title: A randomized trial of a diet and exercise intervention for overweight and obese women from economically disadvantaged neighborhoods: Sisters Taking Action for Real Success (STARS).
abstract: BACKGROUND
  Lower socioeconomic status at both the individual and neighborhood level is associated with increased health risks. Weight loss can reduce this risk, but few high quality weight-loss studies target this population.
  
  
  OBJECTIVE
  STARS tests a culturally appropriate, group-based behavioral and social support intervention on body weight and waist circumference in women from financially disadvantaged neighborhoods.
  
  
  METHODS
  A stratified (by BMI) randomized trial. Randomization to group was generated by a random numbers table with allocation concealment by opaque envelopes.
  
  
  METHODS
  Participants 25-50 years who had a BMI ≥ 25 kg/m(2) and a waist circumference ≥ 88 cm were recruited from 18 census tracts in Columbia, SC with high rates of poverty between November 2008 and November 2010. All participants received a dietary and exercise counseling session. Intervention participants then receive 16 theoretically-based and tailored weekly group sessions followed by 8 weeks of telephone maintenance counseling. Control participants receive 16 weekly health education mailings. Measurements correspond to baseline, post-group intervention, and post-telephone counseling, and for intervention participants, after a 12-week no-contact period. Measurement staff was blinded to group assignment.
  
  
  RESULTS
  Participants (N=155; n=80 intervention, n=75 minimal intervention control) were primarily African American (86.5%) and averaged 38.9 years with a mean BMI of 40.1 kg/m(2) and waist circumference of 115.4 cm. Food insecurity was reported by 43% of participants.
  
  
  CONCLUSIONS
  STARS targets an underserved population with an innovative, tailored, and theoretically-grounded, group-based intervention followed by telephone maintenance. If effective, the approach has the potential to be feasible and cost-effective for community delivery.
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. swilcox@sc.edu
authors.forename: Sara
authors.initials: S
authors.lastname: Wilcox
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Sharpe
authors.forename: Deborah
authors.initials: D
authors.lastname: Parra-Medina
authors.forename: Michelle
authors.initials: M
authors.lastname: Granner
authors.forename: Brent
authors.initials: B
authors.lastname: Hutto
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003376:Counseling; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000534:rehabilitation*; D050177:Overweight / Q000453:epidemiology / Q000534:rehabilitation*; D011203:Poverty; D012307:Risk Factors; D012959:Socioeconomic Factors; D013022:South Carolina / Q000453:epidemiology; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*