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ObesityNCT04082702

Better Me Within Trial to Improve Lifestyle Behaviors in African Americans

A study testing Faith-enhanced diabetes prevention program and Standard diabetes prevention program in people with Obesity and Pre-diabetes, run by Baylor Research Institute at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the diabetes prevention program (DPP) for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data. Read more about this study

Who is it for?
Ages 18 to 120 years, women only
Conditions the study is for
Obesity, Pre-diabetes
What is being tested?
Faith-enhanced diabetes prevention program and Standard diabetes prevention program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
221 participants
Where
1 siteUnited States
Study dates
22 Feb 2013to 31 May 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 120 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Identify as African-American
  • Female
  • 18 years of age or older
  • Parishioner at enrolled church
  • Overweight or obese
  • Willingness to participate in a 10-month study.

Who cannot join

  • Currently attending a weight loss program
  • Diagnosed with diabetes
  • Medical condition that interfered with physical activity or dietary changes
  • Plans to move in the next 10 months.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UNT Health Science Center

    Fort Worth, Texas, 76107

Other trials in United States

About this study

Official title: Reducing Obesity in African American Women Through Lifestyle Enhancement

This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the diabetes prevention program (DPP) for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 after collection of objective eligibility measures. A prospective, randomized, nested by church, design was used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up.

Read the detailed description

Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the diabetes prevention program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (Mean age =48.8 ±11.2; Mean BMI =36.7 ±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design was used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study provides essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease.

Being tested
Faith-enhanced diabetes prevention program, Standard diabetes prevention program
Keywords
CBPR, DPP, African-American, Women, Obesity, Pre-diabetes
Medical subject headings
Obesity, Glucose Intolerance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Faith-enhanced diabetes prevention programBehavioural

    The faith-enhanced curriculum was faith-based and developed using CBPR approaches. The Faith-DPP condition included delivery of the DPP. The group intervention was delivered by one to two trained peers from the church and consisted of 16 weekly group meetings followed by 6 bi-monthly or monthly maintenance sessions. The faith enhanced curriculum included five strategies: 1) a mini sermon (~15 min in length) delivered by a pastor (head pastors were required to deliver at least one per month), first lady, or church leader (pastor associate, deacon, elder, etc.), 2) a memory verse, 3) in class or take-home faith activity (application of faith principles), 4) promises to remember, and 5) scripture and prayer integrated into participant curriculum and facilitator materials. These five faith enhancements were developed by the CAB to enhance the DPP's weekly learning objectives, which resulted in faith components specifically linked to each week of DPP content.

  • Standard diabetes prevention programBehavioural

    The S-DPP condition was faith-placed, a secular program (the DPP) held at an faith-based organization. This condition received the same diabetes prevention program (DPP) as the Faith-DPP, but did not receive any faith enhancements or pastor involvement.

Study groups in NCT04082702
Study groupRoleWhat they receive
Faith-enhanced DPPExperimentalA total of six churches were randomized to this arm that included 119 participants and received 10-month DPP with faith components.
Receives: Behavioral: Faith-enhanced diabetes prevention program
Standard DPPActive comparatorA total of five churches were randomized to this arm that included 102 participants who received the standard DPP on the church settings.
Receives: Behavioral: Standard diabetes prevention program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Body weight

    Weight (lbs) was collected with a digital scale in light clothing with shoes removed. Weight was collected twice and the average was computed. Height was also measured using the same protocol to calculate the BMI (body-mass index).

    Measured: Baseline

  2. Body weight

    Weight (lbs) was collected with a digital scale in light clothing with shoes removed. Weight was collected twice and the average was computed. Height was also measured using the same protocol to calculate the BMI (body-mass index).

    Measured: 4-month

  3. Body weight

    Weight (lbs) was collected with a digital scale in light clothing with shoes removed. Weight was collected twice and the average was computed. Height was also measured using the same protocol to calculate the BMI (body-mass index).

    Measured: 10-month

  4. Waist circumference: Number of participants above the recommended level

    Waist circumference was taken at the top of the pelvis (e.g., above the uppermost lateral border of the right ilium) with a measuring tape twice and averaged.

    Measured: Baseline

  5. Waist circumference: Number of participants above the recommended level

    Waist circumference was taken at the top of the pelvis (e.g., above the uppermost lateral border of the right ilium) with a measuring tape twice and averaged.

    Measured: 4-month

  6. Waist circumference: Number of participants above the recommended level

    Waist circumference was taken at the top of the pelvis (e.g., above the uppermost lateral border of the right ilium) with a measuring tape twice and averaged.

    Measured: 10-month

Secondary outcomes (20)
  1. Fasting glucose

    Fasting glucose was measured with the Cholestech LDX system

    Measured: Baseline

  2. Fasting glucose

    Fasting glucose was measured with the Cholestech LDX system

    Measured: 4-month

  3. Glycated Hemoglobin A1c

    Glycated hemoglobin A1C was measured with Bayer A1c Now + Multi-Test A1c System.

    Measured: Baseline

  4. Glycated Hemoglobin A1c

    Glycated hemoglobin A1C was measured with Bayer A1c Now + Multi-Test A1c System.

    Measured: 4-month

  5. Low-density lipoprotein cholesterol (LDL)

    LDL was measured with a fasting blood sample obtained by finger stick with the Cholestech LDX system

    Measured: Baseline

  6. Low-density lipoprotein cholesterol (LDL)

    LDL was measured with a fasting blood sample obtained by finger stick with the Cholestech LDX system

    Measured: 4-month

  7. High-density lipoprotein cholesterol (HDL)

    HDL was measured with a fasting blood sample obtained by finger stick with the Cholestech LDX system.

    Measured: Baseline

  8. High-density lipoprotein cholesterol (HDL)

    HDL was measured with a fasting blood sample obtained by finger stick with the Cholestech LDX system.

    Measured: 4-month

  9. Blood pressure

    Blood pressure was collected with an automated blood pressure device following a seated 5 min rest in a quiet area. Two measurements were taken following Eighth Joint National Committee protocols and averaged.

    Measured: Baseline

  10. Blood pressure

    Blood pressure was collected with an automated blood pressure device following a seated 5 min rest in a quiet area. Two measurements were taken following Eighth Joint National Committee protocols and averaged.

    Measured: 4-month

  11. Blood pressure

    Blood pressure was collected with an automated blood pressure device following a seated 5 min rest in a quiet area. Two measurements were taken following Eighth Joint National Committee protocols and averaged.

    Measured: 10-month

  12. Dietary patterns: Total energy (Kcal), total fat (gram), total sodium (milligram) intake on a typical day

    Diet was measured with the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI) food frequency questionnaire. Data is scanned and analyzed by Northeastern University's Dietary Assessment Center. Total energy, fat, sodium, and other dietary components were estimated from the questionnaire.

    Desired total energy (Kcal) (range: 500 to 10,000) intake is defined as 2000 Kcal or less.

    Desired fat (gram) (range: 10 to 500) intake is defined as 77 gram or less. Desired sodium (milligram) (range: 100 to 20,000) intake is defined as 2300 milligram or less.

    Measured: Baseline

  13. Dietary patterns: Total energy (Kcal), total fat (gram), total sodium (milligram) intake on a typical day

    Diet was measured with the Lower Mississippi Delta Nutrition Intervention Research Initiative (Delta NIRI) food frequency questionnaire. Data is scanned and analyzed by Northeastern University's Dietary Assessment Center. Total energy, fat, sodium, and other dietary components were estimated from the questionnaire.

    Desired total energy (Kcal) (range: 500 to 10,000) intake is defined as 2000 Kcal or less.

    Desired fat (gram) (range: 10 to 500) intake is defined as 77 gram or less. Desired sodium (milligram) (range: 100 to 20,000) intake is defined as 2300 milligram or less.

    Measured: 4-month

  14. Physical activity: Total number of active minutes per week

    Physical activity was measured by self-report with the Past Week Modifiable Physical Activity Questionnaire. A total of all physical activity minutes was calculated from the questionnaire.

    Desired level of physical activity is defined as 150 minutes or more per week.

    Measured: Baseline

  15. Physical activity: Total number of active minutes per week

    Physical activity was measured by self-report with the Past Week Modifiable Physical Activity Questionnaire. A total of all physical activity minutes was calculated from the questionnaire.

    Desired level of physical activity is defined as 150 minutes or more per week.

    Measured: 4-month

  16. Physical activity

    Physical activity was measured by self-report with the Past Week Modifiable Physical Activity Questionnaire. A total of all physical activity minutes was calculated from the questionnaire.

    Desired level of physical activity is defined as 150 minutes or more per week.

    Measured: 10-month

  17. Estradiol (pg/mL)

    Saliva collected in 4 consecutive weeks and sent to a laboratory to assay

    Measured: Baseline

  18. Estradiol (pg/mL)

    Saliva collected in 4 consecutive weeks and sent to a laboratory to assay

    Measured: 4-month

  19. Cortisol (ng/mL)

    Fasting morning saliva sent to a laboratory to assay

    Measured: Baseline

  20. Cortisol (ng/mL)

    Fasting morning saliva sent to a laboratory to assay

    Measured: 4-month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Sep 2019
  2. Study start22 Feb 2013
  3. Primary completion1 May 2017
  4. Study completion31 May 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
This study uses a prospective, 2-group, randomized nested (by church) design with eleven congregations, comparing a healthy weight management program with a pastor/church leader component (Intervention) to a healthy weight management program without a pastor/church component (Control). Focus groups were conducted with a sample of 64 participants for understanding needs, perspectives and barriers to healthy weight management. A total of 221 overweight and obese female participants from about 11 churches (approximately 25-30 individuals per church) were recruited and participated in this study following the protocols. The DPP Curriculum includes an intervention phase (approximately weekly for 4 months) and maintenance phase (once or twice a month for 6 months). Faith components (handouts and mini-sermon) are only used by the treatment (intervention) group through both the intervention and maintenance phase.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
221 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04082702
Sponsor's protocol ID
P20MD006882-2
Other IDs
P20MD006882
Status last verified
Aug 2019
First submitted
29 Aug 2019
Last updated
11 Dec 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Contact site contact person

Publications

  • Kitzman H, Dodgen L, Mamun A, Slater JL, King G, Slater D, King A, Mandapati S, DeHaven M. Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial. Contemp Clin Trials. 2017 Nov;62:77-90. doi: 10.1016/j.cct.2017.08.003. Epub 2017 Aug 12.

    PubMed 28807739
  • Tan M, Mamun A, Kitzman H, Mandapati SR, Dodgen L. Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases. Prev Chronic Dis. 2017 Nov 22;14:E119. doi: 10.5888/pcd14.170143.

    PubMed 29166248
  • Kitzman H, Mamun A, Dodgen L, Slater D, King G, King A, Slater JL, DeHaven M. Better Me Within Randomized Trial: Faith-Based Diabetes Prevention Program for Weight Loss in African American Women. Am J Health Promot. 2021 Feb;35(2):202-213. doi: 10.1177/0890117120958545. Epub 2020 Sep 18.

    PubMed 32945175
  • Mamun A, Kitzman H, Dodgen L. Reducing metabolic syndrome through a community-based lifestyle intervention in African American women. Nutr Metab Cardiovasc Dis. 2020 Sep 24;30(10):1785-1794. doi: 10.1016/j.numecd.2020.06.005. Epub 2020 Jun 12.

    PubMed 32605881

Questions about this trial

What is this clinical trial studying?

A study testing Faith-enhanced diabetes prevention program and Standard diabetes prevention program in people with Obesity and Pre-diabetes, run by Baylor Research Institute at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Body weight (time frame: Baseline). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04082702, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2019.

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