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Randomized Controlled Trial
. 2020 Mar;28(3):510-520.
doi: 10.1002/oby.22717. Epub 2020 Jan 27.

The WORD: Outcomes of a Behavioral Weight Loss Maintenance Effectiveness Trial in Rural Black Adults of Faith

Karen H Kim Yeary  1 , Carol E Cornell  2 , Page C Moore  3 , C Heath Gauss  2 , T Elaine Prewitt  2 , Jerome Turner  4
Affiliations
Randomized Controlled Trial

The WORD: Outcomes of a Behavioral Weight Loss Maintenance Effectiveness Trial in Rural Black Adults of Faith

Karen H Kim Yeary et al. Obesity (Silver Spring). 2020 Mar.

Abstract

Objective: Rural black communities bear a disproportionate burden of obesity. To increase reach among underserved groups, community-based weight loss and maintenance interventions are crucial.

Methods: The Diabetes Prevention Program (DPP) was adapted for rural black adults of faith to create The Wholeness, Oneness, Righteousness, Deliverance (WORD) trial, a group-based, community health worker-delivered weight loss intervention. A Weight Loss Only arm (16 sessions) was compared with a Weight Loss + Maintenance arm (16 + 12 sessions) in a cluster randomized controlled trial of 31 churches (n = 440). Weight and related behaviors were assessed at 0, 6, 12, and 18 months.

Results: The WORD produced weight loss from baseline to 6 months (percentage body weight change -2.47 [-3.13 to -1.80]). Among those who lost 5% of their baseline weight, there was a statistical trend of lower weight regain in the Weight Loss + Maintenance arm compared with control. Maintenance arm participants reported higher activity at 12 months. There were no between-arm differences at 18 months.

Conclusions: The WORD produced weight loss from baseline to 6 months on par with that produced by other DPP adaptations for black communities, including adaptations using health professionals. Weight regain was also consistent with that reported in prior literature. Continuing sessions as part of the church's mission may foster adoption of DPP-based weight loss programs.

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Conflict of interest statement

Conflict of Interest: The authors declared no conflict of interest.

Figures

Figure 1.
Figure 1.
The WORD CONSORT Figure
Figure 2.
Figure 2.
Mean body weight (kg) along with standard error bars at four time points (baseline, 6 months, 12 months, and 18 months) for both the Weight Loss Only and the Weight Loss + Maintenance arms (based on multiple imputation, except at baseline where there were no missing data for body weight). All participants received the same weight loss intervention during the first 6 months.
Figure 3.
Figure 3.
Mean body mass index (kg/m2) along with standard error bars at four time points (baseline, 6 months, 12 months, and 18 months) for both the Weight Loss Only and the Weight Loss + Maintenance arms (based on multiple imputation, except at baseline where there were no missing data for body mass index). All participants received the same weight loss intervention during the first 6 months.
See this image and copyright information in PMC

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