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Influence of body dissatisfaction on 1-year change in nutrient intake of overweight and obese inner-city African American children.
Sharma, S, Ikeda, J, Fleming, SE
Body image. 2013;(1):121-6
Abstract
This analysis aimed to examine the relationship of baseline body dissatisfaction with 1-year change in nutrient intake of inner-city, overweight and obese, African American children. This is a secondary analysis of 1-year pre-post data available for a convenience sample of 88 children. After adjusting for baseline intake of dietary variables and intervention group status, baseline body dissatisfaction was associated with 1-year increases in intake of energy, and all macronutrients in girls, but not in boys. These relationships were not substantially altered after adjusting for baseline BMIz and global self-worth. After including all adjustment factors, increasing baseline body dissatisfaction in girls was associated with 1-year increased intake of total energy, total sugars, total fat, discretionary fat, and total carbohydrates. This analysis suggests that, in girls but not necessarily in boys, body dissatisfaction might need to be targeted during interventions that aim to improve nutrient intake.
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Improved outcomes in diabetes care for rural African Americans.
Bray, P, Cummings, DM, Morrissey, S, Thompson, D, Holbert, D, Wilson, K, Lukosius, E, Tanenberg, R
Annals of family medicine. 2013;(2):145-50
Abstract
PURPOSE Rural low-income African American patients with diabetes have traditionally poorer clinical outcomes and limited access to state-of-the-art diabetes care. We determined the effectiveness of a redesigned primary care model on patients' glycemic, blood pressure, and lipid level control. METHODS In 3 purposively selected, rural, fee-for-service, primary care practices, African American patients with type 2 diabetes received point-of-care education, coaching, and medication intensification from a diabetes care management team made up of a nurse, pharmacist, and dietitian. In 5 randomly selected control practices matched for practice and patient characteristics, African American patients received usual care. Using univariate and multivariate adjusted models, we evaluated the effects of the intervention on intermediate (median 18 months) and long-term (median 36 months) changes in glycated hemoglobin (hemoglobin A1c) levels, blood pressure, and lipid levels, as well as the proportion of patients meeting target values. RESULTS Among 727 randomly selected rural African American diabetic patients (368 intervention, 359 control), intervention patients had a significantly greater reduction in mean hemoglobin A1c levels at intermediate (-0.5 % vs -0.2%; P <.05) and long-term (-0.5% vs -0.10%; P <.005) follow-up in univariate and multivariate models. The proportion of patients achieving a hemoglobin A1c level of less than 7.5% (68% vs 59%, P <.01) and/or a systolic blood pressure of less than 140 mm Hg (69% vs 57%, P <.01) was also significantly greater in intervention practices in multivariate models. CONCLUSION Redesigning care strategies in rural fee-for-service primary care practices for African American patients with established diabetes results in significantly improved glycemic control relative to usual care.
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Self-management support in "real-world" settings: an empowerment-based intervention.
Tang, TS, Funnell, MM, Brown, MB, Kurlander, JE
Patient education and counseling. 2010;(2):178-84
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Abstract
OBJECTIVE This study examined the impact of a 6-month, empowerment-based diabetes self-management support (DSMS) intervention on clinical outcomes, self-care behaviors, and quality of life (QOL) compared to a 6-month control period. METHODS This control-intervention cohort study recruited 77 African-American adults with type 2 diabetes. Baseline, 6-month, and 12-month assessments measured A1C, weight, body mass index (BMI), blood pressure, lipids, self-care behaviors, and QOL. During the control period, participants received weekly educational newsletters. During the intervention period, participants attended weekly DSMS groups as frequently as they needed. Sessions were guided by participants' self-management questions and concerns, and also emphasized experiential learning, coping, problem-solving, and goal-setting. RESULTS The control period found significant improvements for diastolic BP (p<0.05), serum cholesterol (p<0.001), following a healthy diet (p<0.01), and monitoring blood glucose (p<0.01). The intervention period found significant additional improvements for A1C (p<0.001), weight (p<0.05), BMI (p<0.05), and LDL (p<0.001). Compared to the control period, participation in the intervention led to a significant reduction in A1C (p<0.01). CONCLUSION Findings suggest that an empowerment-based, DSMS intervention is promising for improving and/or maintaining diabetes-related health, particularly A1C. PRACTICAL IMPLICATIONS Incorporating empowerment principles in DSMS interventions may be useful for supporting patients' self-management efforts in "real-world" settings.
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An urban food store intervention positively affects food-related psychosocial variables and food behaviors.
Gittelsohn, J, Song, HJ, Suratkar, S, Kumar, MB, Henry, EG, Sharma, S, Mattingly, M, Anliker, JA
Health education & behavior : the official publication of the Society for Public Health Education. 2010;(3):390-402
Abstract
Obesity and other diet-related chronic diseases are more prevalent in low-income urban areas, which commonly have limited access to healthy foods. The authors implemented an intervention trial in nine food stores, including two supermarkets and seven corner stores, in a low-income, predominantly African American area of Baltimore City, with a comparison group of eight stores in another low-income area of the city. The intervention (Baltimore Healthy Stores; BHS) included an environmental component to increase stocks of more nutritious foods and provided point-of-purchase promotions including signage for healthy choices and interactive nutrition education sessions. Using pre- and postassessments, the authors evaluated the impact of the program on 84 respondents sampled from the intervention and comparison areas. Exposure to intervention materials was modest in the intervention area, and overall healthy food purchasing scores, food knowledge, and self-efficacy did not show significant improvements associated with intervention status. However, based on adjusted multivariate regression results, the BHS program had a positive impact on healthfulness of food preparation methods and showed a trend toward improved intentions to make healthy food choices. Respondents in the intervention areas were significantly more likely to report purchasing promoted foods because of the presence of a BHS shelf label. This is the first food store intervention trial in low-income urban communities to show positive impacts at the consumer level.
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The WORD (wholeness, oneness, righteousness, deliverance): a faith-based weight-loss program utilizing a community-based participatory research approach.
Kim, KH, Linnan, L, Campbell, MK, Brooks, C, Koenig, HG, Wiesen, C
Health education & behavior : the official publication of the Society for Public Health Education. 2008;(5):634-50
Abstract
Despite multidisciplinary efforts to control the nation's obesity epidemic, obesity has persisted as one of the U.S.'s top public health problems, particularly among African Americans. Innovative approaches to address obesity that are sensitive to the unique issues of African Americans are needed. Thus, a faith-based weight-loss intervention using a community-based participatory research approach was developed, implemented, and evaluated with a rural African American faith community. A two-group, quasi-experimental, delayed intervention design was used, with church as the unit of assignment (treatment n=2, control n=2) and individual as the unit of observation (treatment n=36, control n=37). Weekly small groups led by trained community members met for 8 weeks and emphasized healthy nutrition, physical activity, and faith's connection with health. The mean weight loss of the treatment group was 3.60+/-0.64 lbs. compared to the 0.59+/-0.59-lb loss of the control group.
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Racial and Ethnic Approaches to Community Health (REACH) Detroit partnership: improving diabetes-related outcomes among African American and Latino adults.
Two Feathers, J, Kieffer, EC, Palmisano, G, Anderson, M, Sinco, B, Janz, N, Heisler, M, Spencer, M, Guzman, R, Thompson, J, et al
American journal of public health. 2005;(9):1552-60
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Abstract
OBJECTIVES We sought to determine the effects of a community-based, culturally tailored diabetes lifestyle intervention on risk factors for diabetes complications among African Americans and Latinos with type 2 diabetes. METHODS One hundred fifty-one African American and Latino adults with diabetes were recruited from 3 health care systems in Detroit, Michigan, to participate in the Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership diabetes lifestyle intervention. The curriculum, delivered by trained community residents, was aimed at improving dietary, physical activity, and diabetes self-care behaviors. Baseline and postintervention levels of diabetes-specific quality-of-life, diet, physical activity, self-care knowledge and behaviors, and hemoglobin A1C were assessed. RESULTS There were statistically significant improvements in postintervention dietary knowledge and behaviors and physical activity knowledge. A statistically significant improvement in A1C level was achieved among REACH Detroit program participants (P<.0001) compared with a group of patients with diabetes in the same health care system in which no significant changes were observed (P=.160). CONCLUSIONS A culturally tailored diabetes lifestyle intervention delivered by trained community residents produced significant improvement in dietary and diabetes self-care related knowledge and behaviors as well as important metabolic improvements.
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Stress-reduction psychoeducational interventions for black working women.
Napholz, L
The Nursing clinics of North America. 2002;(2):263-72, vi
Abstract
Stress-reduction psychoeducation as a lifestyle modification intervention highlights multiple sources of stress. This article focuses on stress-reduction psychoeducation for Black women and supports the development of culture- and gender-appropriate community interventions as viable methods for stress reduction. The intervention helped participants verbalize strategies for reducing role conflict such as establishing priorities, partitioning and separating roles, overlooking role demands, and changing attitudes toward roles in order to maximize satisfaction in a specific role. Nurses who provide care for Black women in acute care settings, mental health settings, clinics, and occupational settings are in key positions to identify psychological symptomatology related to negative mental health responses associated with multiple role occupancy for at-risk groups of Black working women. Psychoeducational support groups may be a viable alternative to facilitate the problem solving and the support once afforded by informal support networks.
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Effects of a short-term health promotion intervention for a predominantly African-American group of stroke survivors.
Rimmer, JH, Braunschweig, C, Silverman, K, Riley, B, Creviston, T, Nicola, T
American journal of preventive medicine. 2000;(4):332-8
Abstract
BACKGROUND The study examined the effects of a 12-week health promotion intervention for a predominantly urban African-American population of stroke survivors. DESIGN A pre-test/post-test lag control group design was employed. PARTICIPANTS/SETTING Participants were 35 stroke survivors (9 male, 26 female) recruited from local area hospitals and clinics. MAIN OUTCOME MEASURES Biomedical, fitness, nutritional, and psychosocial measures were employed to assess program outcomes. RESULTS Treatment group made significant gains over lag controls in the following areas: (1) reduced total cholesterol, (2) reduced weight, (3) increased cardiovascular fitness, (4) increased strength, (5) increased flexibility, (6) increased life satisfaction and ability to manage self-care needs, and (7) decreased social isolation. CONCLUSION A short-term health promotion intervention for predominantly African-American stroke survivors was effective in improving several physiological and psychological health outcomes.