A Church-Based Diet and Physical Activity Intervention for Rural, Lower Mississippi Delta African American Adults: Delta Body and Soul Effectiveness Study, 2010-2011
A Church-Based Diet and Physical Activity Intervention for Rural, Lower Mississippi Delta African American Adults: Delta Body and Soul Effectiveness Study, 2010-2011
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DOI：
10.5888/pcd10.120286
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发表时间：
2013-06-01
影响因子：
5.5
通讯作者：
Edmond, Emanuel
中科院分区：
文献类型：
--
作者：
Tussing-Humphreys, Lisa;Thomson, Jessica L.;Edmond, Emanuel
在密西西比三角洲（LMD）地区，肥胖、糖尿病和高血压已达到流行水平。我们评估了2010年至2011年期间进行的为期6个月、以教会为基础的饮食和体育活动干预的有效性，以改善饮食质量（由健康饮食指数-2005衡量）和增加LMD地区非洲裔美国成年人的体育活动。方法采用准实验设计，自行选择8个符合条件的教会作为干预组或对照组。评估包括饮食、身体活动、人体测量和临床测量。组间比较的统计检验包括分类变量的chi(2)检验、Fisher’s exact检验和McNemar’s检验，连续变量的混合模型回归分析和干预效应建模。结果对照组的保留率为85%（208人中有176人），干预教会的保留率为84%（195人中有163人）。对照组（均值[标准差]、0.3[1.8]、0.2[1.1]、3.4[9.6]）和干预组（均值[1.7]、0.3[1.2]、3.2[9.7]）饮食质量成分，包括总水果、总蔬菜和总质量均有显著改善，而有氧运动指标（22%）和力量/柔韧性指标（24%）仅在干预组有显著提高。回归分析表明，干预参与水平和车辆拥有量是饮食质量变化的显著正预测因子。结论以教会为基础的饮食与身体活动干预可以有效改善LMD非裔美国成年人的饮食质量和增加身体活动。这些项目成功的关键因素是参与者参与教育课程和车辆通行。
IntroductionObesity, diabetes, and hypertension have reached epidemic levels in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a 6-month, church-based diet and physical activity intervention, conducted during 2010 through 2011, for improving diet quality (measured by the Healthy Eating Index-2005) and increasing physical activity of African American adults in the LMD region.MethodsWe used a quasi-experimental design in which 8 self-selected eligible churches were assigned to intervention or control. Assessments included dietary, physical activity, anthropometric, and clinical measures. Statistical tests for group comparisons included chi(2), Fisher's exact, and McNemar's tests for categorical variables, and mixed-model regression analysis for continuous variables and modeling intervention effects.ResultsRetention rates were 85% (176 of 208) for control and 84% (163 of 195) for intervention churches. Diet quality components, including total fruit, total vegetables, and total quality improved significantly in both control (mean [standard deviation], 0.3 [1.8], 0.2 [1.1], and 3.4 [9.6], respectively) and intervention (o.6 [1.7], 0.3 [1.2], and 3.2 [9.7], respectively) groups, while significant increases in aerobic (22%) and strength/flexibility (24%) physical activity indicators were apparent in the intervention group only. Regression analysis indicated that intervention participation level and vehicle ownership were significant positive predictors of change for several diet quality components.ConclusionThis church-based diet and physical activity intervention may be effective in improving diet quality and increasing physical activity of LMD African American adults. Components key to the success of such programs are participant engagement in educational sessions and vehicle access.