Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change .
Follow-up period and intervention characteristics impacted effectiveness for some outcomes .
Interventions comprising education ( e.g. , providing information about behaviors associated with health risks ) and skills training ( e.g. , teaching skills that equip participants to engage in less risky behavior ) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity .
Although on average smoking was reduced , it appeared changes in smoking were negatively associated with changes in other behaviors , suggesting it may not be optimal to target smoking simultaneously with other risk behaviors
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease , cancer , or Type 2 diabetes .
The Faith, Activity, and Nutrition program: a randomized controlled trial in African-American churches.
BACKGROUND Faith-based interventions hold promise for promoting health in ethnic minority population s. To date , however , few of these interventions have used a community-based participatory research ( CBPR ) approach , have targeted both physical activity and healthy eating , and have focused on structural changes in the church . PURPOSE To report the results of a group r and omized CBPR intervention targeting physical activity and healthy eating in African-American churches . DESIGN Group RCT . Data were collected from 2007 to 2011 . Statistical analyses were conducted in 2012 . SETTING / PARTICIPANTS Seventy-four African Method ist Episcopal ( AME ) churches in South Carolina and 1257 members within them participated in the study . INTERVENTION Churches were r and omized to an immediate ( intervention ) or delayed ( control ) 15-month intervention that targeted organizational and environmental changes consistent with the structural ecologic model . A CBPR approach guided intervention development . Intervention churches attended a full-day committee training and a full-day cook training . They also received a stipend and 15 months of mailings and technical assistance calls to support intervention implementation . MAIN OUTCOME MEASURES Primary outcomes were self-reported moderate- to vigorous-intensity physical activity ( MVPA ) , self-reported fruit and vegetable consumption , and measured blood pressure . Secondary outcomes were self-reported fat- and fiber-related behaviors . Measurements were taken at baseline and 15 months . Intent-to-treat repeated measures ANOVA tested group X time interactions , controlling for church clustering , wave , and size , and participant age , gender , and education . Post hoc ANCOVAs were conducted with measurement completers . RESULTS There was a significant effect favoring the intervention group in self-reported leisure-time MVPA ( d=0.18 , p=0.02 ) , but no effect for other outcomes . ANCOVA analyses showed an intervention effect for self-reported leisure-time MVPA ( d=0.17 , p=0.03 ) and self-reported fruit and vegetable consumption ( d=0.17 , p=0.03 ) . Trainings were evaluated very positively ( training evaluation item means of 4.2 - 4.8 on a 5-point scale ) . CONCLUSIONS This faith-based structural intervention using a CBPR framework showed small but significant increases in self-reported leisure-time MVPA . This program has potential for broad-based dissemination and reach . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT00379925
Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change .
Follow-up period and intervention characteristics impacted effectiveness for some outcomes .
Interventions comprising education ( e.g. , providing information about behaviors associated with health risks ) and skills training ( e.g. , teaching skills that equip participants to engage in less risky behavior ) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity .
Although on average smoking was reduced , it appeared changes in smoking were negatively associated with changes in other behaviors , suggesting it may not be optimal to target smoking simultaneously with other risk behaviors
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease , cancer , or Type 2 diabetes .