Article Database

Household Support for Physical Activity in Adolescent Girls Living in Primarily Low Socioeconomic Status Neighborhoods

Abstract:

The purpose of this study was to examine the association between perception of household support and physical activity levels of adolescent girls living in primarily low socioeconomic status (SES) neighborhoods. The sample consisted of thirty-six adolescent girls (N=36; 60% non-Hispanic Black; mean age of 14.6 ± 1.3 [mean ± sd]; median body mass index (BMI) percentile of 90.5 [58.5, 97.0]) living in primarily low socioeconomic status (SES) neighborhoods. Trained researchers measured participants’ height and weight, and administered questionnaires to assess perception of household support for physical activity and minutes per day participating in moderate-to-vigorous physical activity (MVPA) (3-Day Physical Activity Recall). Pearson’s correlation, controlling for race, age, and BMI, was used to evaluate the association between perception of household support and adolescents’ MVPA levels. There were no significant associations between measures of the perception of household support for physical activity and adolescents’ MVPA levels. There were significant negative associations between total adult household support for physical activity (r=-0.51; p<.01) with BMI and the support provided by the closest adult in the household (r=-0.55; p<.01) with BMI. These data suggest that support for physical activity in the household for adolescents with higher BMI’s may be warranted.

Power Up for Health: Pilot Study Outcomes of a Diabetes Prevention Program for Men from Disadvantaged Neighborhoods

Abstract:

There is a significant evidence base for the Diabetes Prevention Program, a lifestyle intervention to prevent onset of type 2 diabetes among high-risk individuals; however, translation of this intervention for men has been challenging. This report presents outcomes of the pilot study of an adapted 16-week diabetes prevention program entitled ” Power Up for Health.” The study goal was to better engage men of color with prediabetes from disadvantaged neighborhoods of New York City. It was implemented at five different recreation centers located in predominantly low-income neighborhoods across New York City. The curriculum was facilitated by male lifestyle coaches only; one group was conducted in Spanish. Primary outcome was weight loss from baseline to 16 weeks. Other measures included lifestyle activities, depressive symptoms, and self-reported health status. Men ( N = 47) were screened by telephone. Of the 29 eligible men who began the program, 25 attended at least 4 sessions (52% non-Latino Black, 32% Latino, mean age 51.7 ± SD 9.9 years, mean body mass index 35 ± SD 6.9 kg/m²). End of program outcomes ( n = 23) varied by site and included a mean weight loss of 3.8% (9.7 lbs); 3 of the 5 sites had a mean weight loss of 5.6%, meeting the national goal of 5%-7%. Men ( n = 23) attended a mean of 11.6 of 16 sessions. Improvement in depressive symptoms, healthy eating and exercise, and health status were also seen. While recruitment was challenging with many lessons learned, the adapted men’s diabetes prevention program shows promise of success for participants and their coaches.

Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health

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The Diabetes Prevention Program (DPP) landmark randomized trial demonstrated that participants with prediabetes could reduce their risk for type 2 diabetes by 58% if they achieved 5%-7% weight loss through healthy eating and increasing physical activity. The National DPP (NDPP) is a group intervention based on the DPP and has been widely disseminated by the Centers for Disease Control and Prevention (CDC) and many healthcare institutions. While data show that the program is effective in diverse populations, enrollment among men from low-income and minority communities is low. Thus, the study piloted a novel adaptation focused on men living in disadvantaged neighborhoods. The study approach to adaptation and implementation used characteristics of participatory research, including input from an expert panel of African American and Latino leaders, ongoing consultation with an Advisory Panel, and focus groups with members of the target population. Discussions with these groups focused on male perspectives regarding health promotion and barriers and facilitators to participation in health programming for men. There was general agreement when reviewing ongoing pilot program implementation that the adapted program should have male-only groups with male coaches, as the Advisory Panel had originally suggested. The pilot programs were implemented at five New York City Department of Parks and Recreation sites in Harlem, the Bronx, and Brooklyn in 2015-2016.

The Built Environment and Obesity

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Self-Management Behaviors, Glycemic Control, and Metabolic Syndrome in Type 2 Diabetes

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Sex, Race, and the Role of Relationships in Diabetes Health: Intersectionality Matters

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Previous research has seldom used an intersectionality framework to consider how sex and race affect diabetes health, nor has it examined the role of sex and race in the well-established link between romantic relationship quality and health. This study targeted 200 adults with type 2 diabetes (46% Black; 45% female) and examined whether sex, race, and the interaction between sex and race predicted behavioral and psychological health, or moderated the link between relationship quality and health outcomes. Black women reported poorer diabetes self-care and lower self-efficacy compared to other groups. Relationship quality was associated with better self-care, increased self-efficacy, and lower depressive symptoms. The association between relationship quality and medication adherence was stronger for Black women, and the association between relationship quality and self-efficacy was stronger for both Black women and White men. Results suggest that Black women with diabetes experience more health disadvantages than other groups, but some of these disadvantages might be attenuated by supportive romantic relationships.

Perceptions and Experiences of Appetite Awareness Training Among African-American Women Who Binge Eat

Abstract:

Introduction: Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women.

Methods: African-American women, aged 18-70 years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention.

Results: Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns.

Conclusion: AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population.

Level of evidence: Level V, qualitative descriptive study.

Power Up for Health-Participants’ Perspectives on an Adaptation of the National Diabetes Prevention Program to Engage Men

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The National Diabetes Prevention Program (NDPP) has been effectively translated to various community and clinical settings; however, regardless of setting, enrollment among men and lower-income populations is low. This study presents participant perspectives on Power Up for Health, a novel NDPP pilot adaption for men residing in low-income communities in New York City. We conducted nine interviews and one focus group with seven participants after the program ended. Interview and focus group participants had positive perceptions of the program and described the all-male aspect of the program and its reliance on male coaches as major strengths. Men felt the all-male adaptation allowed for more open, in-depth conversations on eating habits, weight loss, body image, and masculinity. Participants also reported increased knowledge and changes to their dietary and physical activity habits. Recommendations for improving the program included making the sessions more interactive by, for example, adding exercise or healthy cooking demonstrations. Overall, findings from the pilot suggest this NDPP adaptation was acceptable to men and facilitated behavior change and unique discussions that would likely not have occurred in a mixed-gender NDPP implementation.

Characterizing a Sample of Chinese Patients With Type 2 Diabetes and Selected Health Outcomes

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African Americans in Standard Behavioral Treatment for Obesity, 2001-2015: What Have We Learned?

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African Americans (AAs) bear a disproportionate burden of the obesity epidemic, yet have historically been underrepresented in weight loss research. We conducted a narrative review of large ( N > 75) randomized prospective clinical trials of standard behavioral treatment for weight loss that reported results in the past 15 years (2001-2015) to (a) determine the rates of inclusion and reported results for AAs and (b) further identify strategies that may result in improved outcomes. Of the 23 trials reviewed, 69.6% of the studies met or exceeded population estimates for AAs in the United States. However, only 10 reported outcomes and/or considered race in the analytic approach. At 6 months, AA participants consistently lost less weight than White participants. The use of culturally tailored intervention materials and monthly personal telephone calls were reported as factors that may have enhanced treatment response. Future behavioral weight loss trials should also increase reporting of outcomes by race.