Obesity Clinical Trial
Official title:
Evaluation of a Media Campaign: Tu Salud Si Cuenta
The Tu Salud, Si Cuenta (TSSC) media campaign uses behavioral journalism, community outreach and environmental changes to promote physical activity and nutritional changes among disadvantaged Mexican-Americans living along the U.S./Mexico border. This intervention posits that increased physical activity and increased fruit and vegetable consumption with smaller portion sizes will result in a decrease in obesity prevalence and diabetes incidence in this population.
The TSSC campaign relies on behavioral journalism which includes the use of Spanish
language, attractive and influential role models to illustrate healthy physical activity and
nutritional habits through television, radio, and print media, to convey healthy physical
activity and nutritional messages to the target population. This intervention method will be
coupled with community outreach and environmental changes in the host community to further
promote these changes. Community outreach includes the use of local, lay community workers
to provide information and health screenings. Environmental changes focus on creating a
positive built environment that promotes physical activity through well-lit streets, walking
trails and safe recreational areas and healthy nutritional behaviors through increased
access to markets and centers where affordable produce can be purchased and nutritional
knowledge on healthy foods preparation and use can be disseminated.
As part of this intervention, a promoter-led community weight-loss challenge will be
comprised of participants from the City of Brownsville's sixteen week weight-loss challenge.
The location and site of the weigh-ins for this challenge occur at City Parks and Recreation
facility on designated dates. Community members who select to participate in the city's
weight loss challenge will be exposed to the Tu Salud Si Cuenta campaign. These individuals
will have the same access to promoter-led exercise classes and nutrition education sessions,
similar to CCHC participants. Recruited participants will also have the same access to
information provided by promoters about health, physical activity and healthful food choices
using motivational interviewing strategies. Participants of the weight-loss challenge are
asked to weigh-in at least two times during the challenge and have their height, blood
pressure and hip and waist circumference assessed.
We are proposing to evaluate the efficacy of this weight loss challenge more stringently and
answer two important questions. The firs is what timing and types of support via text
messages is appropriate for supporting weight loss in a community based weight loss
challenge? The second question is what is the long term weight loss maintenance of
participants in the 16 week weight loss challenge?
To answer the first question we will recruit and enroll Individuals who participate in the
weight-loss challenge in a randomized behavioral intervention trial examining exposure to
text messages and weight loss outcomes. Prior research has shown that making a change in
behavior and weight loss can be dependent upon the type of messages provided to an
individual (Rothman AJ, Salovey P, Antone C, et al, 1993; Patrick K, Raab F, Adams MA,
2009). We will test whether different content delivered via text messages impacts weight
loss outcomes.
For this study, we will enroll up to 200 weight-loss challenge participants to receive text
messages on their personal mobile phones throughout the 16 week challenge. Consent and
enrollment in the trial will take place at registration for the weight-loss community
challenge in the language of their choice. Recruited participants will be randomly assigned
to a group after consenting to the study and the timing and content of text messages will
vary according to group assignment (Groups A - D).
Group A will receive weekly reminders for upcoming weigh-in events. Group B will receive the
same weekly reminders but will also receive one-way messages every two weeks providing the
participant motivational messages/topics and weight loss health tips. Group C will receive
the same text messages as Group B but will also receive weekly prompts to self-monitor
weight status. The final group, Group D will receive the same text messages as Group C plus
daily prompts that will act as a guide for the participant to monitor his or her behavior
changes.
Participants will be asked to complete a short questionnaire about fruit and vegetable
consumption, physical activity and social support for weight loss at the initial and final
weigh in. (See attachment) We will also conduct a brief qualitative interview with 10 people
per group about their opinions regarding the texting content and frequency. Finally, they
will also consent for the research team to access their weight loss measures at initial and
final weigh in and use in the research project to assess weight status changes. For those
participants who do not attend final weigh in, the research team will contact the
participant to obtain a final weight. At the time of enrollment into the behavioral
intervention trial, participants will receive a $5 incentive. They will also receive an
additional $10 incentive at the final weigh-in with their completed measures.
To answer the second research question of what is the long term weight loss maintenance of
participants in the 16 week weight loss challenge we are proposing a follow-up feasibility
study. We will enroll and consent Biggest Loser Challenge participants in a study that will
follow them beyond the 16 week challenge one time at three months. At the registration of
the weight-loss challenge participants will be consented in the language of their choice.
This study will enroll up to 150 consenting participants. Participants will have their
height, weight, blood pressure and hip and waist circumference measures at initial, final
weigh-in and 3 months post using the same protocols as all other Biggest Loser Challenge
Participants. Weight will be taken using a calibrated Tanita scale and hip and waist
circumference will be measured with a tape measure following protocols used in our CCHC
(described below). Trained individual will take all measurements. A special number will be
used to identify the participant in the study and only the investigator will know their
name. These study participants however will also complete a short questionnaire about fruit
and vegetable consumption, physical activity and social support for weight loss. (see
attachment- this is the same instrument being used in the behavioral intervention trial
examining text messaging)
For Biggest Loser Challenge participants who do not complete the final weigh-in measure but
who have enrolled in this study, staff will contact the participants and schedule a time and
location to obtain the final weigh in measures. The measures will need to be obtained within
three weeks of the scheduled final weigh in challenge date. For the three month follow-up
contact again we will contact the participant and schedule a time and location to obtain
follow-up measures. Following all measurements (during the challenge and follow-up period),
participants will have the opportunity to discuss their results with a community health
worker trained to discuss these issues.
Individuals who complete the additional measures beyond the challenge period will receive
incentives for their time associated with participating in the research study. Participants
will receive an item valued at $5.00 for completing the three month post measurements.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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