Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial

Abstract

Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the Diabetes Prevention Program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (Mage=48.8±11.2; MBMI=36.7±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design will be used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study will provide essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease.

Longitudinal Changes in Allostatic Load during a Randomized Church-based, Lifestyle Intervention in African American Women

“…Data collection methods, study groups (FDPP and SDPP), and eligibility for BMW are described elsewhere. 16 Briefly, trained staff collected socioeconomic, health behavior, biomarker, and psychosocial data at baseline and 4-month intervals from February 2014-October 2016. The 221 eligible participants, of 333 women screened, resided in 148 census tracts in the Greater Dallas area.…”

“…23,24 Intervention Participants in this study were categorized based on the type of intervention received: FDPP or SDPP, which were both delivered in church settings and have been described previously. 16 Briefly, the SDPP delivered the standard CDC-approved DPP, while the FDPP provided a faith-enhanced curriculum in addition to the standard DPP. Both programs were delivered by peer leaders.…”

Using codesign to develop a culturally tailored, behavior change mHealth intervention for indigenous and other priority communities: A case study in New Zealand

“…Since then, codesign principles and practices have been used in a range of other domains, including health care (e.g., [21,22]). In the present project, called OL@-OR@, we aimed to codesign a culturally tailored, evidence-based, lifestyle support mHealth program for Māori and Pasifika communities living in New Zealand.…”

Developing Intergenerational Interventions To Address Food Insecurity among Pre-School Children: A Community-based Participatory Approach

“…Practitioners and researchers alike must build mutual trust and share expertise to effectively address pressing social, economic, and health issues such as chronic diet-related health equity concerns. 44,45 Researchers have to earn the trust of community members by engaging in the community with the community. We earned trust by attending family nights and talking with parents, staff, and administrators about programming and data collection efforts.…”