Steps to soulful living (steps): a weight loss program for African-American women.
BACKGROUND
The disproportionate disease burden experienced by African-American women can be explained partially by the higher rates of obesity in this population. African-American women who can benefit from weight loss may be less likely to attempt it and may have relatively less success in using traditional weight loss programs compared to White women. Steps to Soulful Living (Steps) was a pilot study to test the effects of a culturally adapted weight loss program on weight loss in African-American women.


METHODS
Sixty-six African-American women participated in a 6-month weight loss program that included weekly group meetings and supervised exercise sessions. Mean baseline body mass index was 39 kg/m2, and mean baseline weight was 107 kg. Cultural adaptations, defined as program adjustments, made in response to women's preferences as expressed in focus group interviews included changes in intervention format, the content of the group meetings, and the location and format of the exercise sessions.


RESULTS
Seventy-six percent of the participants attended at least 50% of the 26 weekly sessions, and 56% attended at least 75% of the sessions. Average hours of exercise per week approximately doubled during the program in comparison to baseline levels. Mean weight loss at 26 weeks was 3.7 kg, categorizing those who were lost to follow-up as having zero weight loss. Participants who attended at least 75% of the group meetings lost a mean of 6.2 kg at six months. Those who attended fewer meetings lost a mean of 0.9 kg.


CONCLUSIONS
This 6-month program was associated with relatively larger weight losses, particularly among participants with high attendance, than have usually been observed in culturally adapted programs for African-American women.
Karanja
Njeri
N
Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098, USA. njeri.karanja@kpchr.org
Stevens
Victor J
VJ
Hollis
Jack F
JF
Kumanyika
Shiriki K
SK
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003469:Culture; D015930:Diet Records; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology* / Q000628:therapy*; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D014481:United States / Q000453:epidemiology; D015431:Weight Loss; D014932:Women's Health Services