title: Behavioral treatment for weight gain prevention among black women in primary care practice: a randomized clinical trial.
abstract: OBJECTIVE
  Few weight loss treatments produce clinically meaningful weight loss outcomes among black women, particularly in the primary care setting. New weight management strategies are necessary for this population. Weight gain prevention might be an effective treatment option, with particular benefits for overweight and class 1 obese black women.
  
  
  OBJECTIVE
  To compare changes in weight and cardiometabolic risk during a 12-month period among black women randomized to a primary care-based behavioral weight gain prevention intervention, relative to usual care.
  
  
  METHODS
  Two-arm randomized clinical trial (the Shape Program). We recruited patients from a 6-site community health center system. We randomized 194 overweight and class 1 obese (body mass index [calculated as weight in kilograms divided by height in meters squared], 25-34.9) premenopausal black women aged 25 to 44 years. Enrollment began on December 7, 2009; 12- and 18-month assessments were completed in February and October 2, 2012.
  
  
  METHODS
  The medium-intensity intervention included tailored behavior change goals, weekly self-monitoring via interactive voice response, monthly counseling calls, tailored skills training materials, and a gym membership.
  
  
  METHODS
  Twelve-month change in weight and body mass index and maintenance of change at 18 months.
  
  
  RESULTS
  Participants had a mean age of 35.4 years, a mean weight of 81.1 kg, and a mean body mass index of 30.2 at baseline. Most were socioeconomically disadvantaged (79.7% with educational level less than a college degree; 74.3% reporting annual income <$30,000). The 12-month weight change was larger among intervention participants (mean [SD], -1.0 [0.5] kg), relative to usual care (0.5 [0.5] kg; mean difference, -1.4 kg [95% CI, -2.8 to -0.1 kg]; P = .04). At month 12, 62% of intervention participants were at or below their baseline weights compared with 45% of usual-care participants (P = .03). By 18 months, intervention participants maintained significantly larger changes in weight (mean difference, -1.7 kg; 95% CI, -3.3 to -0.2 kg).
  
  
  CONCLUSIONS
  A medium-intensity primary care-based behavioral intervention demonstrated efficacy for weight gain prevention among socioeconomically disadvantaged black women. A "maintain, don't gain" approach might be a useful alternative treatment for reducing obesity-associated disease risk among some premenopausal black women.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00938535.
authors: Duke Obesity Prevention Program, Duke Global Health Institute, Duke University, Durham, North Carolina2Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
authors: Gary G
authors: GG
authors: Bennett
authors: Perry
authors: P
authors: Foley
authors: Erica
authors: E
authors: Levine
authors: Jessica
authors: J
authors: Whiteley
authors: Sandy
authors: S
authors: Askew
authors: Dori M
authors: DM
authors: Steinberg
authors: Bryan
authors: B
authors: Batch
authors: Mary L
authors: ML
authors: Greaney
authors: Heather
authors: H
authors: Miranda
authors: Thomas H
authors: TH
authors: Wroth
authors: Marni Gwyther
authors: MG
authors: Holder
authors: Karen M
authors: KM
authors: Emmons
authors: Elaine
authors: E
authors: Puleo
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D011320:Primary Health Care; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D015430:Weight Gain / Q000502:physiology*
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