title: Sequencing diet and exercise programs for African American women with diabetes.
abstract: This study was designed to compare the effects of 2 programs that present diet and exercise components in a different sequence.
  
  
  
  At an urban YMCA, African American women with type 2 diabetes, aged 30 to 65, were randomly assigned to either 10 weekly sessions about healthy eating followed by 6 weekly sessions about exercise or to the reverse sequence. Sessions consisted of small group discussions and physical activity or food tasting. Primary outcomes were attendance, percent of calories consumed from fat, fruit and vegetable intake, and minutes of exercise per week. Measures were taken at baseline, and 4 and 12 months after the program.
  
  
  
  The only group difference found at the 12-month follow-up was in diastolic blood pressure. Time effects for both groups combined included an increase in minutes of activity, an increase in vegetable intake, and a decrease in percent of calories consumed from fat.
  
  
  
  This study does not provide definitive evidence of which sequence may be best to bring about behavior change. The effects of sequencing difficult behavioral changes such as diet modification and establishing an exercise habit deserve further study.
authors.affiliation: The Center for Aging Research, Indi­ana University School of Medicine, Indianapolis (Dr Nothwehr)
authors.forename: F K
authors.initials: FK
authors.lastname: Nothwehr
authors.affiliation: The Department of Psy­chology, Purdue University, Indianapolis, Indiana (Dr Guare)
authors.forename: J
authors.initials: J
authors.lastname: Guare
authors.affiliation: The Diabetes Research and Training Center, Indi­ana University School of Medicine, Indianapolis (Dr Marrero)
authors.forename: D G
authors.initials: DG
authors.lastname: Marrero
authors.affiliation: The Department of Biostatistics, Indi­ana University School of Medicine, Indianapolis (Ms Hoen)
authors.forename: H
authors.initials: H
authors.lastname: Hoen
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D018592:Cross-Over Studies; D003920:Diabetes Mellitus / Q000534:rehabilitation*; D003927:Diet, Diabetic; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007196:Indiana; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome