There is an urgent need for research on weight loss approaches for reducing the risk and associated complications of obesity in African-American women. According to the National Health and Nutrition Examination Survey (2007 - 2008), women have a higher obesity prevalence (35.5%) than men (32.2%) and non-Hispanic blacks have a higher prevalence (44.1%) than non-Hispanic whites (32.8%), with non-Hispanic black women having the highest prevalence reported (49.6%). Obesity is associated with increased risk of hypertension, diabetes, dyslipidemia, and metabolic syndrome;and increased risk of death from diabetes, kidney disease, some cancers, and primarily cardiovascular diseases. Although lifestyle factors account for 50% of premature mortality, the lack of evidence-based clinical trials has discounted the value of lifestyle interventions as a dependable strategy for reducing obesity prevalence in high-risk populations. The goal ofthe proposed project is to conduct a randomized clinical trial for reducing obesity among African- American women, through a community-based participatory research (CBPR) partnership among African- American congregations and investigators in a high-minority, low-income, underserved community. The proposed study will test the effects of a novel lifestyle-based weight loss program for obese African- American women in their churches, which incorporates the direct participation of Senior Pastors into the program intervention. The project's specific aims are to: 1) develop a church pastor facilitated weight loss program for obese African-American women in the church setting, and, 2) assess the effect of a church pastor facilitated weight loss program for African-American women on decreasing body weight compared to a weight loss program that is not church pastor facilitated. The study's secondary aims are to test the effects of weight loss on reducing risk factors for cardiovascular disease, and to test for differences in weight loss between pre-menopausal and post-menopausal women.
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