Obesity Prevalence, Weight-Related Beliefs and Behaviors among Low-Income Ethnically Diverse National Job Corps Students

The obesity rates of Job Corps students, a predominantly ethnic minority and low income group of youth, are unknown. The purpose of this project was to examine obesity rates among these youth as well as their weight-related perceptions and behavior. First, medical charts (N=641) of all Job Corps students (ages 16-25) who were enrolled in the program in the past year were examined for height and weight. In the second phase of the study, 344 Job Corp students were recruited and information on weight perceptions, knowledge of obesity consequences, and weight loss behavior were examined. Almost half of the participants were overweight or obese. Overweight males were less likely to perceive themselves as being overweight than females. The majority of participants were aware of obesity-related health consequences but of those with past weight loss attempts, only 13% reported using both exercise and diet. High levels of overweight and obesity among Job Corps students are likely to impact employment and career goals. Evidence-based obesity interventions for Job Corps students are needed

Promoting Physical Activity in Low Income African Americans: Project LAPS

Low income African Americans are at increased risk for physical inactivity and related chronic illnesses. Thus, effective interventions are needed to address these health disparities. The current study examined the efficacy of a home-based physical activity intervention among a low income African American sample with high rates of chronic illnesses (obesity, hypertension, diabetes, high cholesterol). Participants (n=214) were randomly assigned to either the home-based physical activity intervention (self-help print materials, five monthly newsletters, two telephone counseling sessions) or an attention control condition, which promoted healthy diet. Results indicated that the intervention did not produce significantly greater increases in physical activity from baseline to six months than the control group. Lessons learned from the current study include the importance of using proactive retention strategies with low income African American participants and taking into consideration the cultural relevance of the intervention

Obesity Prevalence, Weight-Related Beliefs and Behaviors among Low-Income Ethnically Diverse National Job Corps Students

The obesity rates of Job Corps students, a predominantly ethnic minority and low income group of youth, are unknown. The purpose of this project was to examine obesity rates among these youth as well as their weight-related perceptions and behavior. First, medical charts (N=641) of all Job Corps students (ages 16-25) who were enrolled in the program in the past year were examined for height and weight. In the second phase of the study, 344 Job Corp students were recruited and information on weight perceptions, knowledge of obesity consequences, and weight loss behavior were examined. Almost half of the participants were overweight or obese. Overweight males were less likely to perceive themselves as being overweight than females. The majority of participants were aware of obesity-related health consequences but of those with past weight loss attempts, only 13% reported using both exercise and diet. High levels of overweight and obesity among Job Corps students are likely to impact employment and career goals. Evidence-based obesity interventions for Job Corps students are needed

Predictors of Gestational Weight Gain among White and Latina Women and Associations with Birth Weight

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8–6.5) and obese (OR = 4.5, CI = 2.3–9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8–8.8). GWG was positively associated with neonate birth size (p < 0.001). Interventions targeting prepregnancy overweight or obese women and those with excessive first-trimester GWG are needed

Design and methods for a randomized clinical trial treating comorbid obesity and major depressive disorder

<p>Abstract</p> <p>Background</p> <p>Obesity is often comorbid with depression and individuals with this comorbidity fare worse in behavioral weight loss treatment. Treating depression directly prior to behavioral weight loss treatment might bolster weight loss outcomes in this population, but this has not yet been tested in a randomized clinical trial.</p> <p>Methods and design</p> <p>This randomized clinical trial will examine whether behavior therapy for depression administered prior to standard weight loss treatment produces greater weight loss than standard weight loss treatment alone. Obese women with major depressive disorder (N = 174) will be recruited from primary care clinics and the community and randomly assigned to one of the two treatment conditions. Treatment will last 2 years, and will include a 6-month intensive treatment phase followed by an 18-month maintenance phase. Follow-up assessment will occur at 6-months and 1- and 2 years following randomization. The primary outcome is weight loss. The study was designed to provide 90% power for detecting a weight change difference between conditions of 3.1 kg (standard deviation of 5.5 kg) at 1-year assuming a 25% rate of loss to follow-up. Secondary outcomes include depression, physical activity, dietary intake, psychosocial variables and cardiovascular risk factors. Potential mediators (e.g., adherence, depression, physical activity and caloric intake) of the intervention effect on weight change will also be examined.</p> <p>Discussion</p> <p>Treating depression before administering intensive health behavior interventions could potentially boost the impact on both mental and physical health outcomes.</p> <p>Trial registration</p> <p>NCT00572520</p

Design and methods for a cluster randomized trial of the Sunless Study: A skin cancer prevention intervention promoting sunless tanning among beach visitors

<p>Abstract</p> <p>Background</p> <p>Skin cancer is the most prevalent yet most preventable cancer in the US. While protecting oneself from ultraviolet radiation (UVR) can largely reduce risk, rates of unprotected sun exposure remain high. Because the desire to be tan often outweighs health concerns among sunbathers, very few interventions have been successful at reducing sunbathing behavior. Sunless tanning (self-tanners and spray tans), a method of achieving the suntanned look without UVR exposure, might be an effective supplement to prevention interventions.</p> <p>Methods and Design</p> <p>This cluster randomized trial will examine whether a beach-based intervention that promotes sunless tanning as a substitute for sunbathing and includes sun damage imaging and sun safety recommendations is superior to a questionnaire only control group in reducing sunbathing frequency. Female beach visitors (N = 250) will be recruited from 2 public beaches in eastern Massachusetts. Beach site will be the unit of randomization. Follow-up assessment will occur at the end of the summer (1-month following intervention) and 1 year later. The primary outcome is average sunbathing time per week. The study was designed to provide 90% power for detecting a difference of .70 hours between conditions (standard deviation of 2.0) at 1-year with an intra-cluster correlation coefficient of 0.01 and assuming a 25% rate of loss to follow-up. Secondary outcomes include frequency of sunburns, use of sunless tanning products, and sun protection behavior.</p> <p>Discussion</p> <p>Interventions might be improved by promoting behavioral substitutes for sun exposure, such as sunless tanners, that create a tanned look without exposure to UVR.</p> <p>Trial registration</p> <p>NCT00403377</p

Prevalence of overweight and obesity within primary care clinics in a public hospital system

OBJECTIVE: The prevalence of obesity is especially high in low-income minority individuals, many of whom lack health insurance. The goal of the current study was to establish the prevalence of obesity in the primary care clinics at a public hospital that serves predominantly African-American indigent patients and to compare this prevalence to the national norm. RESEARCH METHODS: Information from 845 patients attending four outpatient clinics was obtained via retrospective chart reviews. Age, gender, race, weight, and height were obtained, and body mass index (BMI) was calculated. RESULTS: Eighty-four percent of patients were overweight or obese. The 20% prevalence of extreme obesity was especially high. The primary care clinics had more than twice the rate of obesity as the national norm, even when controlling for demographic characteristics. DISCUSSION: Socioeconomic status and/or cultural influences are likely factors in the higher rate of obesity in this population. Because of this markedly elevated prevalence of obesity, especially extreme obesity, the need for intervention is critical

Translating the diabetes prevention program into a hospital-based weight loss program

OBJECTIVE: Intensive lifestyle interventions have established efficacy, but translation to real-world settings has not been well demonstrated. Using the diffusion of innovations model, we describe the adoption of the Diabetes Prevention Program (DPP) Lifestyle Intervention into a hospital-based program and report feasibility, acceptability, and outcomes. DESIGN: Patients (N = 118; 72% female, mean age = 48.8, mean baseline body mass index = 43.3) were enrolled into 16 weeks of DPP. MAIN OUTCOME MEASURE: Weight loss (kg) was measured at baseline and after treatment. RESULTS: Mean weight loss after 16 weeks was 5.57 kg (SD = 4.6) or 4.6% of baseline weight, and 30% met the 7% weight loss goal. Outcomes are compared with those reported in the DPP trial. Most participants (90.4%) were satisfied with the service; however, only 56% were satisfied with their weight loss. CONCLUSION: The DPP was successfully translated into a real-world clinic with some protocol modifications. Weight loss was modest among heavier patients with more comorbidities than the original DPP sample. Diffusion of innovations theory provides a useful framework for adopting evidence-based programs in the clinical setting

Awareness of diabetes risk factors and prevention strategies among a sample of low-income Latinos with no known diagnosis of diabetes

PURPOSE: This study assessed awareness of type 2 diabetes risk and severity, perceived risk factors, knowledge of diabetes prevention strategies, and challenges of and opportunities for prevention among low-income Latinos in Lawrence, Massachusetts. METHODS: Qualitative research design. Latinos with no known diagnosis of diabetes participated in 4 focus groups, conducted in Spanish, which were recorded and transcribed for systematic analysis. RESULTS: The sample, (N = 41) was largely female (85%) with a wide age range (22-76 years), most (71%) had an educational level of high school or less, and less than half (46%) were employed. Participants had basic knowledge of diabetes, but gaps were apparent. Many perceived family history of diabetes, poor diet, emotional distress, and stress associated with the United States as risk factors for diabetes. There was little or no awareness of risk associated with Latino ethnicity, gestational diabetes, hypertension, lipid abnormalities, or obesity. Few cited physical activity or weight loss as diabetes prevention strategies. More than half the participants perceived themselves at low risk for diabetes. CONCLUSIONS: This Latino sample had limited knowledge of diabetes risk factors and lifestyle changes that can prevent or delay diabetes onset. Insights for intervening for diabetes prevention are offered