Obesity Clinical Trial
Official title:
Intensive Behavioral Weight Management in Public Health Settings: Weight-Wise
The overall goal of the translational research is to evaluate the processes and outcomes of implementing, in a range of public health agencies, an intense, evidence-based behavioral weight loss intervention with demonstrated effectiveness among midlife low-income women. The intervention was originally studied in a single coordinated community health care center/church setting and delivered by research staff. The investigators will evaluate the intervention's translation and test its effectiveness as implemented by existing staff in six public health agencies supported by local community resources.
Low-income women in the US have the highest rates of overweight and obesity, putting them at
increased risk for diabetes, heart disease, and other chronic illnesses. Because mean body
mass index gradually increases during adult life and peaks at 50-59 years of age, low income
women between 40-64 years are a group deserving of special attention. While there is
sufficient evidence that some behavioral weight management interventions are effective in
producing clinically meaningful levels of weight loss with reductions in cardiovascular risk
factors and delayed onset of diabetes, there is a research gap in translating these
efficacious interventions to real life settings and diverse population groups. Research that
seeks to translate effective behavioral weight management interventions from
resource-intensive efficacy trials to long-term adoption and implementation by public health
settings serving a diverse low-income population is timely and of great public health
significance. This translational research can provide important information to
decision-makers about evidence-based intervention delivery, resource allocation, and
workforce preparation.
The overall goal of the proposed research is to evaluate the processes and outcomes of
translating from research to practice an intense, evidence-based behavioral weight loss
intervention with demonstrated effectiveness among midlife low-income women. Originally
studied in a single coordinated community health care center/church setting and delivered by
research staff (Weight-Wise Pilot Study), we will evaluate the translation of and test the
effectiveness of this intervention as implemented by existing staff in a range of county
health departments supported by local community resources.
To evaluate the translation process, we will use the RE-AIM framework, diffusion of
innovation theory, and systematic models of adaptation to assess: 1) factors related to
reach; contextual or setting-specific factors necessary for successful adoption and
implementation; 2) effectiveness of facilitator training and stakeholder collaborations; 3)
adaptation and fidelity during implementation; and 4) costs associated with the
implementation and outcomes. To test the intervention's effectiveness, we will enroll 240
overweight or obese low-income women, 40-64 years of age, at 6 representative public health
agencies. Participants will be randomized to receive a 16-week behavioral weight loss
intervention (special intervention group) or usual care (wait listed control group). The
primary study outcome at 5 month follow-up is weight change; secondary outcomes include
change in blood pressure, dietary intake, physical activity, and quality of life measures.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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