How effective are church-based weight-loss interventions among Black adults? A systematic review.

OBJECTIVE: Churches are frequently used to reach Black adults to effect weight loss. However, there has been no recent review, to our knowledge, inclusive of solely Black adults in church settings. We sought to comprehensively examine the methodological approaches and weight-loss outcomes of church-based weight-loss lifestyle interventions conducted among Black adults to provide insights on literature gaps and offer suggestions for future research. METHODS: Google Scholar, PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for trials conducted in churches that reported weight outcomes at any time point. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guided manuscript development. RESULTS: A total of 15 studies (N = 2285) from 2007 to 2023 met inclusion criteria, and 33% were high-quality randomized trials. The majority were pilot studies (60%) conducted in the Southern United States. Most reported significant postintervention weight loss. The follow-up time points varied from 2 to 12 months. Methodological approaches included the following: cultural adaptations (93%); theory-guided (93%); delivered by community health workers (80%); and delivered in person in a group format (100%). Only one study offered individual-level attention beyond texts/emails. Most participants were well-educated female individuals. CONCLUSIONS: Weight-loss interventions among Black church settings effect statistically significant weight loss, albeit in a small way. Limitations include pilot studies and small samples. More rigorously designed studies are warranted.

"It's Okay With Our Culture but We're in a Different Place and We Have to Show Respect": Marshallese Migrants and Exclusive Breastfeeding Initiation.

BACKGROUND: Pacific Islanders in the United States have lower initiation rates and shorter duration of exclusive breastfeeding compared to other racial/ethnic groups. RESEARCH AIM: To describe infant feeding beliefs and experiences of Marshallese living in the United States. METHODS: We used a prospective and cross-sectional exploratory, descriptive qualitative design with Marshallese participants (N = 36) residing in the United States between July 2019 and July 2020. Data were collected at 6-8 weeks postpartum. Our qualitative analytic approach integrated inductive and deductive techniques. RESULTS: Participants' mean age was 27.1 years (SD = 6.1), and 88.9% (n = 32) were born in the Marshall Islands. A majority of participants were single, widowed, or in an unmarried partnership (n = 28, 77.8%). Most participants had a high school education or lower (n = 30, 83.3%). Mean household size was 7.2 (SD = 2.8). Fewer than half of participants had no health insurance (n = 14, 38.9%), and almost all participants (91.7%) did not work at the time of data collection. Two themes emerged: 1) infant feeding initiation and practices; and 2) concerns over breastfeeding in public. The majority of participants' infants received both human milk and formula. Participants described beliefs that breastfeeding in public was against American customs, which influenced their decision about breastfeeding in public. CONCLUSIONS: Our study was the first to document infant feeding beliefs and experiences of Marshallese living in the United States at 6-8 weeks postpartum. Findings will inform future health education programs.

Strategies to Facilitate Equitable Resource Sharing in Community-Engaged Research.

BACKGROUND: Community subcontracts are an essential component of community-engaged research, particularly community-based participatory research (CBPR). However, several barriers have limited community-based organizations' (CBOs) ability to serve as subcontractors on research grants. This article describes the barriers and strategies to implementing community subcontracts through a case study of the implementation of one federal grant. LESSONS LEARNED: Specific lessons learned at the CBO level, budget-creation level, and university-level are described to overcome barriers in executing community subcontracts in community-engaged research. CONCLUSIONS: We call for institutional changes to facilitate equitable resource sharing in community-engaged research.

Health Research Funding Agencies' Policies, Recommendations, and Tools for Dissemination.

THE PROBLEM: Dissemination is a key component of translational research. However, research participants rarely receive findings from the studies in which they have participated. Funding agencies have a significant amount of influence to promote research dissemination through requirements, recommendations, and tools. However, it is not clear to what extent current funding agencies promote dissemination to study participants.Purpose of Article: A review of major health research funders was conducted to ascertain the current policies, recommendations, and tools related to 1) academic dissemination, 2) lay community dissemination, and 3) returning results to research participants. KEY POINTS: Several agencies have policies, recommendations, and tools for academic dissemination; however, few have the same policies, recommendations, and tools for dissemination to research participants and the lay communities they are recruited from. CONCLUSIONS: Funding agencies have a unique opportunity to encourage the dissemination of research results to research participants and lay community audiences by developing policies to increase dissemination of grantees' research findings.

Engagement practices that join scientific methods with community wisdom: designing a patient-centered, randomized control trial with a Pacific Islander community.

This article illustrates how a collaborative research process can successfully engage an underserved minority community to address health disparities. Pacific Islanders, including the Marshallese, are one of the fastest growing US populations. They face significant health disparities, including extremely high rates of type 2 diabetes. This article describes the engagement process of designing patient-centered outcomes research with Marshallese stakeholders, highlighting the specific influences of their input on a randomized control trial to address diabetes. Over 18 months, an interdisciplinary research team used community-based participatory principles to conduct patient-engaged outcomes research that involved 31 stakeholders in all aspects of research design, from defining the research question to making decisions about budgets and staffing. This required academic researcher flexibility, but yielded a design linking scientific methodology with community wisdom.