Posted 11/05/2007

Study to help overweight/obese Columbia women
learn how to adopt healthier lifestyles

Columbians living in low-income neighborhoods are the focus of an ambitious study by the Prevention Research Center in the Arnold School of Public Health to help overweight/obese women learn to exercise more, lose weight and eat healthier.

Led by Research Professor Dr. Patricia Sharpe, the $2.7 million, five-year study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, which supports research on many of the most serious diseases affecting public health.

Although diet and exercise are the immediate focus, the project’s underlying agenda is combating the chronic health problems that accompany physical inactivity and poor nutrition, such as cardiovascular disease, diabetes, hypertension, and stroke.

The study will enroll a group of 180 women between the ages of 25 and 50, all from areas where 25 percent or more of residents live below the poverty line, said Sharpe.

This is a population segment that tends to have poorer diet and physical activity habits compared to the general population, in part because of restricted access to health-supportive resources in low-income neighborhoods, such as convenient sources of fruits and vegetables.

Columbia has a number of areas that qualify for the study. About two-thirds of the city’s neighborhoods are low income as defined by the U.S. Department of Housing and Urban Development.

Richard Semon, director of the city’s Office of Community Development, said his office is eager to assist Sharpe in identifying local leaders willing to serve on a community advisory committee.

Sharpe said that the advisory group has a critical role in the study, not only in helping recruit and support participants, but also insuring that the effort is sensitive to their living conditions and cultural background.

Sharpe said because Semon’s staff is familiar with the neighborhoods, she and her staff will rely on them to help with introductions to community leaders – “people who get things done.”

Additionally, the organizing is going to be low-key, relying largely on existing social networks and word of mouth rather than a media campaign for recruitment, she said.

Semon said there is a thriving network of some 90 neighborhood organizations across the city that ought to facilitate the organizing.

As for the details of the study, Sharpe will split the participants into two groups. Ninety women will be involved in a 16-week intervention to help them achieve a 10 percent weight loss at a rate of one to two pounds a week over the project period.

The ten percent loss is “a realistic and achievable goal,” said Sharpe.

At the beginning of the study, the women must have a waist measurement of 83 cm (32.6 inches) or more. Also they must be able to participate in moderate intensity exercise for 30 minutes, five times per week.

The group will participate in one counseling session and 16 weekly group sessions with attention directed to concerns such as food preparation, portion control and food choices. The other half will be a usual-care, minimal-contact control group with only one counseling session.

In planning for the intervention's development, the community advisory committee will assist in recruiting women into focus groups to discuss their experiences of both the barriers and supportive aspects in their lives related to a healthy diet and exercise.

The groups also will identify concerns and barriers women may have related to their social and community environment.

The women will be supported in finding the best ways they can to develop an individualized plan for physical activity and healthy eating that fits within the demands of their daily lives, said Sharpe.

After the initial 16 weeks, the participants will receive supportive telephone counseling for an additional 8 weeks. The women's physical, behavioral, and attitudinal status will be measured at four time points throughout the project period.

To enhance community acceptability of the research, the control group will be offered the intervention after all measures are completed.

Other Arnold School of Public health faculty and staff on the research team are Dr. Deborah Parra-Medina, Dr. Sonya Jones, Tom Hurley, and Brent Hutto.

The study is being paid for through an RO1 grant, a funding program that supports top quality scientists doing cutting edge research.