Study design, intervention, and baseline characteristics of a group randomized trial involving a faith-based healthy eating and physical activity intervention (Walk by Faith) to reduce weight and cancer risk among overweight and obese Appalachian adults

Abstract

Background Increased prevalence of overweight and obesity among Appalachian residents may contribute to increased cancer rates in this region. This manuscript describes the design, components, and participant baseline characteristics of a faith-based study to decrease overweight and obesity among Appalachian residents. Methods A group randomized study design was used to assign 13 churches to an intervention to reduce overweight and obesity (Walk by Faith) and 15 churches to a cancer screening intervention (Ribbons of Faith). Church members with a body mass index (BMI) ≥25 were recruited from these churches in Appalachian counties in five states to participate in the study. A standard protocol was used to measure participant characteristics at baseline. The same protocol will be followed to obtain measurements after completion of the active intervention phase (12 months) and the sustainability phase (24 months). Primary outcome is change in BMI from baseline to 12 months. Secondary outcomes include changes in blood pressure, waist-to-hip ratio, and fruit and vegetable consumption, as well as intervention sustainability. Results Church members (n = 664) from 28 churches enrolled in the study. At baseline 64.3% of the participants were obese (BMI ≥30), less than half (41.6%) reported regular exercise, and 85.5% reported consuming less than 5 servings of fruits and vegetables per day. Conclusions Church members recruited to participate in a faith-based study across the Appalachian region reported high rates of unhealthy behaviors. We have demonstrated the feasibility of developing and recruiting participants to a faith-based intervention aimed at improving diet and increasing exercise among underserved populations.

Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study

“…Faith institutions have the potential to be important partners in the effort to address obesity and related health conditions among African American adolescent males as churches have been rich settings for weight loss and weight gain prevention interventions targeting African American adults. 39–42,49–51 However, setting is only a starting point. We believe that faith-oriented concepts and tenets such as religiosity and spirituality can have implications for health and health behaviors and we sought to explore the relationship between spirituality and religiosity and weight maintenance among African American adolescent males using data from the JHS-KIDS pilot study.…”

A Group Randomized Trial to Reduce Obesity among Appalachian Church Members: The Walk by Faith Study

“…The primary outcome of interest was change in participant weight from baseline to 12 months, and secondary outcomes included changes in blood pressure (systolic), physical activity (measured by daily steps recorded by pedometers worn by participants and physical activity questionnaires), and diet (measured by a validated food frequency questionnaire). Details of the study design and theoretical framework for the interventions have been described elsewhere [15]; the study population, intervention, assessments, and outcomes are briefly described below.…”

Environmental health disparities in the Central Appalachian region of the United States

“…Only a limited number of studies have been conducted to delineate the causes of observed health disparities, with the majority of research and outreach programs to date focused on lifestyle and behavioral risk factors. For example, obesity rates are particularly high in Appalachia; consequently, several cancer prevention programs have focused on increasing physical activity and promoting healthy eating, alongside increased screening initiatives in the broader region [17][18][19]. Reduced access to and utilization of health care remains a complicating issue in Appalachia that likely results in delayed diagnosis, suboptimal care, and ultimately worse outcomes from cancer, diabetes and cardiovascular and respiratory disease [20].…”