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Trial of Family and Friend Support for Weight Loss in African American Adults
Shiriki K. Kumanyika, PhD, MPH;
Thomas A. Wadden, PhD;
Justine Shults, PhD;
Jennifer E. Fassbender, MS;
Stacey D. Brown, MSW;
Marjorie A. Bowman, MD, MPA;
Vivian Brake, MS, RD;
William West, BS;
Johnetta Frazier, MA;
Melicia C. Whitt-Glover, PhD;
Michael J. Kallan, MS;
Emily Desnouee, MS;
Xiaoying Wu, MD, MS
Arch Intern Med. 2009;169(19):1795-1804.
Background Family and friend participation may provide culturally salient social support for weight loss in African American adults.
Methods SHARE (Supporting Healthy Activity and eating Right Everyday) was a 2-year trial of a culturally specific weight loss program. African American women and men who enrolled alone (individual stratum, 63 index participants) or together with 1 or 2 family members or friends (family stratum, 130 index participants) were randomized, within strata, to high or low social support treatments; 90% were female.
Results At 6 months, the family index participants lost approximately 5 to 6 kg; the individual index participants lost approximately 3 to 4 kg. The mean weight change was not different in high vs low social support in either stratum and generally not when high or low support treatments were compared across strata. The overall intention-to-treat mean weight change at 24 months was –2.4 kg (95% confidence interval, –3.3 kg to –1.5 kg). The family index participant weight loss was greater among the participants whose partners attended more personally tailored counseling sessions at 6 months in the high-support group and at 6, 12, and 24 months in the low-support group (all P < .05). Also, in the 6-month intention-to-treat analysis, the percentage of weight loss of the family index participants was greater if partners lost at least 5% vs less than 5% of their baseline weight (respectively, –6.1% vs –2.9% [P = .004], high support; and –6.1% vs –3.1% [P = .01], low support).
Conclusions Being assigned to participate with family members, friends, or other group members had no effect on weight change. Enrolling with others was associated with greater weight loss only when partners participated more and lost more weight.
Trial Registration clinicaltrials.gov Identifier: NCT00146081
Author Affiliations: Center for Clinical Epidemiology and Biostatistics (Drs Kumanyika, Shults, Whitt-Glover, and Wu; Mss Fassbender, Brown, Brake, Frazier, and Desnouee; and Mssrs West and Kallan), Center for Weight and Eating Disorders, Department of Psychiatry (Dr Wadden), and Department of Family Medicine and Community Health (Dr Bowman), University of Pennsylvania School of Medicine, Philadelphia. Dr Whitt-Glover is now with the Gramercy Research Group, Winston-Salem, North Carolina.
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The Interdisciplinary Approach to Culturally Tailored Medical Care: "Social Networking" for Decreasing Risk: Comment on "The Effects of a Nurse Case Manager and and a Community Health Worker Team on Diabetic Control, Emergency Department Visits, and Hospitalizations Among Urban African Americans With Type 2 Diabetes Mellitus: A Randomized Controlled Trial " and "Trial of Family and Friend Support for Weight Loss in African American Adults"
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