.001). The baseline PSS score was positively associated with baseline adiposity levels (e.g., weight, ß = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. CONCLUSIONS: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
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The importance and relevance of forensic practice to societal evolution has increased exponentially in recent years. As society evolves in its understanding of the complex relationships between mankind and society, we rely more and more on the services of forensic experts. This article elucidates the professions of forensic psychiatry and forensic psychology. We examine the two distinct professions from the spectrum of collaboration, integration of services, differences, and similarities. We also compare and contrast the educational background and training requirements for these two professions; and present illustrative scenarios and real life examples of the daily functions of both professionals. Lastly, we present demographic data for the areas of employment, numbers, and geographic distribution of the two professions. Forensic psychiatry is the interface between medicine and law, while forensic psychology is the interface between psychology and law. As such, these professions are mired with complexities and challenged by vulnerabilities. Professionals from both fields can serve as expert witnesses in court and therefore face similar challenges in their course of professional practice. Collaboration between these two professions has the potential to increase both the credibility and utility of forensic services to the courts, the individuals served, and the general public.