Forty Black church members came to hear about the course, and of these, 32 enrolled in the pilot study. Of the 8 who did not enroll, 2 declined signing informed consent, and 6 did not find the time that was agreed upon by the majority of the group convenient. One person of the 32 enrolled was not overweight (BMI = 21.2 kg/m2), was in fact interested in gaining weight, and was excluded from data analysis. Five completed only the first one or two sessions and were excluded from analysis, but were not significantly different in weight, BMI, race, age, gender, income, or education from those who completed the pilot.
The remaining 26 participants attended an average of 6 (75%) of the 8 sessions. Their mean age was 68 years (). Most were female, moderately well-educated, retired, and lived in low-income households. Over one quarter received emergency food in the past year. Participants reported having a mean of 2 medical conditions, the most common being hypertension and arthritis. At baseline, mean weight was 194.3 pounds, and mean body mass index (BMI) was obese at 32.7 kg/m2 (range 24.3 to 43.7 kg/m2). Although 25 of the 26 (96.1%) were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥30kg/m2) one third self-reported as normal weight (BMI 18.5–24.9 kg/m2). Interestingly, when comparing what participants thought they weighed with their measured weights, group members weighed, on average, 10 pounds more than they thought (range −0.5 to 42 pounds). They did correctly estimate their heights.
shows that the 26 participants lost a mean of 4.4 pounds (p<.001) or 2.2% of their body weight at 10 weeks. Additional follow up data for 21 of the 26 participants (81%) at 22 weeks, 32 weeks and one year, reveal that group members continued to lose weight. At one year, the mean weight was 185 pounds and the mean BMI was 30.9 kg/m2 (p=0.001). Participants had lost a mean of nearly 10 pounds, or 5% of their initial body weight (range 1.5% to −17.7%).
Participants’ self-reported food intake changed from before to after the course (). At 10 weeks, participants had significantly decreased daily total fat intake from 87.7 to 80.1 grams (recommended daily fat intake is less than 65 grams based on a 2000 kcal diet), daily saturated fat from 23.4 to 20.6 grams (recommended <20 grams), and daily cholesterol intake from 261.9 to 237.0 mg (recommended <300 mg).38
At 1 year, changes were maintained, but not with statistical significance. Daily servings of fruit and vegetables also increased significantly at all time-points (from 3.7 to 4.4 servings per day from baseline to 1 year).
BASELINE AND POST-INTERVENTION DIETARY HABITS
shows other changes in self-reported knowledge and behaviors. The number of days per week that participants engaged in more than 30 minutes of moderate exercise did not increase significantly.50–51
Amount of sedentary time,52
defined as hours per day that participants spend watching television, videos, or DVDs, decreased by more than 1 hour per day at 10 weeks (p=0.034), and by nearly 3 hours at 1 year (p<.001). Knowledge about diet, exercise, and weight loss,46
using a composite three point scale, increased significantly from 2.6 to 2.8 (p=0.003) at 10 weeks, but these data were not collected subsequently. Weight loss locus of control,55
which revealed a greater internal than external locus of control at baseline, remained unchanged.
BASELINE AND POST-INTERVENTION BEHAVIORS AND KNOWLEDGE
Perceived health-related quality of life57–59
improved significantly. The number of participants who labeled their health very good or excellent doubled from the start to the end of the course (p=.046). This changed endured, but no longer retained statistical significance at one year. Twenty seven percent of participants screened positive for depressive symptoms56
at baseline, and this did not change significantly.