Submitted to: Preventing Chronic Disease
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: January 7, 2013
Publication Date: June 6, 2013
Citation: Tussing-Humphreys, L.M., Thomson, J.L., Mayo, T.T., Edmond, E. 2013. A church-based diet and physical activity intervention for rural, lower Mississippi Delta African American adults: Delta Body and Soul effectiveness study, 2010-2011. Preventing Chronic Disease. 10:120286. Interpretive Summary: Poor diet quality and lack of physical activity (PA) are likely contributing to the high prevalence of such chronic diseases as obesity, diabetes, hypertension, and heart disease in the Lower Mississippi Delta (LMD) region of the US. There is a need for comprehensive, diet and PA interventions in this region of the country if we hope to reduce health disparities among its residents. A 6-month, church-based diet and PA intervention, designed to be culturally appropriate for a southern population, was conducted among African American residents in the LMD. The ability of this intervention, Delta Body and Soul, to improve diet quality and increase physical activity levels of study participants was determined. Results indicated that the intervention was successful at improving diet quality and increasing physical activity, particularly among those participants who attended the majority of the educational sessions and among those who owned a vehicle. Additionally, small but meaningful improvements were observed in weight and blood pressure. Further research is needed to explore relationships between individual behaviors and environmental characteristics that may make healthy eating and exercise such a formidable challenge for rural residents.
Technical Abstract: Obesity, diabetes, and hypertension have reached epidemic levels in the largely rural Lower Mississippi Delta (LMD) region. We assessed the effectiveness of a 6-month, church-based, diet and physical activity intervention, conducted during 2010 through 2011, for improving diet quality (measured by the Healthy Eating Index-2005) and increasing physical activity of African American (AA) adults in the LMD region. We used a quasi-experimental design in which 8 self-selected eligible churches were assigned to intervention or control. Assessments included dietary, physical activity, anthropometric, and clinical measures. Statistical tests for group comparisons included '2, Fisher’s exact, and McNemar’s tests for categorical variables, and mixed-model regression analysis for continuous variables and modeling intervention effects. Retention rates were 85% (176 of 208) for control and 84% (163 of 195) for intervention churches. Diet quality components, including total fruit, total vegetables, and total quality improved significantly in both control (mean [standard deviation], 0.3 [1.8], 0.2 [1.1], and 3.4 [9.6], respectively) and intervention (0.6 [1.7], 0.3 [1.2], and 3.2 [9.7], respectively) groups, while significant increases in aerobic (22%) and strength/flexibility (24%) physical activity indicators were apparent in the intervention group only. Regression analysis indicated that intervention participation level and vehicle ownership were significant positive predictors of change for several diet quality components. This church-based, diet and physical intervention may be effective in improving diet quality and increasing physical activity of LMD African American adults. Components key to the success of such programs are participant engagement in educational sessions and vehicle access.