Dataset Information

The Faith, Activity, and Nutrition program: a randomized controlled trial in African-American churches.

ABSTRACT:

Background

Faith-based interventions hold promise for promoting health in ethnic minority populations. To date, however, few of these interventions have used a community-based participatory research (CBPR) approach, have targeted both physical activity and healthy eating, and have focused on structural changes in the church.

Purpose

To report the results of a group randomized CBPR intervention targeting physical activity and healthy eating in African-American churches.

Design

Group RCT. Data were collected from 2007 to 2011. Statistical analyses were conducted in 2012.

Setting/participants

Seventy-four African Methodist Episcopal (AME) churches in South Carolina and 1257 members within them participated in the study.

Intervention

Churches were randomized to an immediate (intervention) or delayed (control) 15-month intervention that targeted organizational and environmental changes consistent with the structural ecologic model. A CBPR approach guided intervention development. Intervention churches attended a full-day committee training and a full-day cook training. They also received a stipend and 15 months of mailings and technical assistance calls to support intervention implementation.

Main outcome measures

Primary outcomes were self-reported moderate- to vigorous-intensity physical activity (MVPA), self-reported fruit and vegetable consumption, and measured blood pressure. Secondary outcomes were self-reported fat- and fiber-related behaviors. Measurements were taken at baseline and 15 months. Intent-to-treat repeated measures ANOVA tested group X time interactions, controlling for church clustering, wave, and size, and participant age, gender, and education. Post hoc ANCOVAs were conducted with measurement completers.

Results

There was a significant effect favoring the intervention group in self-reported leisure-time MVPA (d=0.18, p=0.02), but no effect for other outcomes. ANCOVA analyses showed an intervention effect for self-reported leisure-time MVPA (d=0.17, p=0.03) and self-reported fruit and vegetable consumption (d=0.17, p=0.03). Trainings were evaluated very positively (training evaluation item means of 4.2-4.8 on a 5-point scale).

Conclusions

This faith-based structural intervention using a CBPR framework showed small but significant increases in self-reported leisure-time MVPA. This program has potential for broad-based dissemination and reach.

Trial registration

This study is registered at www.clinicaltrials.gov NCT00379925.

SUBMITTER: Wilcox S

PROVIDER: S-EPMC3884828 | biostudies-literature | 2013 Feb

REPOSITORIES: biostudies-literature

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Publications

The Faith, Activity, and Nutrition program: a randomized controlled trial in African-American churches.

Wilcox Sara S Parrott Allen A Baruth Meghan M Laken Marilyn M Condrasky Margaret M Saunders Ruth R Dowda Marsha M Evans Rebecca R Addy Cheryl C Warren Tatiana Y TY Kinnard Deborah D Zimmerman Lakisha L

American journal of preventive medicine 20130201 2

<h4>Background</h4>Faith-based interventions hold promise for promoting health in ethnic minority populations. To date, however, few of these interventions have used a community-based participatory research (CBPR) approach, have targeted both physical activity and healthy eating, and have focused on structural changes in the church.<h4>Purpose</h4>To report the results of a group randomized CBPR intervention targeting physical activity and healthy eating in African-American churches.<h4>Design</ ...[more]

PMID: 23332327

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Project description:Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.

Project description:PurposeTo determine the effects of a 10-month secular (SEC) versus faith-integrated (FI) community-based physical activity (PA) intervention on cardiometabolic risk factors in low active, African-American women.MethodsParticipants (age: 55.4±11.6 years; body mass index (BMI): 36.0±7.9 kg/m2; average baseline steps/day: 3,807±1,250) from a larger study (n=418) participated in a sub-study to measure cardiometabolic disease indicators (primary outcomes) and PA (secondary outcomes) pre- and post-intervention (SEC: n=42; FI: n=43). Height, weight, waist and hip circumferences, resting blood pressure, hemoglobin A1c, average steps/day, sedentary behavior, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) were acquired at baseline and 10 months. Multivariate generalized linear mixed models that included churches as a random effect were used to compare mean changes in outcomes at 10 months between the two study groups (α=0.05).ResultsThe FI group showed significant time effects for weight (93.4±2.4 to 92.2±2.3 kg), BMI (35.7±1.0 to 35.3±1.0 kg/m2), and waist circumference (106.9±2.2 to 103.8±2.5 cm), while the SEC group had a significant time effect for hip circumference (121.6±1.9 to 119.9±1.7 cm). There were no time effects in either group for blood pressure, hemoglobin A1c, steps/day, sedentary time, or MVPA. FI significantly decreased LPA in both 1-minute activity bouts (641±13 to 588±16 minutes/day) and 10-minute bouts (536±11 to 479±15 minutes/day). There were no significant differences between SEC and FI for any variable.ConclusionsThe improvements in body weight, BMI, and waist circumference shown after the FI intervention could have long-term implications on cardiometabolic health, particularly if exercise is continued. Further research is needed to examine the effects of culturally-relevant interventions on chronic disease indicators in African-American women, particularly those established as high risk for cardiometabolic disease.

Project description:PURPOSE:This study aimed to assess the feasibility of a Home-based, Individually-tailored Physical activity Print (HIPP) intervention for African American women in the Deep South. METHODS:A pilot randomized trial of the HIPP intervention (N = 43) versus wellness contact control (N = 41) was conducted. Recruitment, retention, and adherence were examined, along with physical activity (7-d physical activity recalls, accelerometers) and related psychosocial variables at baseline and 6 months. RESULTS:The sample included 84 overweight/obese African American women 50-69 yr old in Birmingham, AL. Retention was high at 6 months (90%). Most participants reported being satisfied with the HIPP program and finding it helpful (91.67%). There were no significant between-group differences in physical activity (P = 0.22); however, HIPP participants reported larger increases (mean of +73.9 min·wk (SD 90.9)) in moderate-intensity or greater physical activity from baseline to 6 months compared with the control group (+41.5 min·wk (64.4)). The HIPP group also reported significantly greater improvements in physical activity goal setting (P = 0.02) and enjoyment (P = 0.04) from baseline to 6 months compared with the control group. There were no other significant between-group differences (6-min walk test, weight, physical activity planning, behavioral processes, stage of change); however, trends in the data for cognitive processes, self-efficacy, outcome expectations, and family support for physical activity indicated small improvements for HIPP participants (P > 0.05) and declines for control participants. Significant decreases in decisional balance (P = 0.01) and friend support (P = 0.03) from baseline to 6 months were observed in the control arm and not the intervention arm. CONCLUSIONS:The HIPP intervention has great potential as a low-cost, high-reach method for reducing physical activity-related health disparities. The lack of improvement in some domains may indicate that additional resources are needed to help this target population reach national guidelines.

Dataset Information

The Faith, Activity, and Nutrition program: a randomized controlled trial in African-American churches.

Background

Purpose

Design

Setting/participants

Intervention

Main outcome measures

Results

Conclusions

Trial registration

Publications

The Faith, Activity, and Nutrition program: a randomized controlled trial in African-American churches.

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