Implementation of the Fit Body and Soul,a Church-Based Life Style Program for Diabetes Prevention in High-Risk African Americans

Abstract

Purpose

The purpose of this study was to determine the effects of a behavioral faith-based diabetes prevention program called the Fit Body and Soul program in a semi-urban African-American church using a community-based participatory approach.

Methods

The 12-session Fit Body and Soul program was modified from the group lifestyle balance intervention that was modified from the successful National Institute of Health (NIH) funded Diabetes Prevention Program. The Fit Body and Soul program was implemented in a semi-urban African-American church community. Based on the results of physical examinations and increased body mass index (BMI ≥ 25), 40 adult members of the church were identified as being at high risk for diabetes. Four church ministers, after receiving Fit Body and Soul program training for 2 days, served as study interventionists. The primary objective was weight loss of at least 5% by the end of the 12-session Fit Body and Soul intervention.

Results

Screening of church participants was conducted at the Gospel Water Branch Baptist Church in Augusta, Georgia. A total of 40 individuals having a BMI ≥ 25 were selected. Of the 40, a total of 35 (87.5%) attended at least 10 sessions and provided information required for the study. Of the 35, a total of 48% lost at least 5% of baseline weight, 26% lost 7% or more, and 14% lost >10% of baseline weight.

Conclusions

This pilot trial suggests that carrying out a larger Fit Body and Soul study in a faith-based setting, using behavioral lifestyle interventions, in the context of a diabetes prevention program for African American communities is feasible, as is the possibility that subjects in that larger study will achieve a clinically significant degree of weight loss.

Get full access to this article

View all access options for this article.

References

Centers for Disease Control and Prevention, Department of Health and Human Services.

Diabetes: disabling, deadly, and on the rise. http://www.cdc.gov/nccdphp/aag/pdf/aag_ddt2004.pdf . Accessed April 15, 2004.

Kurian AK

Cardarelli KM

Racial and ethnic differences in cardiovascular disease risk factors: a systematic review. Ethn Dis. 2007;17:143-152.

Department of Health and Human Services, Centers for Disease Control and Prevention.

National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2003 . http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf .

Lackland DT

Egan BM

Jones PJ

Impact of nativity and race on "Stroke Belt" mortality. Hypertension . 1999;34:57-62.

Centers for Disease Control and Prevention.

Deaths, percent of total deaths, and death rates for the 15 leading causes of death: United States and each State, 2002. http://www.cdc.gov/nchs/data/dvs/LCWK9_2002.pdf.

Diabetes Control and Complications Trial Research Group.

Lifetime benefits and costs of intensive therapy as practiced in the diabetes control and complications trial. JAMA. 1996;276:1409-1415.

The Diabetes Control and Complications Trial.

The absence of a glycemic threshold for the development of long-term complications: the perspective of the Diabetes Control and Complications Trial. Diabetes. 1996;45:1289-1298.

The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes. 1995;44:968-983.

Centers for Disease Control and Prevention.

Prevalence of diabetes and impaired fasting glucose in adults-United States, 1999-2000. MMWR Morb Mortal Wkly Rep . 2003;52:833-837.

10.

Narayan KM

Boyle JP

Thompson TJ

, et al. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003;290:1884-1890.

11.

Cooper R.

Cutler J.

Desvigine-Nickens P.

, et al. Trends and disparities in coronary artery disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular diseases prevention. Circulation . 2000;102:3137-3147.

12.

Walcott-McQuigg JA

Psychological factors influencing cardiovascular risk reduction behavior in low and middle income African-American women. J Natl Black Nurses Assoc. 2000;11:27-35.

13.

Sowers JR

Diabetes mellitus and cardiovascular disease in women. Arch Intern Med. 1998;158:617-621.

14.

Powell KE

Thompson PD

Caspersen CJ

, et al. Physical activity and the incidence of coronary heart disease . Annu Rev Public Health. 1987;8:253-287.

15.

Shai I.

Jiang R.

Manson JE

, et al. Ethnicity, obesity, and risk of type 2 diabetes in women: a 20-year follow-up study. Diabetes Care. 2006 ;29:1585-1590.

16.

Lackland DT

Moore MA

Hypertension-related mortality and morbidity in the southeast. South Med J. 1997;90:191-198.

17.

Centers for Disease Control and Prevention.

Behavioral risk factor surveillance system. http://www.cdc.gov/nccdphp/brfss/.

18.

Tuomilehto J.

Lindstrom J.

Eriksson JG

, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-1350.

19.

Pan XR

Li GW

Hu YH

, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20:537-544.

20.

Diabetes Prevention Program

Research Group.

The Diabetes Prevention program: reduction in the incidence of type 2 diabetes. N Engl J Med. 2002;346:393-403.

21.

Resnicow K.

Campbell MK

Carr C.

, et al. Body and soul. A dietary intervention conducted through African-American churches. Am J Prev Med . 2004;27:97-105.

22.

Campbell MK

Hudson MA

Resnicow K.

, et al. Church-based health promotion interventions: evidence and lessons learnt. Annu Rev Public Health. 2007;28:213-234.

23.

Thumma S.

Megachurches today 2000: summary of data from the Faith Communities Today 2000 project. http://hirr.hartsem.edu/org/faithmegachurchesFACTsummary.html.

24.

Boltri JM

Davis-Smith YM

Zayas LE

, et al. Developing a church-based diabetes prevention program with African Americans: focus group findings. Diabetes Educ. 2006;32:901-909.

25.

DeHaven MJ

Hunter IB

Wilder L.

, et al. Health programs in faith-based organizations: are they effective ? Am J Public Health. 2004;94:1030-1036.

26.

Campbell MK

Demark-Wahnefried W.

Symons M.

, et al. Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project. Am J Public Health. 1999;89:1390-1396.

27.

Yanek LR

Becker DM

Moy TF

, et al. Project Joy: faith-based cardiovascular health promotion for African-American women. Public Health Rep. 2001;116:68-81.

28.

Resnicow K.

Campbell MK

Carr C.

, et al. Body and soul. A dietary intervention conducted through African-American churches. Am J Prev Med. 2004;27:97-105.

29.

Dodani S.

Kramer K.

Williams L.

, et al. Fit body and soul: a church-based behavioral life style program for diabetes prevention in African Americans: translation into the religious community. Ethn Dis. 2009;19:135-141.

30.

Monami M.

Marchionni N.

Masotti G.

, et al. Prognostic value of International Diabetes Federation and Adult Treatment Panel III definitions of metabolic syndrome in type 2 diabetic patients: what makes the difference? J Endocrinol Invest. 2007;30: 626-630.

31.

Kriska AM

Caspersen CJ

Introduction to the collection of physical activity questionnaires in a collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc. 1997;29:S5-S9.

32.

Benjamin SM

Valdez R.

Geiss LS

, et al. Estimated number of adults with prediabetes in the US in 2000: opportunities for prevention. Diabetes Care. 2003;26:645-649.

33.

Campbell MK

Hudson MA

Resnicow K.

, et al. Church-based health promotion interventions: evidence and lessons learnt. Annu Rev Public Health. 2007;28:213-234.

34.

Samuel-Hodge CD

Headen SW

Skelly AH

, et al. Influences on day-to-day self-management of type 2 diabetes among African-American women: spirituality, the multicaregiver role, and other social context factors. Diabetes Care. 2000;23:928-933.

35.

Centers for Disease Control and Prevention.

Community health workers/promotores de salud: critical connections in communities . http://www.cdc.gov/diabetes/projects/pdfs/comm.pdf . Accessed January 23, 2006.

36.

Smedley BD

Stith AY

Nelson AR

Institute of Medicine. Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press; 2003.