The keys to any chronic disease prevention effort are to develop and implement an intervention that is culturally acceptable by he target population, cost effective, and replicable in other communities. Recent research on cancer causation and prevention has documented that particular mortality. The primary dietary changes involved in this research application include total caloric reduction (weight loss), a decrease in dietary fat, and an increase in dietary fiber. Our research model centers on implementing dietary change self-help groups within Black churches. All Black churches in a predominantly rural county in Mississippi have already been identified. A random sample of 24 experimental churches and 24 control churches will be selected. This will provide us with over 240 individuals in the experimental cohort and over 240 individuals in the control cohort. For inclusion in the group an individual must be 130 percent or above ideal weight. Dietary change self-help groups will be established only within the experimental cohort. Volunteer cancer prevention counselors form the congregation will be identified and trained to function as group leaders. The model will provide a sense of program """"""""ownership"""""""" by the community and will promote diffusion of this model throughout the population. These volunteers will be trained by indigenous paraprofessionals certified in weight loss programs and health education techniques. Outcome measures include a statistically significant weight loss over a two year period (>130% to <120%), and increase in dietary fiber to 20 grams, and an intake of dietary fat less than 30 percent of total calories. This will be documented through analysis of three day food recalls delivered at baseline (six months), 18 months, and 30 months into the study. Qualitative measures will also ge conducted to formatively evaluate the process of how a population adapts to behavioral change and diffusion of this behavioral change to nonparticipants.
