The purpose of this study is to determine the effectiveness of a Nutrition Activation program to change dietary habits of low-income, obese African American women who are at risk for Non-Insulin-Dependent Diabetes Mellitus (NIDDM). The Activation program consists of a combination of strategies based upon Social Learning Theory, such as peer role modeling, staging, and group social support. A second focus of the study is to evaluate the impact of the program on reducing risk factors for NIDDM and obesity through a measurement of Body Mass Index, blood pressures, lipid levels, and waist-hip ratios. The proposed study will include 250 obese low-income African American women who will be recruited through collaborative efforts with Grace Hill Neighborhood Services, a social service organization located in the target community. The subjects will be randomized into either the Activation condition or a no-treatment control group condition. The Activation program will be delivered over a one-year period by trained peers from the target community. Intervention activities will consist of experiential learning exercises implemented within the target neighborhoods that focus on knowledge and skills related to: healthy food shopping, label reading, developing shopping tip sheets, creating low fat, high fiber recipes. Social support groups led by Nutrition Neighbors will be available to subjects in the Activation condition. Evaluation of the program will be performed through comparison of data assessed during pre-, post-, and six- month follow-up interviews. Assessments will include: l) knowledge and attitudes relating to nutrition and diet; 2) lifestyle risk factors such as smoking, physical activity; 3) dietary habits; 4) 24-Hour Dietary Recall (to be performed quarterly or 6 times for each subject); 5) food frequencies; 6) perceived social support; 7) physical data that includes Body Mass Index, blood pressure, waist-hip ratios, and lipid levels. Data analysis will include descriptive and multivariate analytic techniques to determine the impact of the program on outcome variables. Knowledge derived from this study will help identify effective strategies to reduce obesity and other risk factors of NIDDM among an underserved high risk population.
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