Obesity prevention among Black women is a major public health priority; presently, nearly 54% of the adult Black female population is obese. To date, most intervention attention has been focused on weight reduction among the overweight and obese. However, both conditions are notoriously recalcitrant to treatment, particularly among Blacks. We posit that obesity prevention might represent a particularly effective intervention strategy for overweight Black women. Most studies have shown that Black women have a greater social acceptance of overweight, less body weight dissatisfaction, and higher ideal body weights, compared to Whites. Furthermore, numerous studies have shown that obesity is less lethal and causes fewer co-morbidities among Black vs. White women, suggesting that maintaining overweight may be an appropriate public health goal for Black women. We posit that an intervention approach that emphasizes maintaining overweight, while preventing the transition to obesity will resonate among the target population. Very few obesity prevention RCTs appear in the published literature and, to our knowledge, none have been conducted solely among Black women. We propose to randomize overweight, Black women (n=184) to either usual care (UC) or an obesity prevention (OP) intervention condition. The OP condition is comprised of several intervention components that will be delivered over 12 months; each participant will receive a tailored action plan, tailored print materials, monthly coaching calls, and weekly self-monitoring via an interactive voice response system. Assessments will be taken at baseline, 12, and 18-months post baseline. The primary outcome is change in BMI at 18-months. Secondary outcomes include 18-month change in obesity risk behaviors, measures of body composition, psychosocial mediators, and obesity related biomarkers. We have set a target of BMI maintenance among those randomized to the OP condition.

Public Health Relevance

At present, nearly 54% of Black women are obese, but existing weight loss interventions are not very successful for this population. We think that preventing obesity among healthy overweight women might help to prevent obesity and its associated health consequences. We propose to conduct an intervention in the primary care setting that uses an innovative approach to prevent obesity among Black women in middle age. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
7R01DK078798-02
Application #
7756123
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Kuczmarski, Robert J
Project Start
2008-09-05
Project End
2013-08-31
Budget Start
2009-01-01
Budget End
2009-08-31
Support Year
2
Fiscal Year
2008
Total Cost
$639,941
Indirect Cost
Name
Duke University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Greaney, Mary L; Askew, Sandy; Foley, Perry et al. (2017) Linking patients with community resources: use of a free YMCA membership among low-income black women. Transl Behav Med 7:341-348
Greaney, Mary L; Askew, Sandy; Wallington, Sherrie F et al. (2017) The effect of a weight gain prevention intervention on moderate-vigorous physical activity among black women: the Shape Program. Int J Behav Nutr Phys Act 14:139
Steinberg, Dori M; Christy, Jacob; Batch, Bryan C et al. (2017) Preventing Weight Gain Improves Sleep Quality Among Black Women: Results from a RCT. Ann Behav Med 51:555-566
McVay, Megan A; Steinberg, Dori M; Askew, Sandy et al. (2016) Genetic causal attributions for weight status and weight loss during a behavioral weight gain prevention intervention. Genet Med 18:476-82
Lanpher, Michele G; Askew, Sandy; Bennett, Gary G (2016) Health Literacy and Weight Change in a Digital Health Intervention for Women: A Randomized Controlled Trial in Primary Care Practice. J Health Commun 21 Suppl 1:34-42
Foley, Perry; Steinberg, Dori; Levine, Erica et al. (2016) Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients. Contemp Clin Trials 48:12-20
Steinberg, Dori M; Levine, Erica L; Lane, Ilana et al. (2014) Adherence to self-monitoring via interactive voice response technology in an eHealth intervention targeting weight gain prevention among Black women: randomized controlled trial. J Med Internet Res 16:e114
Steinberg, Dori M; Askew, Sandy; Lanpher, Michele G et al. (2014) The effect of a ""maintain, don't gain"" approach to weight management on depression among black women: results from a randomized controlled trial. Am J Public Health 104:1766-73
Bennett, Gary G; Foley, Perry; Levine, Erica et al. (2013) Behavioral treatment for weight gain prevention among black women in primary care practice: a randomized clinical trial. JAMA Intern Med 173:1770-7
Duncan, Dustin T; Castro, Marcia C; Gortmaker, Steven L et al. (2012) Racial differences in the built environment--body mass index relationship? A geospatial analysis of adolescents in urban neighborhoods. Int J Health Geogr 11:11

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