Better Me Within Randomized Trial: Faith-Based Diabetes Prevention Program for Weight Loss in African American Women

Background and Aims-Metabolic syndrome (MetS) increases the risk of cardiovascular disease and type 2 diabetes. Despite a higher prevalence of MetS in African American (AA) women, little is known about the effectiveness of lifestyle interventions in improving metabolic markers in this high-risk group. This study investigated the effectiveness of a community-based lifestyle intervention delivered by lay health coaches in reducing MetS among AA women.Methods and Results-A cluster-randomized diabetes prevention program (DPP) was implemented in 11 churches utilizing a community-based participatory research (CBPR) approach to develop and deliver the interventions. A total of 221 adults, AA women who were overweight or obese, and did not have diabetes were included in this study. The prevalence of MetS was 42.08% before receiving the DPP intervention and 31.22% after the intervention that represented a 10.86% absolute reduction and a 25.81% relative reduction from baseline. The adjusted odds ratio (OR) of being free from MetS at post-intervention in contrast to baseline was 2.14 (p = 0.02). Factors that increased the odds of being free from MetS were younger age, reduction in intake of total calories, total fat, saturated and trans-fat, and dietary sodium. Conclusion-Afaith adapted lifestyle intervention held in church settings and delivered by minimally trained lay health coaches reduced the prevalence of MetS in AA women who were overweight or obese. Findings from this study can be used to translate evidence into public health programs at the community level for the prevention of type 2 diabetes and cardiovascular disease.

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“…CONSORT diagram of community-based DPP trial. The figure was adopted from the Better Me Within trial [38].…”

Section: Study Limitationsmentioning

confidence: 99%

Reducing metabolic syndrome through a community-based lifestyle intervention in African American women

Mamun

Kitzman

Dodgen

2020

Nutrition, Metabolism and Cardiovascular Diseases

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“…Consistent with the findings from our heart disease risk reduction programme, we combined faith‐based components—including active church leader support—into the standard DPP curriculum. Participants in the programme who were followed for 10 months had significant improvements in weight loss, health behaviours, and biometrics 69 . The study is very important for several reasons.…”

Section: Applying a National Best‐practice Model In The Local Community Context—testing The Diabetes Prevention Program On Reducing Weighmentioning

confidence: 99%

“…Thus, a faith‐based version of the DPP has the potential to help African‐American women reach 5% weight loss in a community‐setting outside of the AHC. Further, the programme demonstrated that female African‐American congregation members can successfully deliver the DPP providing a potential pathway for increasing reach and adoption into high‐risk communities 69 …”

Section: Applying a National Best‐practice Model In The Local Community Context—testing The Diabetes Prevention Program On Reducing Weighmentioning

confidence: 99%

“…Participants in the programme who were followed for 10 months had significant improvements in weight loss, health behaviours, and biometrics. 69 The study is very important for several reasons. It demonstrated that participants in the faith-based adaption of the DPP who received at least 15 sessions nearly reached the DPP's original goal of 7% weight loss and met the CDC's goal of 5% weight loss.…”

Section: Applying a National Best-practice Model In The Local Community Context-testing The Diabetes Prevention Program On Reducing Weighmentioning

confidence: 99%

“…Further, the programme demonstrated that female African-American congregation members can successfully deliver the DPP providing a potential pathway for increasing reach and adoption into high-risk communities. 69…”

Section: Applying a National Best-practice Model In The Local Community Context-testing The Diabetes Prevention Program On Reducing Weighmentioning

confidence: 99%

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Working with communities: Meeting the health needs of those living in vulnerable communities when Primary Health Care and Universal Health Care are not available

DeHaven

Gimpel

Kitzman

2020

Evaluation Clinical Practice

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Rationale, aims, and objectives The health care delivery model in the United States does not work; it perpetuates unequal access to care, favours treatment over prevention, and contributes to persistent health disparities and lack of insurance. The vast majority of those who suffer from preventable diseases and health disparities, and who are at greatest risk of not having insurance, are low‐income minorities (Native Americans, Hispanics, and African‐Americans) who live in high risk and vulnerable communities. The historical lack of support in the United States for Universal Health Care (UHC) and Primary Health Care (PHC)—with their emphasis on health care for all, population health, and social determinants of health—requires community health scientists to develop innovative local solutions for addressing unmet community health needs. Methods We developed a model community health science approach for improving health in fragile communities, by combining community‐oriented primary care (COPC), community‐based participatory research (CBPR), asset‐based community development, and service learning principles. During the past two decades, our team has collaborated with community residents, local leaders, and many different types of organizations, to address the health needs of vulnerable patients. The approach defines health as a social outcome, resulting from a combination of clinical science, collective responsibility, and informed social action. Results From 2000 to 2020, we established a federally funded research programme for testing interventions to improve health outcomes in vulnerable communities, by working in partnership with community organizations and other stakeholders. The partnership goals were reducing chronic disease risk and multimorbidity, by stimulating lifestyle changes, increasing healthy behaviours and health knowledge, improving care seeking and patient self‐management, and addressing the social determinants of health and population health. Our programmes have also provided structured community health science training in high‐risk communities for hundreds of doctors in training. Conclusion Our community health science approach demonstrates that the factors contributing to health can only be addressed by working directly with and in affected communities to co‐develop health care solutions across the broad range of causal factors. As the United States begins to consider expanding health care options consistent with PHC and UHC principles, our community health science experience provides useful lessons in how to engage communities to address the deficits of the current system. Perhaps the greatest assets US health care systems have for better addressing population health and the social determinants of health are the important health‐related initiatives already underway in most local communities. Building partnerships based on local resources and ongoing social determinants of health initiatives is the key for medicine to meaningfully engage communities for improving health outcomes and re...

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

Williams,

Abu Farsakh,

Karle

et al. 2024

Obesity

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ObjectiveChurches 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.MethodsGoogle 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.ResultsA 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.ConclusionsWeight‐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.

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Better Me Within Randomized Trial: Faith-Based Diabetes Prevention Program for Weight Loss in African American Women

Cited by 15 publications

References 39 publications

Reducing metabolic syndrome through a community-based lifestyle intervention in African American women

Reducing metabolic syndrome through a community-based lifestyle intervention in African American women

Working with communities: Meeting the health needs of those living in vulnerable communities when Primary Health Care and Universal Health Care are not available

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

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