Community Trial of a Faith-Based Lifestyle Intervention to Prevent Diabetes Among African-Americans

Abstract

About 75% of African Americans (AAs) ages 20 or older are overweight and nearly 50% are obese, but community-based programs to reduce diabetes risk in AAs are rare. Our objective was to reduce weight and fasting plasma glucose (FPG) and increase physical activity (PA) from baseline to week-12 and to month-12 among overweight AA parishioners through a faith-based adaptation of the Diabetes Prevention Program called Fit Body and Soul (FBAS). We conducted a single-blinded, cluster randomized, community trial in 20 AA churches enrolling 604 AAs, aged 20 to 64 years with BMI ≥ 25 kg/m2 and without diabetes. The church (and their parishioners) was randomized to FBAS or health education (HE). FBAS participants had a significant difference in adjusted weight loss compared with those in HE (2.62 kg vs. 0.50 kg, p=0.001) at 12-weeks and (2.39 kg vs. −0.465 kg, p=0.005) at 12-months and were more likely (13%) than HE participants (3%) to achieve a 7% weight loss (p<0.001) at 12-weeks and a 7% weight loss (19% vs. 8%, p<0.001) at 12-months. There were no significant differences in FPG and PA between arms. Of the 15.2% of participants with baseline pre-diabetes, those in FBAS had, however, a significant decline in FPG (10.93 mg/dl) at 12-weeks compared with the 4.22 mg/dl increase in HE (p=0.017), and these differences became larger at 12-months (FBAS, 12.38 mg/dl decrease; HE, 4.44 mg/dl increase)(p=0.021). Our faith-based adaptation of the DPP led to a significant reduction in weight overall and in FPG among pre-diabetes participants.

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment

“…This is not surprising, since women tend to attend church more frequently than men (Pew Research Center, 2009; 2015). Other African American church-based studies have found similar overrepresentation (e.g., Author et al, 2016; Sattin, Williams, Dias, Garvin, Marion et al, 2015; Whitt-Glover, Porter, Yore, Demons, Goldmon et al, 2014). The underrepresentation of African American men may leave the findings lacking on input regarding the unique needs and considerations in addressing men’s health, particularly in church-community interventions.…”

“…Past studies demonstrate that the Black Church can be a practical setting for health promotion interventions, including interventions focused on fruit/vegetable consumption, physical activity, weight loss, smoking cessation, and health screenings (e.g., Author et al, 2004; Campbell, Hudson, Resnicow, Blakeney, Paxton et al, 2007; Duan, Fox, Derose, & Carson, 2000; Francis & Liverpool, 2009; Resnicow, Jackson, Blissett, Wang, McCarty et al, 2005; Sattin, Williams, Dias, Garvin, Marion et al, 2015). However, reports on church-based health promotion interventions indicate they often are designed by researchers, address a single health issue, usually include only one or two levels of intervention strategies (e.g., group, church services), rarely include community-level intervention strategies, and have had mixed levels of success.…”

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

“…One study found a beneficial effect of faith- based programming on weight when compared to general health education [38]. The Better Me Within randomized trial allows for comparison of a faith- based DPP program (e.g., faith-enhanced DPP) developed by faith leaders using CBPR approaches as compared to a faith- placed DPP program (secular program held at a church).…”

A Church-Based Weight Loss Intervention in African American Adults using Text Messages (LEAN Study): Cluster Randomized Controlled Trial (Preprint)

“…weight on their quality of life. [41,42] This is an important aspect for individuals with overweight or obesity. Kennedy et al [40] also utilized the Impact of Weight on Quality of Life scale, but they did not find changes in their church-based weight loss intervention.…”