Health is Power: An Ecological Theory-based Health Intervention for Women of Color

NCT ID: NCT02394171

Last Updated: 2015-03-20

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 410 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2005-05-31
• Study Completion Date: 2012-04-30

Brief Summary

Health Is Power (HIP) was a community based health intervention designed to increase physical activity among women of color. It was funded by a grant from the National Cancer Institute of the National Institutes of Health. The purposes of the study were (1) to determine whether a 6 month, group cohesion intervention is more effective for increasing physical activity compared to a 6 month, group cohesion comparison targeting improving dietary habits (2) to determine whether residence in a neighborhood supportive for physical activity helped women maintain their physical activity from 6 to , and (3) to determine whether this effect was transculturally replicable.

Detailed Description

Objective Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. Health Is Power (HIP) was a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity in African American and Hispanic or Latina women in Houston and Austin, Texas and then tested whether women living in more supportive areas maintained their physical activity over time. Intervention development was guided by group dynamics principles anchored within an ecologic model. Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods - integrated into strategies to promote group cohesion - framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. Neighborhood contextual and environmental measures were measured to test ecologic factors that may contribute to behavioral maintenance.

Conditions

Physical Activity

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Physical Activity

Women completed a physical activity group cohesion intervention which included six content intensive intervention sessions over a 24 week period that focused on specific group dynamics team building strategies to increase physical activity. A small team structure was used for peer problem solving and support throughout the intervention. Teams were given weekly physical activity goals, with slowly increasing weekly minutes milestones to gradually meet recommended amounts of physical activity. Sessions included brief instructions, team-based activities, and discussion with the entire group lead by a trained health educator. The intervention sessions ended with the health educator leading the teams in a brisk 15-minute walk.

Group Type: EXPERIMENTAL

Group Cohesion

Intervention Type: BEHAVIORAL

See description in arm/group above

Fruit and Vegetable

Women completed a fruit and vegetable group cohesion intervention which involved six content intensive intervention sessions over a 24 week period that focused on specific group dynamics team building strategies to increase fruit and vegetable consumption. A small team structure was used for peer problem solving and support throughout. Teams were given weekly fruit and vegetable consumption goals at each session, with slowly increasing weekly servings milestones to gradually meet recommended amounts of fruit and vegetable consumption. Sessions included brief instructions, team-based activities, and discussion with the entire group lead by a trained health educator. The intervention sessions ended with the health educator leading the teams in a fruit and vegetable taste test.

Group Type: ACTIVE_COMPARATOR

Group Cohesion

Intervention Type: BEHAVIORAL

See description in arm/group above

Interventions

Group Cohesion

See description in arm/group above

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• African American or Hispanic/ Latina
• Between the ages of 25 and 60 years old
• Able to read, speak, and write in English or Spanish
• Not pregnant or planning to become pregnant within the next 12 months
• Resident of Harris or Travis County, Texas
• Not planning on moving in the next 12 months
• Physically inactive or did not do more than 30 min of physical activity per day on 3 or more days per week
• No history of medical illness or currently taking medication (could have medical waiver from physician if did not meet this)
• Willing to be randomized to either a physical activity group or a vegetable and fruit group
• Available between 5:30 and 8:00 PM on meeting dates.

• Minimum Eligible Age: 26 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Arizona State University

OTHER

Sponsor Role: lead

Responsible Party

Rebecca Lee

Full Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

References

Smith-Ray RL, Mama S, Reese-Smith JY, Estabrooks PA, Lee RE. Improving participation rates for women of color in health research: the role of group cohesion. Prev Sci. 2012 Feb;13(1):27-35. doi: 10.1007/s11121-011-0241-6.

Reference Type: BACKGROUND

PMID: 21826476 (View on PubMed)

Soltero EG, Hernandez DC, O'Connor DP, Lee RE. Does social support mediate the relationship among neighborhood disadvantage, incivilities, crime and physical activity? Prev Med. 2015 Mar;72:44-9. doi: 10.1016/j.ypmed.2014.12.030. Epub 2015 Jan 3.

Reference Type: BACKGROUND

PMID: 25562756 (View on PubMed)

McAlexander KM, Mama SK, Medina A, O'Connor DP, Lee RE. The concordance of directly and indirectly measured built environment attributes and physical activity adoption. Int J Behav Nutr Phys Act. 2011 Jul 7;8:72. doi: 10.1186/1479-5868-8-72.

Reference Type: BACKGROUND

PMID: 21736740 (View on PubMed)

Lee RE, O'Connor DP, Smith-Ray R, Mama SK, Medina AV, Reese-Smith JY, Banda JA, Layne CS, Brosnan M, Cubbin C, McMillan T, Estabrooks PA. Mediating effects of group cohesion on physical activity and diet in women of color: health is power. Am J Health Promot. 2012 Mar-Apr;26(4):e116-25. doi: 10.4278/ajhp.101215-QUAN-400.

Reference Type: BACKGROUND

PMID: 22375580 (View on PubMed)

McAlexander KM, Mama SK, Medina AV, O'Connor DP, Lee RE. Concordance and correlates of direct and indirect built environment measurement among minority women. Am J Health Promot. 2012 Mar-Apr;26(4):239-44. doi: 10.4278/ajhp.100715-QUAN-241.

Reference Type: BACKGROUND

PMID: 22375575 (View on PubMed)

Ledoux T, Adamus-Leach H, O'Connor DP, Mama S, Lee RE. The association of binge eating and neighbourhood fast-food restaurant availability on diet and weight status. Public Health Nutr. 2015 Feb;18(2):352-60. doi: 10.1017/S1368980013003546. Epub 2014 Jan 24.

Reference Type: BACKGROUND

PMID: 24476972 (View on PubMed)

Lee RE, Mama SK, Medina AV, Reese-Smith JY, Banda JA, Layne CS, Baxter M, O'Connor DP, McNeill L, Estabrooks PA. Multiple measures of physical activity, dietary habits and weight status in African American and Hispanic or Latina women. J Community Health. 2011 Dec;36(6):1011-23. doi: 10.1007/s10900-011-9403-5.

Reference Type: BACKGROUND

PMID: 21519867 (View on PubMed)

Ledoux TA, Mama SK, O'Connor DP, Adamus H, Fraser ML, Lee RE. Home Availability and the Impact of Weekly Stressful Events Are Associated with Fruit and Vegetable Intake among African American and Hispanic/Latina Women. J Obes. 2012;2012:737891. doi: 10.1155/2012/737891. Epub 2012 May 14.

Reference Type: BACKGROUND

PMID: 22666558 (View on PubMed)

Adamus-Leach HJ, Wilson PL, O'Connor DP, Rhode PC, Mama SK, Lee RE. Depression, stress and body fat are associated with binge eating in a community sample of African American and Hispanic women. Eat Weight Disord. 2013 Jun;18(2):221-7. doi: 10.1007/s40519-013-0021-3. Epub 2013 Apr 9.

Reference Type: BACKGROUND

PMID: 23760851 (View on PubMed)

Wilson PL, O'Connor DP, Kaplan CD, Bode S, Mama SK, Lee RE. Relationship of fruit, vegetable, and fat consumption to binge eating symptoms in African American and Hispanic or Latina women. Eat Behav. 2012 Apr;13(2):179-82. doi: 10.1016/j.eatbeh.2012.01.007. Epub 2012 Jan 24.

Reference Type: BACKGROUND

PMID: 22365808 (View on PubMed)

Lee RE, Medina AV, Mama SK, Reese-Smith JY, O'Connor DP, Brosnan M, Cubbin C, McMillan T, Estabrooks PA. Health is Power: an ecological, theory-based health intervention for women of color. Contemp Clin Trials. 2011 Nov;32(6):916-23. doi: 10.1016/j.cct.2011.07.008. Epub 2011 Jul 18.

Reference Type: BACKGROUND

PMID: 21782975 (View on PubMed)

Lopez Y 3rd, O'Connor DP, Ledoux TA, Lee RE. Analysis of body composition methods in a community sample of African American women. Women Health. 2011 Nov 30;51(8):709-23. doi: 10.1080/03630242.2011.623222.

Reference Type: BACKGROUND

PMID: 22185287 (View on PubMed)

Lee RE, Mama SK, Medina AV, Ho A, Adamus HJ. Neighborhood factors influence physical activity among African American and Hispanic or Latina women. Health Place. 2012 Jan;18(1):63-70. doi: 10.1016/j.healthplace.2011.08.013.

Reference Type: BACKGROUND

PMID: 22243907 (View on PubMed)

Mama SK, Quill BE, Fernandez-Esquer ME, Reese-Smith JY, Banda JA, Lee RE. Body image and physical activity among Latina and African American women. Ethn Dis. 2011 Summer;21(3):281-7.

Reference Type: BACKGROUND

PMID: 21942159 (View on PubMed)

Mama SK, McNeill LH, McCurdy SA, Evans AE, Diamond PM, Adamus-Leach HJ, Lee RE. Psychosocial factors and theory in physical activity studies in minorities. Am J Health Behav. 2015 Jan;39(1):68-76. doi: 10.5993/AJHB.39.1.8.

Reference Type: BACKGROUND

PMID: 25290599 (View on PubMed)

Other Identifiers

RebeccaLee

Identifier Type: -

Identifier Source: org_study_id