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1.
Artículo en Inglés | MEDLINE | ID: mdl-31984668

RESUMEN

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.

2.
J Cardiovasc Nurs ; 34(2): 137-140, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30358660

RESUMEN

BACKGROUND: In patients with heart failure (HF), high dietary sodium intake is common and associated with HF symptoms, poor health-related quality of life (HRQOL), and high hospitalization rates. PURPOSE: The aims of this study were to examine the feasibility of a tailored dietary intervention with a practical tool (MyFitnessPal) and to obtain preliminary data about the effects on sodium intake, factors affecting sodium intake (knowledge, skills, experiences, confidence, perceived benefits and barriers, and depressive symptoms), HF symptoms, and HRQOL. METHODS: A 6-session intervention was delivered to 11 participants. Paired t tests were used to compare the baseline outcomes with those at 3 months. RESULTS: Participants completed 98% of intervention sessions, and 91% used MyFitnessPal. Sodium intake was reduced, and factors affecting sodium intake, symptoms, and HRQOL were improved (all P < .05). CONCLUSION: The intervention was feasible and warrants further research to test the effects of the intervention on the outcomes using larger, heterogeneous samples.

3.
Am J Health Promot ; 33(4): 549-557, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30309257

RESUMEN

PURPOSE: There is minimal information regarding the Reach and Adoption of evidence-based weight loss maintenance interventions for African Americans of faith. DESIGN: The WORD (Wholeness, Oneness, Righteousness, Deliverance) was an 18-month, cluster randomized trial designed to reduce and maintain weight loss in African American adults of faith. Participants received the Diabetes Prevention Program adapted core weight loss program for 6 months, and churches were subsequently randomized to 12-month maintenance treatment or control. All participants underwent body weight and associated behavioral and psychosocial assessments at baseline, 6, 12, and 18 months. The current article focuses on assessing Reach and Adoption at baseline and 6 months using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. SETTING: Lower Mississippi Delta. PARTICIPANTS: Thirty churches, 61 WORD Leaders (WLs), and 426 participants. INTERVENTION: Group delivered by trained community members (WLs). MEASURES: Body mass index and percentage weight lost from baseline to 6-month follow-up were measured. Reach was assessed at participant, WL, and church levels through calculating participation rates and sociodemographics of each level. Adoption was assessed at church and WL levels. ANALYSIS: Descriptive statistics summarized baseline characteristics of each level. Continuous and categorical end point comparisons were made. RESULTS: Participants' participation rate was 0.84 (n = 437 agreed to participate, n = 519 eligible invited to participate); they were predominantly female, employed, and had a mean age of 49.8. Dropouts by 6 months were younger, had differential marital status, and religious attendance compared with retained participants. Church participation rate was 0.63 (n = 30 enrolled, n = 48 eligible approached) and the majority reported ≤100 active members. The WL participation rate was 0.61 (n = 61 implemented intervention, n = 100 eligible approached); they were primarily female and aged 53.9 (mean). CONCLUSION: Recruitment, engagement, and delivery strategies employed by the WORD show promise of sustained engagement and adoption in other faith-based behavioral weight management programs for African Americans.

4.
Obesity (Silver Spring) ; 24(11): 2334-2340, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27616628

RESUMEN

OBJECTIVE: To examine whether the addition of online motivational interviewing (MI) chats to a Web-based, group behavioral obesity treatment program augments weight loss outcomes relative to the Web-based weight control program alone. METHODS: Healthy individuals (N = 398, 24% minority) with overweight/obesity were randomized to a 36-session group Internet behavioral weight control treatment (BT) or the same group Internet treatment plus six individual MI chat sessions (BT + MI). Both conditions received weekly synchronous online chat group sessions for 6 months followed by 12 monthly group chats. Participants in both groups received identical behavioral lessons and individualized therapist feedback on progress toward meeting exercise and calorie goals. BT + MI also received six individual MI sessions delivered by a separate MI counselor via Web chat. Weight loss was measured at 6 and 18 months. RESULTS: There were no significant differences in weight loss between BT (-5.5 ± 6.0 kg) and BT + MI (-5.1 ± 6.3 kg) at 6 months or at 18 months (-3.3 ± 7.1 kg vs. -3.5 ± 7.7 kg for BT and BT + MI, respectively). Attendance at group chats did not differ between groups, nor did self-monitoring patterns, suggesting comparable engagement in the weight control program in both conditions. CONCLUSIONS: Online MI chat sessions were not a viable strategy to enhance Web-based weight control treatment outcomes.


Asunto(s)
Internet , Entrevista Motivacional/métodos , Pérdida de Peso , Programas de Reducción de Peso , Adulto , Índice de Masa Corporal , Ingestión de Energía , Medicina Basada en la Evidencia , Ejercicio , Femenino , Conductas Relacionadas con la Salud , Humanos , Estilo de Vida , Modelos Lineales , Masculino , Persona de Mediana Edad , Obesidad/terapia , Factores Socioeconómicos , Resultado del Tratamiento
5.
Res Aging ; 36(1): 22-39, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25651599

RESUMEN

Senior centers are ideal locations to deliver evidence-based health promotion programs to the rapidly growing population of older Americans to help them remain healthy and independent in the community. However, little reported research is conducted in partnership with senior centers; thus, not much is known about barriers and facilitators for senior centers serving as research sites. To fill this gap and potentially accelerate research within senior centers to enhance translation of evidence-based interventions into practice, the present study examined barriers and facilitators of senior centers invited to participate in a cluster-randomized controlled trial. Primary barriers to participation related to staffing and perceived inability to recruit older adult participants meeting research criteria. The primary facilitator was a desire to offer programs that were of interest and beneficial to seniors. Senior centers are interested in participating in research that provides benefit to older adults but may need assistance from researchers to overcome participation barriers.


Asunto(s)
Proyectos de Investigación , Centros para Personas Mayores , Investigación en Medicina Traslacional , Anciano , Anciano de 80 o más Años , Arkansas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
Prev Med ; 57(4): 400-2, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23831492

RESUMEN

OBJECTIVE: Older adults in the U.S. have high rates of obesity. Despite the demonstrated efficacy of lifestyle interventions among older adults, lifestyle interventions are not widely implemented in community settings. Program delivery by lay health educators (LHEs) might support greater dissemination because of lower delivery cost and greater accessibility. We examined the costs of a LHE-delivered translation of the Diabetes Prevention Program (DPP) evidence-based lifestyle intervention for older adults in Arkansas senior centers. METHODS: This examination of costs used data from a cluster randomized control trial (conducted 2008-2010) in which 7 senior centers (116 participants) were randomized to implement a LHE-delivered 12-session translation of the DPP lifestyle intervention. We compiled direct lifestyle intervention implementation costs, including training, recruitment, materials, and ongoing intervention implementation support. Weight loss data (at 4-month follow-up) were collected from participants. RESULTS: Participant weight loss averaged 3.7kg at 4-months. The total estimated cost to implement the lifestyle intervention is $2731 per senior center, or $165 per participant. The implementation cost per kilogram lost is $45. CONCLUSIONS: A LHE-delivered DPP translation in senior centers is effective in achieving weight loss at low cost and offers promise for the dissemination of this evidence-based intervention.


Asunto(s)
Diabetes Mellitus/prevención & control , Educación del Paciente como Asunto/economía , Anciano , Arkansas , Análisis Costo-Beneficio , Costos y Análisis de Costo , Diabetes Mellitus/economía , Humanos , Persona de Mediana Edad , Educación del Paciente como Asunto/métodos , Evaluación de Programas y Proyectos de Salud , Conducta de Reducción del Riesgo , Centros para Personas Mayores/economía , Centros para Personas Mayores/métodos , Pérdida de Peso , Recursos Humanos
7.
Health Educ Behav ; 40(1): 78-87, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22505570

RESUMEN

The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week adaptation of the Diabetes Prevention Program Lifestyle Balance intervention augmented with stress management strategies (Lifestyle + Stress) or Lifestyle Alone. A trend toward greater percentage of baseline weight loss at 3-month data collection was observed in Lifestyle + Stress (-2.7 ± 3.6%) compared with Lifestyle Alone (-1.4 ± 2.3%; p = .17) and a greater reduction in salivary cortisol (Lifestyle + Stress: -0.2461 ± 0.3985 ng/mL; Lifestyle Alone: -0.0002 ± 0.6275 ng/mL; p = .20). These promising results suggest that augmenting a behavioral weight control intervention with stress management components may be beneficial for overweight/obese AA women with moderate to high stress levels and merit further investigation with an adequately powered trial.


Asunto(s)
Afroamericanos/psicología , Estrés Psicológico/terapia , Programas de Reducción de Peso/métodos , Adulto , Femenino , Humanos , Hidrocortisona/análisis , Obesidad/psicología , Obesidad/terapia , Cooperación del Paciente , Proyectos Piloto , Pruebas Psicológicas , Conducta de Reducción del Riesgo , Saliva/química , Pérdida de Peso
8.
J Aging Health ; 25(1): 97-118, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23248351

RESUMEN

OBJECTIVE: To determine whether a cognitive intervention delivered by lay health educators (LHEs) in senior centers was effective in improving cognition in obese older adults. METHODS: This cluster randomized trial was conducted in 16 senior centers from which 228 senior adults were recruited. The centers were randomized to either the cognitive intervention or a control, weight-loss intervention. The primary outcome variable, cognitive function, was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS: Analyses of RBANS indices as continuous variables did not indicate significant differences between arms. However, after adjusting for baseline delayed memory, gender, and baseline body mass index, seniors in the cognitive intervention arm had a 2.7 times higher odds of a reliable improvement (clinically significant) in delayed memory from baseline as compared to those in the control intervention (95% CI, 1.3-5.6, p = .011). The intervention effect was not significant for the proportion showing reliable improvement in immediate memory or in attention. Attendance at the 12-session program was high with an average of 83% (67%-92%) sessions attended and 87% of participants in the cognitive arm indicating they would recommend the program. DISCUSSION: Cognitive interventions can be effectively delivered in the community by LHEs.


Asunto(s)
Cognición/fisiología , Terapia Cognitivo-Conductual/métodos , Servicios de Salud Comunitaria/organización & administración , Servicios de Salud para Ancianos/organización & administración , Obesidad/terapia , Servicios de Salud Rural/organización & administración , Programas de Reducción de Peso/métodos , Anciano , Arkansas , Análisis por Conglomerados , Práctica Clínica Basada en la Evidencia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Pruebas Neuropsicológicas , Evaluación de Programas y Proyectos de Salud
9.
Gerontologist ; 53(1): 162-71, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22936536

RESUMEN

PURPOSE OF THE STUDY: Lay health educators (LHEs) offer great promise for facilitating the translation of evidence-based health promotion programs to underserved areas; yet, there is little guidance on how to train LHEs to implement these programs, particularly in the crucial area of empirically validated obesity interventions. DESIGN AND METHODS: This article describes experiences in recruiting, training, and retaining 20 LHEs who delivered a 12-month evidence-based behavioral lifestyle intervention (based on the Diabetes Prevention Program) in senior centers across a rural state. A mixed method approach was used which incorporated collecting the folllowing: quantitative data on sociodemographic characteristics of LHEs; process data related to training, recruitment, intervention implementation, and retention of LHEs; and a quantitative program evaluation questionnaire, which was supplemented by a qualitative program evaluation questionnaire. Descriptive statistics were calculated for quantitative data, and qualitative data were analyzed using content analysis. RESULTS: The training program was well received, and the LHEs effectively recruited participants and implemented the lifestyle intervention in senior centers following a structured protocol. IMPLICATIONS: The methods used in this study produced excellent long-term retention of LHEs and good adherence to intervention protocol, and as such may provide a model that could be effective for others seeking to implement LHE-delivered health promotion programs.


Asunto(s)
Técnicos Medios en Salud/educación , Educadores en Salud/educación , Promoción de la Salud/métodos , Obesidad/terapia , Pérdida de Peso , Programas de Reducción de Peso/métodos , Adulto , Medicina Basada en la Evidencia , Femenino , Educadores en Salud/psicología , Humanos , Estilo de Vida , Masculino , Área sin Atención Médica , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Servicios de Salud Rural , Población Rural , Encuestas y Cuestionarios
10.
Prev Chronic Dis ; 9: E63, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22360874

RESUMEN

INTRODUCTION: Older adults could benefit from public health interventions that address the health conditions they face. However, translation of evidence-based interventions into the community has been slow. We implemented 2 evidence-based interventions delivered by lay health educators in Arkansas senior centers from 2008 to 2011: a behavioral weight loss intervention and a memory improvement intervention. The objective of this study was to measure the ability of these programs to reach and serve the growing population of older Americans. We report on differences in program enrollment by age, sex, race, and ethnicity and suggest how our approach to calculating the reach of the 2 interventions can guide future research and program development. METHODS: We defined the reach of the 2 interventions as the proportion of people who needed the intervention and responded to initial recruitment efforts but who did not enroll compared with the proportion of people who needed the intervention and actually enrolled in the program. To calculate these proportions, we used Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance framework formulas. We defined need as the prevalence of obesity (body mass index in kg/m2 ≥30) and the level of concern about memory problems among older adults aged 60 years or older. Our target population was 2,198 people aged 60 years or older who attend 15 senior centers in Arkansas. RESULTS: More than half of our target population responded to recruitment efforts for the behavioral weight loss intervention (61.9%) and for the memory improvement intervention (58.1%), yielding an overall response rate of 59.7%. More than one-third (35.6%) of the target population enrolled in the behavioral weight loss intervention, and 22.8% enrolled in the memory improvement intervention, for an overall reach for the 2 programs of 27.9%. CONCLUSION: The reach of 2 evidence-based interventions designed for older adults that targeted specific health conditions and that were delivered in senior centers by community members was high. Our approach to calculating reach in applied settings can guide future research and program development.


Asunto(s)
Medicina Basada en la Evidencia/métodos , Promoción de la Salud , Trastornos de la Memoria/terapia , Pérdida de Peso , Anciano , Anciano de 80 o más Años , Arkansas/epidemiología , Difusión de Innovaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad
11.
J Cult Divers ; 18(3): 90-4, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22073526

RESUMEN

Collaboratively, the nutritional health problems of the Lower Mississippi Delta (LMD) region were examined and opportunities identified for conducting research interventions. To combat the nutritional health problems in the LMD, community residents yielded to a more comprehensive and participatory approach known as community-based participatory research (CBPR). Community residents partnered with academic researchers and other organizational entities to improve the overall quality of diet and health in their respective communities using CBPR. The collaborative work in the LMD focused on interventions conducted in each of three specific communities across three states: Marvell, Arkansas (Marvell NIRI), and its surrounding public school district; Franklin Parish in Louisiana (Franklin NIRI); and the city of Hollandale, Mississippi (Hollandale NIRI). This paper examined some of the research interventions conducted in Franklin, Hollandale, and Marvell NIRI respectively, how leadership emerged from each of these communities, and lessons learned as a result of the CBPR model.


Asunto(s)
Investigación Participativa Basada en la Comunidad/métodos , Promoción de la Salud/organización & administración , Obesidad/prevención & control , Adolescente , Adulto , Arkansas , Niño , Relaciones Comunidad-Institución , Promoción de la Salud/métodos , Humanos , Louisiana , Mississippi
12.
Am J Prev Med ; 41(4): 385-91, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21961465

RESUMEN

BACKGROUND: Older adults have high obesity rates and respond well to evidence-based weight-loss programs, such as the Diabetes Prevention Program (DPP) Lifestyle intervention. The goal of this study was to determine whether a translation of the DPP Lifestyle program delivered by lay health educators and conducted in senior centers is effective in promoting weight loss among older adults. DESIGN: An RCT with older adults nested within senior centers. Senior centers identified lay health educators to receive training and deliver the intervention program at the senior center. Senior centers were randomized to DPP Lifestyle program or an attention control intervention (cognitive training). SETTING/PARTICIPANTS: Senior centers (N=15) located throughout Arkansas. Participants (N=228) were obese (BMI=34.5±4.9) older (aged 71.2±6.6 years) adults able to engage in moderate exercise. Follow-up data were collected at 4 months on 93% of the original cohort between February 2009 and July 2010. INTERVENTIONS: A 12-session translation of the Diabetes Prevention Program Lifestyle behavioral weight-control program delivered in group sessions by trained lay health educators. MAIN OUTCOME MEASURES: Body weight was assessed by digital scale. Percentage weight loss from baseline and proportion achieving ≥5% and ≥7% weight loss were examined. Analyses were completed in March 2011. RESULTS: Participants attending senior centers randomized to Lifestyle lost a significantly greater percentage of baseline weight (3.8%, 95% CI=2.9%, 4.6%) than those in the control senior centers (0.2%, 95% CI= -0.6%, -0.9%) after adjusting for baseline BMI and gender (p<0.001). Among participants attending senior centers offering the Lifestyle program, 38% lost ≥5% of baseline weight compared with 5% in the control arm (p<0.001). Similarly, significantly more participants (24%) in Lifestyle senior centers lost ≥7% than did control participants (3%, p=0.001). CONCLUSIONS: A behavioral lifestyle weight-loss intervention delivered by a lay health educator offers a promising vehicle for translation of evidence-based obesity treatment programs in underserved areas. TRIAL REGISTRATION: This study is registered at Clinicaltrials.govNCT01377506.


Asunto(s)
Promoción de la Salud/organización & administración , Estilo de Vida , Obesidad/terapia , Pérdida de Peso , Programas de Reducción de Peso/métodos , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Difusión de Innovaciones , Medicina Basada en la Evidencia , Femenino , Educadores en Salud , Humanos , Masculino
13.
Prev Chronic Dis ; 8(6): A146, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22005639

RESUMEN

BACKGROUND: African Americans and rural residents are disproportionately affected by obesity. Innovative approaches to address obesity that are sensitive to the issues of rural African Americans are needed. Faith-based and community-based participatory approaches show promise for engaging racial/ethnic minorities to change health outcomes, but few faith-based weight loss interventions have used a community-based participatory approach. COMMUNITY CONTEXT: A faith-based weight loss intervention in the Lower Mississippi Delta arose from a 5-year partnership between academic and community partners representing more than 30 churches and community organizations. METHODS: Community and academic partners translated the 16 core sessions of the Diabetes Prevention Program for rural, church-going African American adults. The feasibility of the lay health advisor-led delivery of the 16-week (January-May 2010), 16-session, adapted intervention was assessed in 26 participants from 3 churches by measuring recruitment, program retention, implementation ease, participant outcomes, and program satisfaction. OUTCOME: Twenty-two of 26 participants (85%) provided 16-week follow-up data. Lay health advisors reported that all program components were easy to implement except the self-monitoring component. Participants lost an average of 2.34 kg from baseline to 16-week follow-up, for a mean weight change of -2.7%. Participants reported enjoying the spiritual and group-based aspects of the program and having difficulties with keeping track of foods consumed. The intervention engaged community partners in research, strengthened community-academic partnerships, and built community capacity. INTERPRETATION: This study demonstrates the feasibility of delivering this adapted intervention by lay leaders through rural churches.


Asunto(s)
Terapia Conductista/métodos , Medicina Basada en la Evidencia/métodos , Educación en Salud , Estilo de Vida , Curación Mental , Obesidad/rehabilitación , Población Rural , Adulto , Afroamericanos , Estudios de Factibilidad , Estudios de Seguimiento , Humanos , Morbilidad/tendencias , Obesidad/etnología , Resultado del Tratamiento , Estados Unidos , Pérdida de Peso
14.
Am J Addict ; 20(1): 1-8, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21175914

RESUMEN

Weight concern is a common and significant barrier to abstinence for many smokers. This quasi-experimental pilot study used multivariate logistic regression to examine the effects of offering a weight management treatment program on tobacco dependence treatment outcomes. Age, gender, ethnicity, educational level, nicotine dependence level, body mass index, and concern about weight gain were entered as factors/covariates to account for differences between groups. Offering a weight management program increased attendance at the first scheduled contact (88.1% vs. 71.6%; OR = 2.93; p = .029) and increased 6-month abstinence (21.4% vs. 10.1%; OR = 2.42; p = .052). With factors and covariates included in the multivariate models to account for group differences, those offered weight management were five times more likely to attend their first session (OR = 5.10; 95% CI 1.53-16.98; p = .008) and three times more likely to be abstinent 6 months after tobacco treatment (OR = 2.98; 95% CI = 1.09-8.17; p = .033). Proactively informing weight-concerned, overweight/obese smokers about the availability of a weight management program as an incentive for completing treatment for tobacco dependence may improve tobacco treatment outcomes.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Obesidad/psicología , Obesidad/terapia , Sobrepeso/psicología , Sobrepeso/terapia , Cese del Hábito de Fumar/psicología , Tabaquismo/terapia , Adulto , Femenino , Accesibilidad a los Servicios de Salud , Líneas Directas , Humanos , Masculino , Cooperación del Paciente/estadística & datos numéricos , Proyectos Piloto , Cese del Hábito de Fumar/métodos , Tabaquismo/complicaciones
15.
Fam Community Health ; 33(3): 175-85, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20531098

RESUMEN

Since its inception, capacity building has been a stated goal of the Delta Nutrition Intervention Research Initiative, a tri-state collaboration in the Lower Mississippi Delta to address high rates of chronic disease. Textual analysis of project documents identifies and describes strategies carried out to foster capacity building. Strategies to build community capacity include fostering participation, cultivating leadership opportunities, training community members as co-researchers, securing community resources, and implementing the intervention together. Incorporating capacity-building approaches in health promotion and nutrition-intervention programming in rural communities provides a means to enhance potential for sustainability of health outcomes and developed effectiveness.


Asunto(s)
Creación de Capacidad/métodos , Investigación Participativa Basada en la Comunidad , Promoción de la Salud/métodos , Terapia Nutricional/métodos , Salud Rural , Adulto , Femenino , Humanos , Masculino , Mississippi
16.
J Health Psychol ; 15(3): 382-90, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20348359

RESUMEN

Most faith-based obesity intervention research has been conducted in African-American Protestant churches. However, Catholic communities might also benefit from a faith-tailored approach. Overweight Catholic individuals (n = 34, 71% female) were randomized to a Catholic-tailored or standard behavioral 16-week group weight control program. Both conditions experienced significant weight losses (Catholic-tailored: -8.1 + 4.1%, Standard: -7.9 + 4.2%); however, treatment satisfaction was significantly greater in the Catholic-tailored program. The Catholic-tailored program experienced trends for greater attendance, more completed self-monitoring journals, and smaller weight regain six months post-treatment than the standard program. Catholic-tailored programs may represent a feasible, culturally acceptable and effective approach to weight loss/maintenance in this faith community.


Asunto(s)
Catolicismo , Redes Comunitarias , Obesidad/terapia , Adulto , Arkansas , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto
17.
Prev Chronic Dis ; 4(4): A112, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17875256

RESUMEN

Obesity is more prevalent among African Americans and other racial and ethnic minority populations than among whites. The behaviors that determine weight status are embedded in the core social and cultural processes and environments of day-to-day life in these populations. Therefore, identifying effective, sustainable solutions to obesity requires an ecological model that is inclusive of relevant contextual variables. Race and ethnicity are potent stratification variables in U.S. society and strongly influence life contexts, including many aspects that relate to eating and physical activity behaviors. This article describes a synthesis initiated by the African American Collaborative Obesity Research Network (AACORN) to build and broaden the obesity research paradigm. The focus is on African Americans, but the expanded paradigm has broader implications and may apply to other populations of color. The synthesis involves both community and researcher perspectives, drawing on and integrating insights from an expanded set of knowledge domains to promote a deeper understanding of relevant contexts. To augment the traditional, biomedical focus on energy balance, the expanded paradigm includes insights from family sociology, literature, philosophy, transcultural psychology, marketing, economics, and studies of the built environment. We also emphasize the need for more attention to tensions that may affect African American or other researchers who identify or are identified as members of the communities they study. This expanded paradigm, for which development is ongoing, poses new challenges for researchers who focus on obesity and obesity-related health disparities but also promises discovery of new directions that can lead to new solutions.


Asunto(s)
Afroamericanos , Obesidad/etnología , Obesidad/prevención & control , Proyectos de Investigación , Afroamericanos/estadística & datos numéricos , Métodos Epidemiológicos , Humanos , Modelos Teóricos , Investigación/organización & administración , Medicina Social , Estados Unidos
18.
Obesity (Silver Spring) ; 14(10): 1825-31, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17062813

RESUMEN

OBJECTIVE: To characterize sugar-sweetened beverage intake of college students. RESEARCH METHODS AND PROCEDURES: Undergraduates in an urban southern community campus were surveyed anonymously about sugared beverage consumption (soda, fruit drinks, energy drinks, sports drinks, sweet ice tea) in the past month. RESULTS: Two hundred sixty-five undergraduates responded (66% women, 46% minority, 100% of volunteers solicited). Most students (95%) reported sugared beverage intake in the past month, and 65% reported daily intake. Men were more likely than women to report daily intake (74% vs. 61%, p = 0.035). Soda was the most common sugar-sweetened beverage. Black undergraduates reported higher sugared beverage intake than whites (p = 0.02), with 91% of blacks reporting sugar-sweetened fruit drink intake in the past month and 50% reporting daily consumption. Mean estimated caloric intake from combined types of sugar-sweetened beverages was significantly higher among black students than whites, 796 +/- 941 vs. 397 +/- 396 kcal/d (p = 0.0003); the primary source of sugar-sweetened beverage calories among blacks was sugared fruit drinks (556 +/- 918 kcal/d). Younger undergraduates reported significantly higher intake than older students (p = 0.025). DISCUSSION: Self-reported sugar-sweetened beverage consumption among undergraduates is substantial and likely contributes considerable non-nutritive calories, which may contribute to weight gain. Black undergraduates may be particularly vulnerable due to higher sugared beverage intake. Obesity prevention interventions targeting reductions in sugar-sweetened beverages in this population merit consideration.


Asunto(s)
Bebidas , Sacarosa en la Dieta/administración & dosificación , Estudiantes/estadística & datos numéricos , Adulto , Afroamericanos/estadística & datos numéricos , Arkansas , Ingestión de Energía/fisiología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Frutas , Humanos , Masculino , Análisis Multivariante , Análisis de Regresión , Factores Sexuales , Encuestas y Cuestionarios , Universidades , Aumento de Peso/fisiología
19.
Am J Public Health ; 96(11): 1989-95, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17018820

RESUMEN

OBJECTIVES: We compared voluntary participation and comprehension of informed consent among individuals of African ancestry enrolled in similarly designed genetic studies of hypertension in the United States and Nigeria. METHODS: Survey questionnaires were used to evaluate factors associated with voluntariness (the number of people volunteering) and understanding of the study's genetic purpose. A total of 655 individuals (United States: 348; Nigeria: 307) were interviewed after participation in the genetic studies. RESULTS: Most US respondents (99%), compared with 72% of Nigerian respondents, reported being told the study purpose. Fewer than half of the respondents at both sites reported that the study purpose was to learn about genetic inheritance of hypertension. Most respondents indicated that their participation was voluntary. In the United States, 97% reported that they could withdraw, compared with 67% in Nigeria. In Nigeria, nearly half the married women reported asking permission from husbands to enroll in the hypertension study; no respondents sought permission from local elders to participate in the study. CONCLUSIONS: Our findings highlight the need for more effective approaches and interventions to improve comprehension of consent for genetic research among ethnically and linguistically diverse populations in all settings.


Asunto(s)
Afroamericanos/genética , Grupo de Ascendencia Continental Africana/genética , Comprensión , Comparación Transcultural , Investigación Genética/ética , Conocimientos, Actitudes y Práctica en Salud , Hipertensión/etnología , Hipertensión/genética , Consentimiento Informado/psicología , Internacionalidad , Adulto , Afroamericanos/educación , Afroamericanos/psicología , Grupo de Ascendencia Continental Africana/educación , Grupo de Ascendencia Continental Africana/psicología , Femenino , Variación Genética , Genética de Población , Humanos , Consentimiento Informado/ética , Consentimiento Informado/estadística & datos numéricos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Nigeria , Selección de Paciente , Negativa a Participar/etnología , Identificación Social , Estados Unidos
20.
Obes Res ; 13(12): 2037-47, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16421334

RESUMEN

The longstanding high burden of obesity in African-American women and the more recent, steeper than average rise in obesity prevalence among African-American children constitute a mandate for an increased focus on obesity prevention and treatment research in African-American communities. The African-American Collaborative Obesity Research Network (AACORN) was formed to stimulate and support greater participation in framing and implementing the obesity research agenda by investigators who have both social and cultural grounding in African-American life experiences and obesity-related scientific expertise. AACORN's examination of obesity research agenda issues began in 2003 in conjunction with the Think Tank on Enhancing Obesity Research at the National Heart, Lung, and Blood Institute (NHLBI). The assessment was subsequently expanded to take into account the overall NIH strategic plan for obesity research, literature reviews, and descriptions of ongoing studies. In identifying priorities, AACORN members considered the quality, quantity, focus, and contextual relevance of published research relevant to obesity prevention and treatment in African-American adults or children. Fifteen recommended research priorities are presented in five categories adapted from the NHLBI Think Tank proceedings: health effects, social and environmental context, prevention and treatment, research methods, and research training and funding. These recommendations from an African-American perspective build on and reinforce certain aspects of the NHLBI and overall NIH research agendas by providing more specific rationale and directions on areas for enhancement in the type of research being done or in the conceptualization and implementation of that research.


Asunto(s)
Afroamericanos , Conductas Relacionadas con la Salud/etnología , Obesidad/prevención & control , Obesidad/terapia , Investigación/tendencias , Adulto , Terapia Conductista , Niño , Femenino , Humanos , Estilo de Vida , Masculino , National Institutes of Health (U.S.)/tendencias , Obesidad/etnología , Desarrollo de Programa , Investigación/economía , Investigación/organización & administración , Factores de Riesgo , Sociedades Médicas/organización & administración , Sociedades Médicas/tendencias , Estados Unidos
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