Promoting weight-loss maintenance among Black women primary care patients: A cluster RCT of a culturally sensitive versus standard behavioural approach

Carolyn M Tucker, Stephen D Anton, Guillermo M Wippold, Michael Marsiske, Lori A Bilello, Meagan A Henry, Nipa R Shah, Shiva P Gautam, Kirsten G Klein, Anne Mathews, Fern Webb, Frederic Desmond, Carolyn M Tucker, Stephen D Anton, Guillermo M Wippold, Michael Marsiske, Lori A Bilello, Meagan A Henry, Nipa R Shah, Shiva P Gautam, Kirsten G Klein, Anne Mathews, Fern Webb, Frederic Desmond

Abstract

The prevalence of obesity is higher among Black women (56.6%) compared to Hispanic women (50%) and non-Hispanic White women (42%). Notably, interventions to reduce obesity typically result in initial weight loss that is not maintained. This study tested (a) the effectiveness of a 6-month Health-Smart Weight Loss (HSWL) Program for Black women patients with obesity implemented by community health workers (CHWs) within primary care clinics and (b) the comparative effectiveness of two 12-month physician-implemented weight loss maintenance programs-a Patient-Centred Culturally Sensitive Weight Loss Maintenance Program (PCCS-WLM Program) and a Standard Behavioural Weight Loss Maintenance Program (SB-WLM Program). Black women patients (N = 683) with obesity from 20 community primary care clinics participated in the HSWL Program and were then randomized to either maintenance program. The HSWL Program led to significant weight loss (i.e., 2.7 pounds, 1.22 kg, p < .01, -1.1%) among the participants. Participants in both the PCCS-WLM Program and the SB-WLM Program maintained their weight loss; however, at month 18, participants in the PCCS-WLM Program had a significantly lower weight than those in the SB-WLM (i.e., 231.9 vs. 239.4 pounds or 105.19 vs. 108.59 kg). This study suggests that (a) the HSWL Program can produce significant weight loss among Black women patients with obesity when implemented in primary care clinics by CHWs, and (b) primary care physicians can be trained to successfully promote weight loss maintenance among their Black women patients.

Keywords: African American; community health; cultural sensitivity; primary care; weight loss; women.

Conflict of interest statement

The authors declare no conflict of interest.

© 2022 The Authors. Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

Figures

FIGURE 1
FIGURE 1
CONSORT diagram.
FIGURE 2
FIGURE 2
Percent of participants achieving ≥5% weight loss by occasion.
FIGURE 3
FIGURE 3
Participant weight loss by occasion.

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Source: PubMed

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