title: Evaluation of a Behavioral Intervention With Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes.
abstract: To examine the effects of a community-based behavioral intervention with multiple components on health outcomes among low-income and uninsured adults who were obese and had diabetes and treated in a "real-world" setting.
  
  
  
  A longitudinal design with a retrospective comparison group was used to examine the ability of a health promotion program to improve body mass index (BMI) and hemoglobin A1c (HbA1c) among 87 treatment group and 62 comparison group participants.
  
  
  
  Urban/metropolitan city in the United States.
  
  
  
  A community-based behavioral intervention with 3 components including health-coach visits, registered dietitian visits, and exercise consultations delivered over 12 months.
  
  
  
  Biometric measurements were collected at baseline, 3, 6, 9, 12, and 18 months, whereas self-reported measurements were collected at baseline, 6 months, and 12 months.
  
  
  
  Linear mixed models with participant-level random intercepts were fitted for BMI and HbA1c.
  
  
  
  The treatment group demonstrated reductions in BMI (percentage change = -2.1%, P < .001) and HbA1c (-0.6%, P < .001) as well as improvement in diabetes knowledge (+5.4%, P = .025), whereas the comparison group did not show any improvements in biometric measures. Dietitian visits were the most effective treatment component to reduce HbA1c (coefficient = -0.08, P = .025).
  
  
  
  Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.
authors.affiliation: 1 Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN, USA.
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.affiliation: 2 Fogelman College of Business and Economics, The University of Memphis, Memphis, TN, USA.
authors.forename: Joonhyung
authors.initials: J
authors.lastname: Lee
authors.affiliation: 3 Integrated Health Programs, Church Health, Memphis, TN, USA.
authors.forename: Jenny
authors.initials: J
authors.lastname: Bartlett-Prescott
authors.affiliation: 4 Methodist Le Bonheur Healthcare Hospital, Memphis, TN, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Carson
authors.affiliation: 1 Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN, USA.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Post
authors.affiliation: 5 Division of Social and Behavioral Sciences, The University of Memphis School of Public Health, Memphis, TN, USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Ward
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000458:organization & administration*; D001794:Blood Pressure; D015992:Body Mass Index; D001837:Body Weights and Measures; D055812:Community-Based Participatory Research; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006304:Health Status; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D017057:Medically Uninsured; D008603:Mental Health; D008875:Middle Aged; D064686:Nutritionists / Q000458:organization & administration*; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids
keywords: behavioral intervention with multiple components; body mass index; exercise consultations; hbA1c; health promotion; health-coach visit; registered dietitian visit; twin epidemic of diabetes and obesity; vulnerable populations