title: Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial.
abstract: BACKGROUND
  Older adults have high obesity rates and respond well to evidence-based weight-loss programs, such as the Diabetes Prevention Program (DPP) Lifestyle intervention. The goal of this study was to determine whether a translation of the DPP Lifestyle program delivered by lay health educators and conducted in senior centers is effective in promoting weight loss among older adults.
  
  
  METHODS
  An RCT with older adults nested within senior centers. Senior centers identified lay health educators to receive training and deliver the intervention program at the senior center. Senior centers were randomized to DPP Lifestyle program or an attention control intervention (cognitive training).
  
  
  METHODS
  Senior centers (N=15) located throughout Arkansas. Participants (N=228) were obese (BMI=34.5±4.9) older (aged 71.2±6.6 years) adults able to engage in moderate exercise. Follow-up data were collected at 4 months on 93% of the original cohort between February 2009 and July 2010.
  
  
  METHODS
  A 12-session translation of the Diabetes Prevention Program Lifestyle behavioral weight-control program delivered in group sessions by trained lay health educators.
  
  
  METHODS
  Body weight was assessed by digital scale. Percentage weight loss from baseline and proportion achieving ≥5% and ≥7% weight loss were examined. Analyses were completed in March 2011.
  
  
  RESULTS
  Participants attending senior centers randomized to Lifestyle lost a significantly greater percentage of baseline weight (3.8%, 95% CI=2.9%, 4.6%) than those in the control senior centers (0.2%, 95% CI= -0.6%, -0.9%) after adjusting for baseline BMI and gender (p<0.001). Among participants attending senior centers offering the Lifestyle program, 38% lost ≥5% of baseline weight compared with 5% in the control arm (p<0.001). Similarly, significantly more participants (24%) in Lifestyle senior centers lost ≥7% than did control participants (3%, p=0.001).
  
  
  CONCLUSIONS
  A behavioral lifestyle weight-loss intervention delivered by a lay health educator offers a promising vehicle for translation of evidence-based obesity treatment programs in underserved areas.
  
  
  BACKGROUND
  This study is registered at Clinicaltrials.govNCT01377506.
authors.affiliation: Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA. westdelia@uams.edu
authors.forename: Delia Smith
authors.initials: DS
authors.lastname: West
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bursac
authors.forename: Carol E
authors.initials: CE
authors.lastname: Cornell
authors.forename: Holly C
authors.initials: HC
authors.lastname: Felix
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Fausett
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Krukowski
authors.forename: Shelly
authors.initials: S
authors.lastname: Lensing
authors.forename: Sharhonda J
authors.initials: SJ
authors.lastname: Love
authors.forename: T Elaine
authors.initials: TE
authors.lastname: Prewitt
authors.forename: Cornelia
authors.initials: C
authors.lastname: Beck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005260:Female; D040441:Health Educators; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000628:therapy*; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*