Obesity Clinical Trial
To develop a culturally tailored intervention intended to promote adherence to nutrition and physical activity regimens designed to result in weight loss for African American women.
BACKGROUND:
Besides smoking cessation, weight loss and improved nutrition are the most important
behavioral changes, which can lead to improved health. Weight loss is also a critically
important behavioral recommendation for treating certain illnesses such as hypertension and
diabetes; for recovery from stroke or myocardial infarction; and for primary prevention of
these conditions as well as certain cancers. Unfortunately, adherence is very poor even with
motivated patients. This is a serious issue for all but especially African American women.
These diseases affect them disproportionately. They are more likely to be overweight and
there is a serious scarcity of culturally appropriate programs available. Also, many of
these women receive their care in high demand/low resource clinics so that any program must
also be practical and affordable within these constraints.
The study is in response to a Request for Applications issued in January, 2001 on
"Overcoming Barriers to Treatment Adherence in Minorities and Persons Living in Poverty."
DESIGN NARRATIVE:
The current research involves studying adherence to recommend changes in behaviors related
to nutritional intake and physical activity designed to reduce weight. The investigators
will develop and test two versions of a 16-session weight loss program with the content
delivered by videotape. They are nearing the end of another study, SisterTalk, for which a
culturally appropriate weight control program was designed in partnership with and then
delivered to African American women by cable television. Based upon that previous study,
they plan to address a number of specific barriers to adherence by designing one version for
clinic delivery and another for home delivery. Both approaches, each addressing different
adherence issues, will be compared to a Wait List Control Group at 4 and 12 months after
beginning the program. The primary outcome measures are adherence to recommended nutritional
behaviors and physical activity levels. The program is based upon Social Action Theory and
provides the opportunity to study many of that theory's mediating variables and their
relationships to specific adherence behaviors. This will include extensive process
evaluation procedures.They will also gather a great deal of data concerning the specific
barriers and facilitators to adherence to nutrition and physical activity recommendations
encountered by low-income African American women who are hypertensive or at high risk for
hypertension.
;
Primary Purpose: Prevention
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