There is increased interest in developing culturally-competent health interventions. Two studies that were recently conducted attempted to address diet and physical activity shortcomings that are prevalent in the African American Community. They both did well to incorporate important cultural considerations.
Lynch, Liebman, Ventrelle, Avery, and Richardon (2014) presented information about a self-management intervention targeted at African Americans with comorbid diabetes and hypertension. In this randomized controlled trial, the authors sought to investigate the effectiveness of a pilot version of a 6-month intensive community-based intervention. The focus of the intervention was on altering diet, physical activity, and increasing peer support to aid in weight loss. Overall, 61 participants were randomized into an intervention group or a control group. The intervention sessions took place over 18 meetings, and these were led by a dietician. Culturally-competent nutrition information was employed as were behavioral skills training techniques. Social support was encouraged and it focused on changing diet and activity levels. The main outcome goal for this study was weight loss. Overall, the control group and treatment groups did not differ in their weight loss at the end of the study. Another outcome of the study was hemoglobin A1c, and the authors of the study did find a significant change, where the A1c levels were lower in the intervention group compared to the controls. This study was largely unsuccessful in meeting its goals, but in my opinion, the program did reach the population that it was trying to serve. Namely, I appreciated that the dieticians were community-based and they tailored their delivery of relevant nutrition information to the needs of the African American community. Although the program was not successful in helping individuals achieve weight loss, it was helpful in producing change in the secondary outcome measure, A1c.
Tussing-Humphreys, Thomson, Mayo, and Edmond (2011) investigated the utility of a church-based diet and physical activity intervention for rural, lower Mississippi Delta African American adults due to the high prevalence of obesity, diabetes, and hypertension within this geographic area. They implemented a 6-month church-based diet and physical activity intervention with the goals of increasing activity and improving the quality of the diet. They utilized a quasi-experimental design and eight churches self-selected to participate in the intervention. The intervention was adapted from a project called the Body and Soul program (Resnicow et al., 2004). The intervention involved a “kickoff celebration” followed by monthly, hour-long informational sessions which emphasized consuming healthy foods like fruits, vegetables, whole grains, and low-fat dairy products. It was recommended that individuals decrease added sugars, sodium, and solid fats. Portion sizes were reviewed and healthy foods were served at these educational events. One session focused on physical activity, and this was promoted through a religious-based walking program. Pedometers were distributed to track daily steps. The study had a relatively high retention rate, with 176 of the initial 208 individuals continuing to take part in the intervention over the course of the study period. Diet quality improved in both the control and intervention group, and increases in physical activity were apparent only in the intervention group. The results of regressions demonstrated that participation level in the intervention and vehicle ownership were positively related to change in diet quality. Overall, this intervention appears to have been done in a very culturally-competent manner, and that can be seen not only in the quality of the outcomes, but in the high retention rate for this six-month program. By targeting the churches, there was likely a sense of community change that was addressed, and these researchers did a great job of finding ways to bring about positive change in an area of the country that struggles with obesity, hypertension, and diabetes.
- Lynch, E.B., Liebman, R., Ventrelle, J., Avery, E.F., & Richardson, D. (2014). A self-management intervention for African Americans with comorbid diabetes and hypertension: A pilot randomized controlled trial. Prevention of Chronic Disease, 11, 1-11.
- Resnicow, K., Campbell, M.K., Carr, C., McCarty, F., Wang, T., & Periasamy, S. (2004). Body and Soul: A dietary intervention conducted through African-American churches. American Journal of Preventative Medicine, 27(2), 97-105.
- Tussing-Humphreys, L., Thomson, J.L., Mayo, T., & Edmond, E. (2011). A church-based diet and physical activity intervention for rural, lower Mississippi Delta African American adults: Delta Body and Soul effectiveness study, 2010-2011. Prevention of Chronic Disease, 10, 1-12.