BackgroundAfrican American adults experience a high prevalence of obesity and its associated comorbidities, including diabetes. Church-based interventions have been shown to be effective in decreasing weight in this population. mHealth interventions can address two needs for obesity treatment in this community, including enhancing weight loss and providing wide dissemination.ObjectiveThis study aimed to assess the feasibility and efficacy of a church-based weight loss intervention that incorporates mHealth technology.MethodsIn this study, 8 churches (n=97) were randomly assigned to the intervention or delayed intervention condition (control group). We recruited participants through their respective church. Volunteer church members were trained by study staff to deliver the 10-session, 6-month intervention. Participants in the intervention group attended group sessions and received automated short message service (SMS) text messages designed to reinforce behavioral strategies. Conversely, participants in the delayed intervention condition received SMS text messages related to health conditions relevant for African American adults. We obtained measures of body composition, blood pressure, blood glucose, and cholesterol.ResultsWe successfully recruited 97 African American adults, with a mean age of 56.0 (SE 10.3) years and a mean body mass index of 38.6 (SE 6.4) kg/m2 (89/97, 91.8% females), who attended the churches that were randomized to the intervention (n=68) or control (n=29) condition. Of these, 74.2% (72/97) of the participants (47/68, 69.1% intervention; 25/29, 86.2% delayed intervention) completed the 6-month assessment. The average intervention group attendance was 55%. There was a significant difference in weight loss (P=.04) between participants in the intervention (–1.5 (SE 0.5) kg) and control (0.11 (SE 0.6) kg) groups. Among participants in the intervention group, the correlation between the number of SMS text messages sent and the percent body fat loss was r=.3 with P=.04. The participants reported high satisfaction with the automated SMS text messages.ConclusionsAutomated SMS text messages were well-received by participants, suggesting that more enhanced mHealth technologies are a viable option for interventions targeting African American adults.Trial RegistrationClinicalTrials.gov NCT02863887; https://clinicaltrials.gov/ct2/show/NCT02863887 (Archived by WebCite at http://www.webcitation.org/71JiYzizO)
Word count: 3984Study Protocol: The study protocol can be obtained from the corresponding author (RLNJr).1 Background: African Americans experience a high prevalence of obesity and its associated comorbidities, including diabetes. Church-based interventions have been shown to be effective in decreasing weight in this population. mHealth interventions have the ability to address two needs for obesity treatment in this community, including enhancing weight loss and providing wide dissemination.Objective: To assess the feasibility and efficacy of a church-based weight loss intervention that incorporated mHealth technology. Methods:Eight churches (n = 97) were randomly assigned to the intervention or delayedintervention condition. Participants were recruited through their respective church. Volunteer church members were trained by study staff to deliver the 10-session, 6-month intervention.Participants in the intervention attended group sessions and received automated text messages designed to reinforce behavioral strategies. Participants in the delayed intervention received text messages related to health conditions relevant for African Americans. Measures of body composition, blood pressure, blood glucose, and cholesterol were taken.Results: Ninety-seven African American adults (mean age = 56.0 (10.3) years; 91.8% female; mean BMI = 38.6 (6.4) kg/m 2 ) were successfully recruited into the study and attended churches that were randomized into the intervention (n = 68) or delayed intervention (n = 29) condition. Seventy-two (74.2%) of these individuals (69.1% intervention; 86.2% delayed intervention) completed the 6-month assessment. The average attendance was 55%. There was a significant difference in weight loss (p = 0.041) between participants in the intervention (-1.5 kg (0.5)) and control (0.11 kg (0.6)) groups. There was a marginally significant difference (p = 0.067) in percent body fat (-0.4% (0.8) Trial registration:The study is registered in clinicaltrials.gov [NCT02863887].
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