Steps Ahead, Adapting Physical Activity Guidelines for the Lower Mississippi Delta Population
Condition: Obesity
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      The Lower Mississippi Delta (LMD) population is characterized by high levels of overweight
      and obesity, which are the result of long-term disruptions in energy imbalance where dietary
      energy intake has exceeded energy expenditure associated with physical activity. To address
      this issue, the overall goal of this project is to determine ways in which the U.S.
      Department of Health and Human Services and U.S. Department of Agriculture Dietary Guidelines
      for Americans (2005) physical activity recommendations can be effectively adapted for the LMD
      population. Phase I of this study was completed in early 2011.
    

Detailed description: 
      During Phase I, we determined the feasibility of adapting physical activity recommendations
      by incorporating pedometers (step-counters) as self-monitoring tools within the context of an
      education program. Lessons learned from the feasibility study have been incorporated into the
      design of the current proposed Phase II program. This study will be an appropriately powered,
      randomized controlled effectiveness trial of physical activity and adapted dietary guidelines
      (DG) eating patterns to reduce unhealthy weight gain. The Steps Ahead study will use the
      step-based physical activity recommendations identified in Phase I.

      Participants will be randomized and orientated into one of two groups. One group will be an
      adapted DG group who will receive education on the adapted DG guidelines. The second group
      will be an adapted DG plus physical activity group who will also receive the adapted DG
      guidelines education plus a physical activity intervention. The diet and physical activity
      recommendations have been developed to be used as low-intensity interventions in order to
      ensure maximal sustainability in the population. This intervention will be undertaken in East
      Baton Rouge parish, an area of the Delta region which contains communities and neighborhoods
      representative of the broader Delta region.
    

Intervention name(s): Adapted Dietary Guidelines; Adapted Physical Activity Guidelines
Intervention type(s): Behavioral; Behavioral
Intervention description(s): This group will receive dietary counseling to reduce their overall dietary food intake by 100 kcal/day, as prescribed by the dietary guidelines for the prevention of weight gain, and to follow an adapted eating pattern (to be determined from formative research in Phase I research).
The education sessions will be organized into two phases: an initial adoption phase and a subsequent adherence phase. During the adoption phase, participants will meet for one session per week for the first four weeks. During this session their interim weight will be recorded before they receive their session. During the adherence phase, participants will be contacted by telephone biweekly by a trained interventionist.; The physical activity education sessions will be organized into two phases: an initial adoption phase and a subsequent adherence phase. The adoption phase will be for 1 hour and 45 minutes for the first 4 weeks with classes occurring once per week in conjunction with the DG education classes. During the adoption phase, participants monitor their own walking using pedometers and attend weekly group meetings to review the previous week's walking behaviors, discuss preferred strategies for success, and set personally relevant and incremental steps/day goals. During the adherence phase (the remaining 8 weeks), participants will continue with their self-monitoring and goal-setting (using their pedometers), with reduced contact with the study interventionists over the telephone (biweekly).
Other intervention name(s): Pedometer
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: physical activity; dietary; adults; pedometer; education