Abstract A27: Effects of the Healthy Eating and Active Living in the Spirit (HEALS) educational and behavioral intervention on inflammation among an African American faith community
Authors: Wirth Michael D. , Hebert James R. , Brandt Heather M. , Davis Lisa , Davis Briana , Harmon Brook E. , Hurley Thomas G. , Drayton Ruby , Adams Swann A. , Blair Steven N. 
Published: October 2015

The Healthy Eating and Active Living in the Spirit (HEALS) educational and behavioral intervention (2009-2012) was designed to test the effect of a diet, physical activity, and stress reduction intervention on inflammation levels in African Americans at high risk of chronic inflammation and disease in a faith-based community. African-American churches, located in and around Columbia, South Carolina were randomized into a 12-month intervention arm or delayed-intervention arm that served as the study's control group. The 12-week intervention included weekly sessions on cooking, healthy recipes, physical activity, stress reduction, and tracking weight and blood pressure. After the 12-week intervention, participants were invited to attend monthly booster sessions for an additional 9 months to reinforce and expand on topics introduced in the initial 12-week phase. Control churches had to delay the intervention until after churches randomized to the intervention first completed the 12-month follow-up. Participants attended clinics at baseline, 12 weeks (immediately post-intervention for the intervention group), and at 1-year. Prior to each clinic visit participants completed a questionnaire packet to assess demographic characteristics, dietary intake, physical activity, depression/stress, health history, sleep habits, social support, and social desirability and approval. During clinic visits, participants had their blood pressure, height, weight, and percent body fat (via bioelectrical impedance assessment) measured. Physical activity levels were objectively measured using Bodymedia's SenseWear® physical activity armband monitors. Blood samples were collected to characterize inflammatory biomarkers (i.e., high-sensitivity c-reactive protein [CRP] and interleukin-6 [IL-6]). Of the 627 potential participants from randomized churches, 434 attended clinic 1 (baseline, 233 intervention, 201 controls). Clinic 2 (12-weeks from baseline) was attended by 155 intervention and 155 control arm participants. A total of 113 intervention arm and 128 control arm participants attended Clinic 3 (12 months from baseline). The average age of the study population was 56.9±11.3 and the population was primarily female (80%) and obese (BMI=32.6±6.9kg/m2). Baseline lifestyle factors associated with inflammatory biomarkers included total active energy expenditure (quartile 4 compared to quartile 1: CRP = 2.0 vs. 3.6 mg/L, p=0.01) and minutes of moderate-to-vigorous physical activity minutes (quartile 4 compared to quartile 1: CRP=1.7 vs. 4.5 mg/L, p&lt;0.01; IL-6=1.5 vs. 2.1 pg/mL, p=0.01). Among male participants, the intervention group had significantly lower mean adjusted CRP values compared to controls (2.6 vs. 3.7mg/L, p=0.05) at the 12-week follow-up. However, this finding was not observed among female participants. At the 1-year follow-up no statistically significant differences for inflammatory markers between intervention and control arms were observed overall or separately in males and females. However, among male participants the difference in CRP between intervention and controls remained but was not statistically significant (2.6 vs. 3.9, p=0.17). A more beneficial effect from this diet, physical activity, and stress reduction behavioral and educational intervention was observed among African-American male participants than among African-American female participants. It is possible that a more intensive intervention is necessary to evince and sustain more noticeable changes in inflammation levels. Additionally, targeting those who are more motivated to make lifestyle changes may increase effectiveness of future lifestyle interventions.

Citation Format: Michael D. Wirth, James R. Hebert, Heather M. Brandt, Lisa Davis, Briana Davis, Brook E. Harmon, Thomas G. Hurley, Ruby Drayton, Swann A. Adams, Steven N. Blair. Effects of the Healthy Eating and Active Living in the Spirit (HEALS) educational and behavioral intervention on inflammation among an African American faith community. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A27.