title: The WORD (Wholeness, Oneness, Righteousness, Deliverance): design of a randomized controlled trial testing the effectiveness of an evidence-based weight loss and maintenance intervention translated for a faith-based, rural, African American population using a community-based participatory approach.
abstract: BACKGROUND
  The positive effects of weight loss on obesity-related risk factors diminish unless weight loss is maintained. Yet little work has focused on the translation of evidence-based weight loss interventions with the aim of sustaining weight loss in underserved populations. Using a community-based participatory approach (CBPR) that engages the strong faith-based social infrastructure characteristic of rural African American communities is a promising way to sustain weight loss in African Americans, who bear a disproportionate burden of the obesity epidemic.
  
  
  OBJECTIVE
  Led by a collaborative community-academic partnership, The WORD aims to change dietary and physical activity behaviors to produce and maintain weight loss in rural, African American adults of faith.
  
  
  METHODS
  The WORD is a randomized controlled trial with 450 participants nested within 30 churches. All churches will receive a 16-session core weight loss intervention. Half of the churches will be randomized to receive an additional 12-session maintenance component.
  
  
  METHODS
  The WORD is a cultural adaptation of the Diabetes Prevention Program, whereby small groups will be led by trained church members. Participants will be assessed at baseline, 6, 12, and 18 months. A detailed cost-effectiveness and process evaluation will be included.
  
  
  CONCLUSIONS
  The WORD aims to sustain weight loss in rural African Americans. The utilization of a CBPR approach and the engagement of the faith-based social infrastructure of African American communities will maximize the intervention's sustainability. Unique aspects of this trial include the focus on weight loss maintenance and the use of a faith-based CBPR approach in translating evidence-based obesity interventions.
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA. Electronic address: khk@uams.edu.
authors.forename: Karen Hye-cheon Kim
authors.initials: KH
authors.lastname: Yeary
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Carol E
authors.initials: CE
authors.lastname: Cornell
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Prewitt
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bursac
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: J Mick
authors.initials: JM
authors.lastname: Tilford
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Jerome
authors.initials: J
authors.lastname: Turner
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Kenya
authors.initials: K
authors.lastname: Eddings
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: ShaRhonda
authors.initials: S
authors.lastname: Love
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Whittington
authors.affiliation: University of Arkansas for Medical Sciences, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205-7199, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Harris
mesh_terms: D001741:Black or African American; D015992:Body Mass Index; D055812:Community-Based Participatory Research; D003299:Cooperative Behavior; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D033181:Information Dissemination; D008297:Male; D009765:Obesity / Q000208:ethnology / Q000517:prevention & control; D050177:Overweight / Q000208:ethnology / Q000628:therapy*; D012067:Religion; D012107:Research Design; D012424:Rural Population; D012959:Socioeconomic Factors; D015431:Weight Loss
keywords: African American; Community-based participatory research; Faith-based; Obesity; Randomized clinical trial; Rural; Weight loss