title: Impact of Improving Home Environments on Energy Intake and Physical Activity: A Randomized Controlled Trial.
abstract: OBJECTIVE
  We assessed the effectiveness of an intervention targeting home food and activity environments to reduce energy intake and increase physical activity among overweight and obese patients from 3 community health centers in rural Georgia.
  
  
  METHODS
  We conducted a randomized controlled trial (n = 349) from 2011 to 2013, with follow-up at 6 and 12 months. Health coaches delivered the 16-week intervention by using tailored home environment profiles showing areas in need of improvement and positive aspects of the home environment, behavioral contracts for healthy actions, and mailed support materials.
  
  
  RESULTS
  Participants were mostly African American women (84.8%), with a mean age of 50.2 years and a mean body mass index (weight in kilograms divided by the square of height in meters) of 38.3. Daily energy intake decreased more for the intervention than control group at 6 (-274 vs -69 kcal) and 12 months (-195 vs -76 kcal). We observed no change for either objective or self-reported physical activity. At 12 months, 82.6% of intervention participants had not gained weight compared with 71.4% of control participants.
  
  
  CONCLUSIONS
  The intervention was effective in changing home environments and reducing energy intake.
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Kegler
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: Regine
authors.initials: R
authors.lastname: Haardörfer
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: Iris C
authors.initials: IC
authors.lastname: Alcantara
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Gazmararian
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: J K
authors.initials: JK
authors.lastname: Veluswamy
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: Tarccara L
authors.initials: TL
authors.lastname: Hodge
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: Ann R
authors.initials: AR
authors.lastname: Addison
authors.affiliation: Michelle C. Kegler, Regine Haardörfer, and Iris C. Alcantara are with Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA. Julie A. Gazmararian is with Department of Epidemiology, Emory Prevention Research Center, Rollins School of Public Health, Emory University. J. K. Veluswamy and Tarccara L. Hodge are with Cancer Coalition of South Georgia, Albany. Ann R. Addison is with Primary Care of Southwest Georgia, Blakely. James A. Hotz is with Albany Area Primary Health Care Inc, Albany.
authors.forename: James A
authors.initials: JA
authors.lastname: Hotz
mesh_terms: D061725:Accelerometry; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D055812:Community-Based Participatory Research; D015930:Diet Records; D002149:Energy Intake / Q000502:physiology*; D004779:Environment Design; D005260:Female; D005523:Food Supply; D005845:Georgia; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control*; D012111:Residence Characteristics; D012423:Rural Health