Partnerships to Overcome Obesity Disparities in Hawaii: 18-month CBPR Study

Study Overview
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Brief Summary
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This is a 5-year community-based participatory research intervention study with the goals of 1) conducting a more definitive study of weight loss maintenance in Native Hawaiians and Pacific Peoples and 2) identifying the aspects of the community-academic partnership that fosters a co-learning and co-equal environment.

Detailed Description
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Obesity and overweight are well recognized public health concerns in the US and the magnitude of excess weight is greater among racial/ethnic minority populations. For NHs and PPs 70 to 80% of adults are estimated to be overweight or obese. Obesity-related disparities such as diabetes and heart disease (CVD) are also increasing among NHs and PPs. To address obesity and related disparities, a community-based participatory research (CBPR) partnership was formed entitled, the Partnership for Improving Lifestyle Interventions (PILI) 'Ohana Program (Pili meaning relationship and 'Ohana meaning family). The PILI 'Ohana Program (POP) consists of 5 community organizations and the Department of Native Hawaiian Health (DNHH) at the John A. Burns School of Medicine (JABSOM) of the University of Hawai'i (UH). With a 3-year CBPR planning grant from the National Center on Minority Health and Health Disparities (NCMHD), the POP was successful at establishing this community-academic partnership aimed at obesity-related disparities in Hawai'i and in implementing a pilot intervention to address weight loss maintenance (the PILI 'Ohana Intervention) in NHs and PPs, which serves as preliminary data for this application. The specific aims are as follow: 1) To identify the aspects of the PILI 'Ohana (family + community focused) Intervention deemed effective by former participants and community-peer educators of the pilot intervention. 2) To test whether a face-to-face or DVD delivery method of the PILI 'Ohana intervention is effective in improving weight loss maintenance versus a control group in NHs and PPs. 3) To identify the strengths of the PILI 'Ohana Program that supports a co-learning and co-equal environment.

Official Title
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Partnerships to Overcome Obesity Disparities in Hawaii

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: PILI 'Ohana 18-month weight loss maintenance


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Self-reported Native Hawaiian, Filipino, or other Pacific Islander ethnic background; Age 18 years or older Overweight or Obese defined as BMI > 25 kg/m2 (NH or Pacific Islanders) or > 23 kg/m2 (Filipino ethnic background) Willing and able to follow a weight loss maintenance intervention program that could include 150 minutes of brisk walking per week (or equivalent) and a dietary regimen designed to maintain weight loss Able to identify at least one family, friend, or co-worker who would be willing to support the participant during the course of the study Exclusion Criteria: Survival less than 6 months Planning to move out of the community during the intervention study period Pregnancy Any dietary or exercise restrictions that would prevent an individual from fully participating in the intervention protocol (i.e., end-stage renal disease on a renal diet, etc.) Any co-morbid condition (physical and mental disabilities) that would prevent the individual from participating in the intervention protocol (i.e., severe arthritis, hemi-paresis, major psychiatric illness, eating disorders, etc.).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: self-guided weight loss maintenance<br>15-month self-guided weight loss maintenance group will receive monthly reminders to maintain their weight loss and newsletters that contain health information. | |
| Experimental: DVD group<br>15-month weight loss maintenance intervention deliver via DVD. | Behavioral: PILI 'Ohana 18-month weight loss maintenance<br>* All participants will receive a 8 lesson 3-month weight loss intervention. They will then be randomized. Those continuing with the intervention will receive 17 more lessons delivered face-to-face or via DVD over 15 months for a total of 18 months. Each lesson lasts approximately 1 hour and helps participants integrate healthy eating and physical activity into their lifestyles. Participants will also be encouraged to attend 13 community activities during the last 13 months of the intervention.<br>* Other names: PILI 'Ohana Partnership;|
| Experimental: face-to-face group<br>15-month weight loss/weight loss maintenance intervention delivered in a group setting | Behavioral: PILI 'Ohana 18-month weight loss maintenance<br>* All participants will receive a 8 lesson 3-month weight loss intervention. They will then be randomized. Those continuing with the intervention will receive 17 more lessons delivered face-to-face or via DVD over 15 months for a total of 18 months. Each lesson lasts approximately 1 hour and helps participants integrate healthy eating and physical activity into their lifestyles. Participants will also be encouraged to attend 13 community activities during the last 13 months of the intervention.<br>* Other names: PILI 'Ohana Partnership;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight loss | Amount of Weight loss in kilograms from baseline to 18 month follow-up | 18-months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Systolic/diastolic blood pressure | Systolic/diastolic blood pressure (mmHg) as measured by an electronic blood pressure device | 18-months | 
| Self-reported dietary fat intake | Self-reported dietary fat intake using an 18-item Food Frequency Questionnaire | 18-months | 
| Self-reported physical activity | Self-reported physical activity frequency and intensity using a 3-item brief physical activity questionnaire | 18-months | 
| Physical functioning | Physical functioning as measured by distance walked in feet via a 6-minunte Walk Test | 18-month | 
| Self-reported health beliefs | Self-reported health beliefs associated with diet, physical activity, and weight using a standardized questionnaire | 18-month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Behavioral weight loss maintenance intervention, Weight loss, Weight loss maintenance