A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults

Indiana University, Bloomington, IN 47405, USA.
Preventive Medicine (Impact Factor: 2.93). 02/2008; 47(6):573-82. DOI: 10.1016/j.ypmed.2007.12.010
Source: PubMed

ABSTRACT The present review examines efficacious psycho-behavioral interventions in preventing weight gains or reducing weight among US multiethnic and minority adults as few studies were conducted to review such interventions to date.
Data were examined from 24 controlled intervention studies, representing 23 programs and involving 13,326 adults. Studies were identified through manual and online search of databases that include MEDLINE, Academic Search Premier, ERIC, PsycARTICLES, SPORTDiscus, and CINAHL Plus.
Whereas one-component (n=5, d=0.08, 90% CI=-0.04, 0.35) and two-component interventions (n=13, d=0.22, 90% CI=0.05, 0.40) showed a low mean effect size, three-component interventions (n=6, d=0.52, 90% CI=0.39, 0.65) showed a moderate effect size. Interventions conducted in individual sessions (n=15, d=0.40, 90% CI=0.24, 0.56) showed a higher mean effect size than group interventions (n=9, d=0.08, 90% CI=-0.04, 0.30) although the confidence intervals overlapped.
The study results indicate that future obesity prevention interventions targeting multiethnic and minority adults might benefit from incorporating individual sessions, family involvement, and problem solving strategies into multi-component programs that focus on lifestyle changes.

  • [Show abstract] [Hide abstract]
    ABSTRACT: We aim to analyze the effects of an 8-month physical activity intervention on cardiorespiratory fitness, body mass index (BMI), and vigilance performance in an adult obese population. We conducted an 8-month physical activity intervention based on dance and rhythmic activities. The weekly frequency was 2 sessions of 1 hr per day. Training sessions were divided into 3 phases: a 10-min warm-up, 40 min of dance and rhythmic activities, and 10 min to cool-down. To assess cardiorespiratory fitness, participants performed a modified version of the 6-min walk test from the Senior Fitness Test battery (Larsson & Mattsson, 2001; Rikli & Jones, 1999). Vigilance performance was measured by means of the psychomotor vigilance task (PVT). Two measurements were performed immediately before and after the intervention. The results revealed that participants improved their cardiorespiratory fitness, BMI, and vigilance performance after the intervention. All in all, findings contribute new empirical evidence to the field that investigates the benefits of physical activity intervention on cognitive processes in obese population.
    Journal of Motor Behavior 03/2015; DOI:10.1080/00222895.2015.1012580 · 1.41 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Low-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is “promotora(s).” Objectives This study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas. Methods A community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35-64 years, predominantly with low income and < = 8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012. Results Women in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and participation in the individual teaching and counseling sessions and high retention rates support the feasibility and acceptability of the promotora-led lifestyle behavior intervention. Conclusions Our findings demonstrate that lifestyle behaviors and other risk factors of overweight Latina women may be improved through a promotora-led lifestyle behavior intervention. Feasibility of implementing this intervention in community settings and engaging promotoras as facilitators is supported. Trial Registration NCT01333241.
    International Journal of Nursing Studies 09/2014; 52(1). DOI:10.1016/j.ijnurstu.2014.09.005 · 2.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The marked prevalence of obesity among lesbian women is well-documented. In the general population, obesity is related to a myriad of negative health conditions associated with mortality, and it is reasonable to assume that obesity confers similar risk for lesbian women. Review of the scholarly literature revealed limited research on obesity interventions for lesbian women. Preliminary studies suggest that culturally tailored interventions that integrate lesbian women's experiences are needed. As a result, the following areas of literature were reviewed and integrated to generate 8 recommendations for researchers and clinicians who are interested in designing and testing interventions and/or adding cultural competence to existing practice to reduce obesity among lesbian women: the development of culturally tailored interventions; lesbian women's experiences, culture, behaviors, and beliefs; and existing culturally tailored interventions for lesbian women for obesity and other health-related problems. The integration of culturally tailored components into an obesity intervention for lesbian women is an essential first step toward the development and validation of comprehensive empirically supported treatments that will reduce health disparities and improve lesbian women's health and well-being. Obesity has increased dramatically over the past decade such that currently 35.7% of U.S. adults are obese (Ogden, Carroll, Kit, & Flegal, 2012). Of particular significance, obesity is more prev-alent among lesbian women compared with heterosexual women (Boehmer, Bowen, & Bauer, 2007; Conron, Mimiaga, & Landers, 2010). Using data from the National Survey of Family Growth, Boehmer et al. (2007) reported that lesbian women were almost 2.5 times more likely to be obese than heterosexual women after accounting for demographic variables and parity. These findings have compelling implications because obesity is associated with a variety of serious health conditions including hypertension, diabe-tes, cardiovascular disease, and cancer (Cecchini et al., 2010). By focusing efforts on reducing overweight and obesity among les-bian women, negative physical and mental health problems and, potentially, premature death may be reduced. Consequently, two major goals of the Healthy People 2020 initiative are to "promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights" ("Nutrition and Weight Status," 2012, para. 1) as well as to increase the health of lesbian, gay, bisexual, and transgender (LGBT) populations ("Lesbian, Gay, Bisexual, and Transgender Health," 2012). In response to these Healthy People 2020 initiatives, it is essen-tial to develop and validate culturally tailored interventions (i.e., interventions specifically targeted to a group in the context of group members' unique values, beliefs, and experiences) for les-bian women who desire to lose weight, engage in healthier lifestyle choices, or improve overall health. Cultural tailoring involves "understanding the importance of social and cultural influences on patients' health beliefs and behaviors; considering how these fac-tors interact at multiple levels of the health care delivery system (e.g., at the level of structural processes of care or clinical deci-sion-making); and, finally, devising interventions that take these issues into account to assure quality health care delivery to diverse patient populations" (Betancourt, Green, Carrillo, & Ananeh-Firempong, 2003, p. 297). Culturally tailored interventions to address mental and physical health problems have been effective for racial and ethnic minority groups (e.g., Agurs-Collins et al., 1997; Poston et al., 2003; Zhang et al., 2013) and for lesbian women (e.g., Matthews, Li, Kuhns, Tasker, & Cesario, 2013; Walls & Wisneski, 2010). To date, however, limited research has focused on developing and validating culturally tailored interven-tions to reduce overweight and obesity among lesbian women. Therefore, the purpose of this article was to review the broader literature to generate initial recommendations for culturally tai-lored intervention and practice aimed at reducing overweight and obesity and improving diet and exercise among lesbian women with the ultimate goal of achieving greater overall health. We chose to focus solely on lesbian women rather than sexual minority women (including bisexual women) because population-based studies demonstrate an increased risk for obesity for lesbian women, but not bisexual women (Boehmer et al., 2007; Conron et al., 2010). In spite of the serious health and mortality risk associated with obesity (Flegal, Graubard, Williamson, & Gail, 2005), culturally tailored interventions focused on reducing obesity in lesbian
    01/2014; 1(4):361-375. DOI:10.1037/sgd0000074


Available from
May 26, 2014