Tanglewood Trail Walking Program in Rural Kentucky 2017

Tanglewood Trail Walking Program to Increase Phytonutrient Intake and Physical Activity in a Rural Kentucky Town

The Tanglewood Trail Walking Program is a well-established community health initiative that encourages community members to walk approximately 1 mile to the Whitesburg Farmers Market each Saturday. The study aims to determine if walking to the market with a community health coach results in healthier options being selected at the market.

Study Overview

• Status: Completed
• Conditions: Dietary Habits
• Intervention / Treatment: Behavioral: walking group led by a community organizer

Detailed Description

In the summer of 2017, community members of Whitesburg, KY were recruited to join the Tanglewood Trail Walking Program to the Whitesburg farmers market. Each Saturday, participants reported whether or not they walked the 1-mile trail to the farmers market and they reported which fruits and vegetables they purchased. The Walking Program was held June - Sept 2017. Participants completed questionnaires about fruit and vegetable consumption and physical activity. Participants also provided physical and biological measurements.

Although originally designed to compare data among walkers and non-walkers, the protocol was changed due to participant feasibility. Data were analyzed by comparing "low engagers" - those who walked to the market fewer than three times during the program - or "high engagers" - those who walked three or more times during the program. Data were collected at baseline and 3 months.

The data for years 2019 and 2020 of the Tanglewood to Trail walking program are registered separately in ClinicalTrials.gov.

• Study Type: Interventional
• Enrollment (Actual): 123
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Kentucky
    • Lexington, Kentucky, United States, 40506
      • University of Kentucky

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• ability to walk 1 kilometer

Exclusion Criteria:

• pregnant
• institutionalized adults
• impaired consent ability
• prisoners

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Walking Group (Low Engagers); Subjects will participate in a walking group led by a community organizer as a means to get to a local farmer's market. Low engagers are defined as those participants who walked to the market two or fewer times during the program.	Behavioral: walking group led by a community organizer; Subjects will walk 1 kilometer from a pre-determined point to a local farmer's market.
Experimental: Walking Group (High Engagers); Subjects will participate in a walking group led by a community organizer as a means to get to a local farmer's market. High engagers are defined as those participants who walked to the market three or more times during the program.	Behavioral: walking group led by a community organizer; Subjects will walk 1 kilometer from a pre-determined point to a local farmer's market.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Carotenoid Levels Over Time	Subjects' carotenoid status will be measured using a carotenoid Raman Spectroscopy to determine if walking combined with a voucher for fruits and vegetables increases intake in fruits and vegetables as measured by carotenoid status.	Baseline and 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Understanding of Plant-based Phytonutrients	Participants will be asked a question demonstrating their understanding of the importance of ingesting plant-based nutrients. Possible answers are yes, no, or not sure. Data will be presented as the number of participants in each group that understood the importance of plant-based nutrients.	3 months
Belief in the Benefit of Plant-based Nutrients	Participants will be asked a question demonstrating their appreciation of plant-based nutrients. Possible answers are yes, no, or not sure. Data will be presented as the number of participants in each group that understood the importance of plant-based nutrients.	3 months
Belief in the Preventative Effects of Plant-Based Nutrients	Participants will be asked a question demonstrating their beliefs of plant-based nutrients. Possible answers are yes, no, or not sure. Data will be presented as the number of participants in each group that understood the importance of plant-based nutrients.	3 months
Knowledge of Which Foods Contain Phytonutrients	Participants will be asked a question about which foods contain phytonutrients. Possible answers are meat, dairy, plant foods, all foods, or don't know. Data will be presented as the number of participants in each group that correctly identified plant foods.	3 months
Knowledge of Environmental Pollutants	Participants will be asked to identify environmental pollutants from a list. Possible answers are polychlorinated biphenyls (PCBs), mercury, nitrites, all of those, none of those, or don't know. Data will be presented as the number of participants in each group that correctly identified all of those.	3 months
Change in A1c	Subjects' A1c will be measured to determine if walking combined with a voucher for fruits and vegetables changes participant A1c. Data were collected at baseline and 3 months and the difference will be calculated.	Baseline and 3 months
Change in LDL Cholesterol	Subjects' LDL will be measured to determine if walking combined with a voucher for fruits and vegetables changes participant LDL.	Baseline and 3 months
Change in HDL Cholesterol	Subjects' HDL will be measured to determine if walking combined with a voucher for fruits and vegetables changes participant HDL.	Baseline and 3 months
Change in Total Cholesterol	Subjects' total cholesterol will be measured to determine if walking combined with a voucher for fruits and vegetables changes participant total cholesterol.	Baseline and 3 months
Change in Weight	Subjects' weight will be measured to determine if walking combined with a voucher for fruits and vegetables changes participant weight.	Baseline and 3 months
Change in Waist Circumference	Subjects' waist circumference will be measured to determine if walking combined with a voucher for fruits and vegetables changes participant waist circumference.	Baseline and 3 months
Change in Self-reported Activity Level	Subjects' self-reported activity level will be measured as self-reported days of leisure physical activity per week.	Baseline and 3 months
Change in Self-reported Fruit and Vegetable Intake	Subjects' self-reported total servings of fruit and vegetable intake per day.	Baseline and 3 months
Group Cohesion	Subjects' group cohesion was measured post-intervention using the Physical Activity Group Environment Questionnaire" (also known as PAGE-Q). There are 20 questions, ranked using a Likert Scale with 1 being "strongly disagree" and 9 "strongly agree." Scores range from 20-180; higher scores indicate more social cohesion.	3 months
Belief in the Role of Healthy Diet in Protecting Health From Pollutants	Participants will be asked a question demonstrating their beliefs that a healthy diet might protect health from environmental pollutants. Possible answers are yes, no, or not sure. Data will be presented as the number of participants in each group that understood the importance of a healthy diet.	3 months

Collaborators and Investigators

• Sponsor: Dawn Brewer
• Collaborators: National Institute of Environmental Health Sciences (NIEHS)

Study record dates

Study Major Dates

• Study Start (Actual): May 30, 2017
• Primary Completion (Actual): September 24, 2020
• Study Completion (Actual): September 24, 2020

Study Registration Dates

• First Submitted: March 19, 2018
• First Submitted That Met QC Criteria: April 4, 2018
• First Posted (Actual): April 12, 2018

Study Record Updates

• Last Update Posted (Actual): November 17, 2021
• Last Update Submitted That Met QC Criteria: November 12, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Keywords: physical activity; Appalachia; farmers market; fruit and vegetable voucher program
• Other Study ID Numbers: 17-0283-P2H 2017; P42ES007380 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No current plan to share data.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No