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- Title
A Cluster Randomized Controlled Trial Comparing Diabetes Prevention Program Interventions for Overweight/Obese Marshallese Adults.
- Authors
McElfish, Pearl A.; Felix, Holly C.; Bursac, Zoran; Rowland, Brett; Yeary, Karen H. K.; Long, Christopher R.; Selig, James P.; Kaholokula, Joseph Keawe'aimoku; Riklon, Sheldon
- Abstract
This study compared the effectiveness of two Diabetes Prevention Program (DPP) interventions on weight loss among overweight and obese Marshallese adults. The study was a two-arm cluster randomized controlled trial conducted in 30 churches in Arkansas and Oklahoma. Marshallese adults with a body mass index ≥25 kg/m2 were eligible for the study. The study sample included 380 participants. Participants received either a faith-based adaptation of the DPP or a family-focused adaptation of the DPP, each delivered over 24 weeks. The primary outcome was weight change from baseline. Secondary outcomes included changes in Hemoglobin A1c, blood pressure, dietary intake, family support for healthy behaviors, and physical activity. Outcomes were examined longitudinally using general linear mixed effects regression models, adjusting for baseline outcomes, sociodemographic covariates, and clustering of participants within churches. Reductions in weight were small for both groups. Overall, only 7.1% of all participants lost 5% or more of their baseline body weight. There were no significant differences in weight loss between the 2 arms at 6 months (P =.3599) or at 12 months (P =.3207). Significant differences in systolic and diastolic blood pressure were found between the 2 arms at 6 months (P =.0293; P =.0068, respectively). Significant within-arm changes were found for sugar-sweetened beverage consumption and family support for both arms at both follow-ups. Both interventions achieved a modest weight loss. While even modest weight loss can be clinically significant, future research is needed to identify chronic disease prevention interventions that can successfully reduce weight for this at-risk population.
- Subjects
MICRONESIA; OKLAHOMA; ARKANSAS; OBESITY complications; PREVENTION of obesity; DIABETES prevention; OBESITY &; psychology; IMMIGRANTS; GLYCOSYLATED hemoglobin; STATISTICAL power analysis; STATISTICS; EVALUATION of human services programs; BODY weight; BEVERAGES; FOOD consumption; FAMILY support; SYSTOLIC blood pressure; EFFECT sizes (Statistics); AGE distribution; REGRESSION analysis; PREVENTIVE health services; RANDOMIZED controlled trials; COMPARATIVE studies; PHYSICAL activity; DIASTOLIC blood pressure; PRE-tests &; post-tests; T-test (Statistics); SEX distribution; PACIFIC Islanders; WEIGHT loss; HEALTH behavior; RESEARCH funding; INTRACLASS correlation; DESCRIPTIVE statistics; REPEATED measures design; STATISTICAL sampling; BODY mass index; BLOOD pressure measurement; LOGISTIC regression analysis; SOCIODEMOGRAPHIC factors; DATA analysis; DATA analysis software; BIOMETRY; CHURCH buildings; LONGITUDINAL method; ADULTS
- Publication
Inquiry (00469580), 2023, p1
- ISSN
0046-9580
- Publication type
Article
- DOI
10.1177/00469580231152051