The WORD: Outcomes of a Behavioral Weight Loss Maintenance Effectiveness Trial in Rural Black Adults of Faith

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2020 Jan 28

PMID 31984668

Citations 7

Authors

Karen H Kim Yeary

Carol E Cornell

Page C Moore

C Heath Gauss

T Elaine Prewitt

Jerome Turner

Affiliations

Soon will be listed here.

Abstract

Objective: Rural black communities bear a disproportionate burden of obesity. To increase reach among underserved groups, community-based weight loss and maintenance interventions are crucial.

Methods: The Diabetes Prevention Program (DPP) was adapted for rural black adults of faith to create The Wholeness, Oneness, Righteousness, Deliverance (WORD) trial, a group-based, community health worker-delivered weight loss intervention. A Weight Loss Only arm (16 sessions) was compared with a Weight Loss + Maintenance arm (16 + 12 sessions) in a cluster randomized controlled trial of 31 churches (n = 440). Weight and related behaviors were assessed at 0, 6, 12, and 18 months.

Results: The WORD produced weight loss from baseline to 6 months (percentage body weight change -2.47 [-3.13 to -1.80]). Among those who lost 5% of their baseline weight, there was a statistical trend of lower weight regain in the Weight Loss + Maintenance arm compared with control. Maintenance arm participants reported higher activity at 12 months. There were no between-arm differences at 18 months.

Conclusions: The WORD produced weight loss from baseline to 6 months on par with that produced by other DPP adaptations for black communities, including adaptations using health professionals. Weight regain was also consistent with that reported in prior literature. Continuing sessions as part of the church's mission may foster adoption of DPP-based weight loss programs.

Citing Articles

Cancer interventions with faith-based organizations: a scoping review.

Yeary K, Allen J, Arredondo E, Atemnkeng J, Buzcu-Guven B, Day K Cancer Causes Control. 2025; .

PMID: 40038170 DOI: 10.1007/s10552-025-01977-6.

Behavioral and Dietary Strategies for Weight Loss and Weight Loss Maintenance Among Black/African American Adults and the Potential Role of Media: A Narrative Review.

Keseko E, Bell A, Turner-McGrievy G Nutrients. 2025; 17(4).

PMID: 40004946 PMC: 11858451. DOI: 10.3390/nu17040617.

An Intermittent Fasting Intervention for Black Adults Can Be Feasibly Implemented in Black Churches: A Cluster Randomized Controlled Pilot Study.

Yeary K, Johnson D, Harris N, Yu H, Saad-Harfouche F, Dauphin C J Acad Nutr Diet. 2024; 125(2):172-187.e2.

PMID: 38986868 PMC: 11707046. DOI: 10.1016/j.jand.2024.07.003.

Black Feminism and Womanism: A Narrative Review of the Weight Loss Literature.

Blackman Carr L, Barlow J Ethn Dis. 2024; 33(4):170-179.

PMID: 38854411 PMC: 11155623. DOI: 10.18865/ed.33.4.170.

County Rurality and Incidence and Prevalence of Diagnosed Diabetes in the United States.

Dugani S, Lahr B, Xie H, Mielke M, Bailey K, Vella A Mayo Clin Proc. 2024; 99(7):1078-1090.

PMID: 38506780 PMC: 11222038. DOI: 10.1016/j.mayocp.2023.11.022.

References

Flegal K, Carroll M, Ogden C, Johnson C . Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002; 288(14):1723-7. DOI: 10.1001/jama.288.14.1723. View

Yeary K, Moore P, Gauss C, Cornell C, Prewitt T, Shakya S . Reach and Adoption of a Randomized Weight Loss Maintenance Trial in Rural African Americans of Faith: The WORD (Wholeness, Oneness, Righteousness, Deliverance). Am J Health Promot. 2018; 33(4):549-557. PMC: 7066866. DOI: 10.1177/0890117118805065. View

Franz M, Boucher J, Rutten-Ramos S, VanWormer J . Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet. 2015; 115(9):1447-63. DOI: 10.1016/j.jand.2015.02.031. View

Samuel-Hodge C, Johnson C, Braxton D, Lackey M . Effectiveness of Diabetes Prevention Program translations among African Americans. Obes Rev. 2014; 15 Suppl 4:107-24. DOI: 10.1111/obr.12211. View

Mann T, Tomiyama A, Westling E, Lew A, Samuels B, Chatman J . Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007; 62(3):220-33. DOI: 10.1037/0003-066X.62.3.220. View

Resnicow K, Jackson A, Wang T, De A, McCarty F, Dudley W . A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: results of the Eat for Life trial. Am J Public Health. 2001; 91(10):1686-93. PMC: 1446855. DOI: 10.2105/ajph.91.10.1686. View

Kumanyika S, Shults J, Fassbender J, Whitt M, Brake V, Kallan M . Outpatient weight management in African-Americans: the Healthy Eating and Lifestyle Program (HELP) study. Prev Med. 2005; 41(2):488-502. DOI: 10.1016/j.ypmed.2004.09.049. View

Tsai A, Wadden T, Rogers M, Day S, Moore R, Islam B . A primary care intervention for weight loss: results of a randomized controlled pilot study. Obesity (Silver Spring). 2009; 18(8):1614-8. DOI: 10.1038/oby.2009.457. View

Kumanyika S, Espeland M, Bahnson J, Bottom J, Charleston J, Folmar S . Ethnic comparison of weight loss in the Trial of Nonpharmacologic Interventions in the Elderly. Obes Res. 2002; 10(2):96-106. DOI: 10.1038/oby.2002.16. View

10.

Campbell M, Demark-Wahnefried W, Symons M, Kalsbeek W, Dodds J, Cowan A . Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project. Am J Public Health. 1999; 89(9):1390-6. PMC: 1508774. DOI: 10.2105/ajph.89.9.1390. View

11.

Boltri J, Monique Davis-Smith Y, Seale J, Shellenberger S, Okosun I, Cornelius M . Diabetes prevention in a faith-based setting: results of translational research. J Public Health Manag Pract. 2007; 14(1):29-32. DOI: 10.1097/01.PHH.0000303410.66485.91. View

12.

Shannon J, Kristal A, Curry S, Beresford S . Application of a behavioral approach to measuring dietary change: the fat- and fiber-related diet behavior questionnaire. Cancer Epidemiol Biomarkers Prev. 1997; 6(5):355-61. View

13.

Dodani S, Kramer M, Williams L, Crawford S, Kriska A . Fit body and soul: a church-based behavioral lifestyle program for diabetes prevention in African Americans. Ethn Dis. 2009; 19(2):135-41. View

14.

Gray A, Rivero-Arias O, Clarke P . Estimating the association between SF-12 responses and EQ-5D utility values by response mapping. Med Decis Making. 2006; 26(1):18-29. DOI: 10.1177/0272989X05284108. View

15.

Dodani S, Fields J . Implementation of the fit body and soul, a church-based life style program for diabetes prevention in high-risk African Americans: a feasibility study. Diabetes Educ. 2010; 36(3):465-72. DOI: 10.1177/0145721710366756. View

16.

Campbell M, Motsinger B, Ingram A, Jewell D, Makarushka C, Beatty B . The North Carolina Black Churches United for Better Health Project: intervention and process evaluation. Health Educ Behav. 2000; 27(2):241-53. DOI: 10.1177/109019810002700210. View

17.

Appel L, Champagne C, Harsha D, Cooper L, Obarzanek E, Elmer P . Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003; 289(16):2083-93. DOI: 10.1001/jama.289.16.2083. View

18.

Myers C, Slack T, Martin C, Broyles S, Heymsfield S . Regional disparities in obesity prevalence in the United States: A spatial regime analysis. Obesity (Silver Spring). 2014; 23(2):481-7. PMC: 4310761. DOI: 10.1002/oby.20963. View

19.

Rickel K, Milsom V, Ross K, Hoover V, Peterson N, Perri M . Differential response of African American and Caucasian women to extended-care programs for obesity management. Ethn Dis. 2011; 21(2):170-5. PMC: 3772655. View

20.

Yeary K, Cornell C, Turner J, Moore P, Bursac Z, Prewitt T . Feasibility of an evidence-based weight loss intervention for a faith-based, rural, African American population. Prev Chronic Dis. 2011; 8(6):A146. PMC: 3221585. View