Virginia Commonwealth University School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA.
Transl Behav Med. 2021 Jun 17;11(6):1235-1243. doi: 10.1093/tbm/ibaa140.
Black Americans and individuals from economically disadvantaged backgrounds are at disproportionate risk for obesity, yet are underrepresented in behavioral weight loss (BWL) trials and experience less benefit from traditional programs. The Wellness Engagement (WE) Project sought to translate evidence-based BWL within a CBPR framework to promote change across multiple domains of influence in an under-resourced, predominantly Black community. The purpose of this paper is to describe the efforts we undertook to translate data from our extensive formative phase into programming well suited to meet the needs of the Petersburg community. In addition, we present data from our pilot work on feasibility and acceptability. Formative data were collected using a variety of methods including a community-wide survey, asset mapping, house chats, focus groups, and key informant interviews. In collaboration with key stakeholders and community members, evidence-based approaches to weight loss were adapted to meet the needs of the community with respect to both content and delivery modality. Materials were adapted to focus on small, realistic changes appropriate for the specific context. Behavioral groups, experiential nutrition and exercise sessions, and walking groups leveraged existing assets and were open to all community members. Feasibility and acceptability ratings were promising. Furthermore, the WE Project appeared to contribute to a culture of wellness. CBPR might be a viable approach for engaging under-resourced Black communities in behavioral weight management; larger scale implementation and evaluation efforts are needed.
美国黑人和经济条件较差背景的个体面临不成比例的肥胖风险,但在行为减肥(BWL)试验中代表性不足,从传统计划中获益较少。健康参与(WE)项目旨在在 CBPR 框架内转化基于证据的 BWL,以促进资源匮乏、以黑人为主要群体的社区中多个影响领域的变革。本文的目的是描述我们为将丰富的形成性阶段数据转化为适合满足彼得堡社区需求的方案而进行的努力。此外,我们还展示了我们在可行性和可接受性方面的初步工作数据。使用各种方法收集了形成性数据,包括社区范围的调查、资产映射、家访、焦点小组和关键知情人访谈。与主要利益攸关方和社区成员合作,对减肥的循证方法进行了调整,以满足社区在内容和提供模式方面的需求。材料经过调整,重点关注适合特定背景的小而现实的变化。行为小组、体验式营养和运动课程以及步行小组利用现有资产,对所有社区成员开放。可行性和可接受性评分很有希望。此外,WE 项目似乎有助于营造健康文化。CBPR 可能是让资源匮乏的黑人社区参与行为性体重管理的可行方法;需要进行更大规模的实施和评估工作。