title: Randomized controlled trial targeting obesity-related behaviors: Better Together Healthy Caswell County.
abstract: BACKGROUND
  Collaborative and multilevel interventions to effectively address obesity-related behaviors among rural communities with health disparities can be challenging, and traditional research approaches may be unsuitable. The primary objective of our 15-week randomized controlled pilot study, which was guided by community-based participatory research (CBPR) principles, was to determine the effectiveness of providing twice-weekly access to group fitness classes, with and without weekly nutrition and physical activity education sessions, in Caswell County, North Carolina, a rural region devoid of medical and physical activity resources.
  
  
  METHODS
  Participants were randomly divided into 2 groups: group 1 was offered fitness sessions and education in healthful eating and physical activity; group 2 was offered fitness sessions only. Outcome measures were assessed at baseline and immediately after the intervention. Standardized assessment procedures, validated measures, and tests for analysis of variance were used.
  
  
  RESULTS
  Of 91 enrolled participants, most were African American (62%) or female (91%). Groups were not significantly different at baseline. Group 1 experienced significantly greater improvements in body mass index (F = 15.0, P < .001) and waist circumference (F = 7.0, P = .01), compared with group 2. Both groups significantly increased weekly minutes of moderate physical activity (F = 9.4, P < .003). Participants in group 1 also had significantly greater weight loss with higher attendance at the education (F = 14.7, P < .001) and fitness sessions (F = 18.5, P < .001).
  
  
  CONCLUSIONS
  This study offers effective programmatic strategies that can reduce weight and increase physical activity and demonstrates feasibility for a larger scale CBPR obesity trial targeting underserved residents affected by health disparities. This study also signifies successful collaboration among community and academic partners engaged in a CBPR coalition.
authors.affiliation: Virginia Tech, Human Nutrition, Foods, and Exercise, 1981 Kraft Dr, Blacksburg, VA 24061, USA. zoellner@vt.edu
authors.forename: Jamie
authors.initials: J
authors.lastname: Zoellner
authors.forename: Jennie L
authors.initials: JL
authors.lastname: Hill
authors.forename: Karissa
authors.initials: K
authors.lastname: Grier
authors.forename: Clarice
authors.initials: C
authors.lastname: Chau
authors.forename: Donna
authors.initials: D
authors.lastname: Kopec
authors.forename: Bryan
authors.initials: B
authors.lastname: Price
authors.forename: Carolyn
authors.initials: C
authors.lastname: Dunn
mesh_terms: D055812:Community-Based Participatory Research; D003376:Counseling; D004032:Diet; D015444:Exercise; D005260:Female; D006266:Health Education; D040361:Healthy People Programs; D006801:Humans; D008297:Male; D009657:North Carolina; D009765:Obesity / Q000628:therapy*; D010865:Pilot Projects; D012424:Rural Population