y Eat, Pray, Move: A Pilot Cluster Randomized Controlled Trial of a Multilevel Church-Based Intervention to Address Obesity Among African Americans and Latinos
y Eat, Pray, Move: A Pilot Cluster Randomized Controlled Trial of a Multilevel Church-Based Intervention to Address Obesity Among African Americans and Latinos
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DOI：
10.1177/0890117118813333
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发表时间：
2019-05-01
影响因子：
2.7
通讯作者：
Wong, Eunice C.
中科院分区：
文献类型：
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作者：
Derose, Kathryn P.;Williams, Malcolm V.;Wong, Eunice C.
目的：实施一个多层次的，基于教会的干预与不同的差距人群使用社区为基础的参与性研究和评估的可行性，可接受性，并在改善肥胖相关的结果的初步有效性。设计：整群随机对照试验（试点）。设定：两个中型（类似于200名成年人）非裔美国人浸信会和两个非常大（类似于2000年）拉丁美洲天主教堂在南洛杉矶，加州。参与者：成人（18岁以上）会众（基线时入组n = 268，每个教会45 - 99人）。干预措施：在5个月内实施了各种组成部分，包括牧师的2次布道，教育讲义，教会蔬菜和水果园，烹饪和营养课程，每日移动的信息，社区食物和体育活动环境地图，以及确定会众政策变化，以增加健康膳食。措施：结果包括客观测量的体重，身体质量指数（BMI），收缩压和舒张压（BP），加上自我报告的饮食总体健康状况和每周体育活动的通常时间;控制变量包括性别，年龄，种族，民族，英语水平，教育，家庭收入和（体育活动结果）自我报告的健康状况。分析：多变量线性回归模型估计干预的平均效应大小，控制配对固定效应、干预的主要效应和结果的基线值。结果如下：在完成随访的患者中（68%），干预导致统计学上显著减少体重增加和体重减轻（-0.05效应量; 95%置信区间[CI] = -0.06至-0.04），BMI较低（-0.08; 95% CI = -0.11至-0.05），以及更健康的饮食（-0.09; 95% CI = -0.17至-0.00）。没有证据表明干预对BP或每周体力活动分钟数有影响。结论：在不同的教会中实施多层次干预导致肥胖结局的小幅改善。需要更长的时间来充分执行和评估社区和会众环境战略的影响，并考虑到干预措施可能产生的更大影响。
Purpose: To implement a multilevel, church-based intervention with diverse disparity populations using community-based participatory research and evaluate feasibility, acceptability, and preliminary effectiveness in improving obesity-related outcomes. Design: Cluster randomized controlled trial (pilot). Setting: Two midsized (similar to 200 adults) African American baptist and 2 very large (similar to 2000) Latino Catholic churches in South Los Angeles, California. Participants: Adult (18+ years) congregants (n = 268 enrolled at baseline, ranging from 45 to 99 per church). Intervention: Various components were implemented over 5 months and included 2 sermons by pastor, educational handouts, church vegetable and fruit gardens, cooking and nutrition classes, daily mobile messaging, community mapping of food and physical activity environments, and identification of congregational policy changes to increase healthy meals. Measures: Outcomes included objectively measured body weight, body mass index (BMI), and systolic and diastolic blood pressure (BP), plus self-reported overall healthiness of diet and usual minutes spent in physical activity each week; control variables include sex, age, race-ethnicity, English proficiency, education, household income, and (for physical activity outcome) self-reported health status. Analysis: Multivariate linear regression models estimated the average effect size of the intervention, controlling for pair fixed effects, a main effect of the intervention, and baseline values of the outcomes. Results: Among those completing follow-up (68%), the intervention resulted in statistically significantly less weight gain and greater weight loss (-0.05 effect sizes; 95% confidence interval [CI] = -0.06 to -0.04), lower BMI (-0.08; 95% CI = -0.11 to -0.05), and healthier diet (-0.09; 95% CI = -0.17 to -0.00). There was no evidence of an intervention impact on BP or physical activity minutes per week. Conclusion: Implementing a multilevel intervention across diverse congregations resulted in small improvements in obesity outcomes. A longer time line is needed to fully implement and assess effects of community and congregation environmental strategies and to allow for potential larger impacts of the intervention.