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Title: A church-based pilot study designed to improve dietary quality for rural, Lower Mississippi Delta, African American Adults

Author
item Tussing Humphreys, Lisa
item Thomson, Jessica
item ONUFRAK, STEPHEN - Centers For Disease Control And Prevention (CDC) - United States

Submitted to: Journal of Religion and Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/4/2014
Publication Date: 4/1/2015
Citation: Tussing Humphreys, L.M., Thomson, J.L., Onufrak, S. 2015. A church-based pilot study designed to improve dietary quality for rural, Lower Mississippi Delta, African American Adults. Journal of Religion and Health. 54:455-469.

Interpretive Summary: The largely rural Lower Mississippi Delta (LMD) region of Mississippi suffers from epidemic levels of obesity and related chronic diseases such as diabetes, hypertension, and heart disease. Diet quality among LMD residents is significantly lower than the general United States population and may contribute to the high rate of chronic health conditions in this region. In African American (AA) communities, particularly in remote rural regions such as the LMD, churches are often the primary organizational unit and source of social support and leadership. Churches represent a potential venue for widespread health promotion as the majority of AA adults in this LMD attend church regularly. Therefore our goal was to assess the feasibility of implementing a six-month, church-based, dietary, pilot intervention, called Delta Body and Soul (DBS), for AA adults in the LMD region of Mississippi. Feasibility was based on ability to successfully implement the program, attendance at class sessions, and the number of participants remaining at the end of the program. We also determined if dietary quality, weight, cholesterol and blood sugar were impacted by participation in the program. To test Delta Body and Soul, five churches received the program and two churches did not receive the program; all participants completed surveys and clinical measurements at the start and end of the program. Participants completed a demographic and health survey, Delta food frequency questionnaire, and had weight, height, blood pressure, cholesterol and blood sugar measured. Following the first screening, the three intervention churches implemented a peer-led, six-month educational program emphasizing increased consumption of fruits, vegetables, whole grains, and low-fat dairy and decreased consumption of fat, sugar, and sodium. One-hundred and sixty AA adults were recruited and 126 completed the program. Participants were predominately female (83%) and overweight or obese (83%). A majority (91%) attended at least one educational session and 70% three or more sessions. High attendance at educational sessions (4 or more sessions) was associated with greater improvement in blood sugar and dietary quality. The results from this study suggest that implementing the DBS program is feasible and those that participate in the majority of educational sessions will have improvement in dietary quality and blood sugar.

Technical Abstract: To assess the feasibility of implementing a six-month, church-based, dietary, pilot intervention, called Delta Body and Soul (DBS), for African American (AA) adults in the Lower Mississippi Delta (LMD) region of Mississippi. Effectiveness of the intervention to improve diet quality [measured using the Healthy Eating Index-2005 (HEI-2005)] and several clinical parameters were also assessed. Methods: Five churches were assigned to intervention (n=3) or control (n=2) treatment. At baseline and six-month follow-up, participants completed a demographic and health survey, Delta food frequency questionnaire, and had anthropometric (weight and height) and physiologic (blood lipids and glucose) parameters measured. Following the baseline screening, intervention churches implemented a peer-led, six-month educational program emphasizing increased consumption of fruits, vegetables, whole grains, and low-fat dairy and decreased consumption of fat, sugar, and sodium. Results: One-hundred and sixty AA adults were recruited and 126 completed the baseline and follow-up screening (74% intervention vs. 90% control; P= .02). Participants were predominately female (83%) and overweight or obese (83%). A majority (91%) attended at least one educational session and 70% three or more sessions. High adherence (4 or more sessions) was associated with greater improvement in blood glucose (mean change:-11.2 mg/dL), HEI-2005 total score (mean change: +4.7 units) and several HEI-2005 sub-component scores. Conclusions: Results suggest that implementation of a large-scale efficacy trial of the DBS program in LMD churches is feasible and will result in significant dietary and clinical outcome improvements in AA adult residents of the LMD if they adhere to the intervention components.