Prime Time Sister Circles(®)II: Evaluating a Culturally Relevant Intervention to Decrease Psychological and Physical Risk Factors for Chronic Disease in Mid-Life African American Women.

PURPOSE: This article presents the results of two evaluation studies of the Prime Time Sister Circles(®) (PTSC). The PTSC is a gender, cultural, and age specific, curriculum-based, low-cost, short-term, replicable support group approach aimed at reducing key modifiable health risk factors for chronic illnesses in midlife African American women. METHODS: Study 1 includes an evaluation of 31 PTSCs (N=656 women) documenting changes in psychological and attitudinal outcomes (health satisfaction, health locus of control), behavioral outcomes (healthy eating patterns, physical activity, stress management), and clinical outcomes (weight, BMI, blood pressure, non-fasting blood sugar). Study 2 includes evaluation of a subset of the PTSC sites (N=211 women) with comparison (N=55 women) data from those same locations. RESULTS: Study 1 showed significant changes (p<.0001) in the PTSC women's reports of (lower) stress, (higher) health locus of control, (increased) health satisfaction, (increased) physical activity, and (healthier) eating patterns. The PTSC women demonstrated a significant weight reduction at posttest (p <.0001) and had slightly better clinical outcomes in BMI, hypertension, and non-fasting blood sugar. Results document the sustainability of selected changes over a six-month period. Findings from the Study 2 strengthen the effectiveness claims of the PTSC intervention with significant changes for the PTSC women on selected outcomes and little changes for the comparison women. CONCLUSIONS: Results reaffirm findings regarding the effectiveness of the PTSC, as originally reported in Gaston, Porter, and Thomas (2007) and extends the credibility of findings by examining participants' clinical outcomes in addition to self-reports.

Paradoxes in obesity with mid-life African American women.

PURPOSE: To examine the relationship among socioeconomic status, psychological factors (ie, health locus of control, health satisfaction), and health behaviors (ie, physical exercise, eating patterns) in a volunteer sample of mid-life African American women residing within Washington, DC. METHODS: The study's sample included 351 African American women who participated in the 12-week Prime Time Sister Circles (PTSC) intervention and completed the initial self-report survey. Of the women completing the baseline survey, clinical assessments were taken on 277 participants. RESULTS: The majority (64.4%) of the women were either obese or extremely obese based upon their body mass index (BMI). Fewer than one-third of the women were satisfied with their weight. Despite these outcomes, most (61.8%) of the sample rated their health, in comparison to other African American women, as either good or very good. Further, more than one-half of the women were somewhat to very satisfied with their health knowledge, attitudes, behaviors, and their physical, emotional, and spiritual health. There was no significant relationship between obesity level and socioeconomic status, as measured by education, personal income, and total household income. Additionally, there were no significant differences in weight or eating behaviors by education, personal income, and total household income. The findings revealed a significant difference in the number of days the women reported engaging in physical exercise by personal income (p < .01) and total household income (p = .05), surprisingly, with the women in the lower-income categories reporting engaging in more days of physical exercise than women in the higher-income categories. CONCLUSIONS: This study documents the paradox of obesity in mid-life African American women related to socioeconomic status inasmuch as there were no differences observed in the prevalence of obesity by socioeconomic status indicators. The obese women of lower socioeconomic status reported exercising more than obese women of high socioeconomic status. Paradoxically, most of the obese women were dissatisfied with their body weight, shape, and physical health, but more than 50% were satisfied with their health attitudes and behaviors and 61.8% rated their health favorably. The paradoxes of obesity and African American women across various income levels are important to understand for interventions to success.

Attitudes and experiences regarding genetic research among persons of African descent.

Minorities are underrepresented in genetic research. This study examined the attitudes, experiences, and willingness of persons of African descent related to participation in genetic research. A total of 272 persons of African descent completed a questionnaire about attitudes and experiences associated with genetic research. Descriptive, Chi-square, and logistic regression were used to examine the impact of attitudes and experiences in predicting the odds of willingness to participate in genetic research. A majority of participants (97%) indicated that they have never participated in genetic research; however, a majority also reported that they would be willing to participate in a genetic study specifically for the detection of risk factors for cancer (87%), diabetes (89%), alcohol use disorder (73%), and Alzheimer's disease (88%). Participants who disagreed that "results from genetic research can explain why some diseases are found more often in some ethnic groups than others" were less likely to be willing to participate in studies related to cancer (OR = 0.16), diabetes (OR = .16), alcohol use disorder (OR = 0.27), and Alzheimer's disease (OR = 0.27). Participants reported limited experiences engaging in genetic research; yet, they overwhelmingly acknowledged the importance of genetic research and expressed willingness to participate in multifactorial genetic studies despite concerns about genetic discrimination, stigma, and/or a potentially poor prognosis. Further research on the underlying reasons why persons of African descent choose to participate in genetic research should be explored and addressed to make research more inclusive and ethically sound.

Prime Time Sister Circles: evaluating a gender-specific, culturally relevant health intervention to decrease major risk factors in mid-life African-American women.

PURPOSE: To evaluate the effectiveness of Prime Time Sister Circles (PTSC), a curriculum-based, culture- and gender-specific health intervention, in assisting mid-life African-American women to decrease the major risk factors of physical inactivity, poor nutrition and stress. METHODS: One-hundred-thirty-four African-American women were involved in 11 sites across the country in PTSC and comparison groups. PTSC uses a cognitive behavioral modality based on three theoretical approaches to reduce risk factors and promote positive health changes. Pretest and posttest (10 weeks, and six and 12 months) data were collected on various indicators. RESULTS: t test analyses demonstrated a statistically significant increase in the women's involvement in physical activity at 10 weeks, and six and 12 months. A significant 10-week difference was found in the women's diet, with them reporting eating more nutritious foods, t(77) = 3.32, p < 0.001. The women also indicated from pretest to 10 weeks, and six and 12 months that they changed what they ate to prevent disease (40.4%, 62.8%, 97.5% and 100%, respectively). A majority of the women at 10 weeks (62.7%) and 12 months (65.9%) reported utilizing stress management strategies. There was also a 60% increase in yearly mammograms and a 54% increase in blood pressures checks. Finally, 83.7% of the women at 12 months felt that the positive changes could be maintained over their lifetime. CONCLUSIONS: This study demonstrates the effectiveness of PTSC in modifying health-related knowledge, attitudes and certain high-risk behaviors in mid-life African-American women.

Evaluation guidelines for the Clinical and Translational Science Awards (CTSAs).

The National Center for Advancing Translational Sciences (NCATS), a part of the National Institutes of Health, currently funds the Clinical and Translational Science Awards (CTSAs), a national consortium of 61 medical research institutions in 30 states and the District of Columbia. The program seeks to transform the way biomedical research is conducted, speed the translation of laboratory discoveries into treatments for patients, engage communities in clinical research efforts, and train a new generation of clinical and translational researchers. An endeavor as ambitious and complex as the CTSA program requires high-quality evaluations in order to show that the program is well implemented, efficiently managed, and demonstrably effective. In this paper, the Evaluation Key Function Committee of the CTSA Consortium presents an overall framework for evaluating the CTSA program and offers policies to guide the evaluation work. The guidelines set forth are designed to serve as a tool for education within the CTSA community by illuminating key issues and practices that should be considered during evaluation planning, implementation, and utilization. Additionally, these guidelines can provide a basis for ongoing discussions about how the principles articulated in this paper can most effectively be translated into operational reality.