17 Jun Community-Wide Interventions Decreased Obesity in African Americans
MedicalResearch.com Interview with:
Dr. Youlian Liao MD
Division of Community Health
National Center for Chronic Disease Prevention and Health Promotion,
Centers for Disease Control and Prevention
MedicalResearch.com: What is the background for this study?
Response: There is an obesity epidemic in the nation. Obesity is more prevalent among Blacks than the general U.S. population, and the obesity trend is less favorable for Blacks. Although many successful short-term weight loss interventions among Blacks have been reported, data on the impact of large-scale community-wide interventions on the prevalence of obesity at the population level are lacking.
MedicalResearch.com: What are the main findings?
Response: As an effort to eliminate racial and ethnic disparities in health, the Racial and Ethnic Approaches to Community Health (REACH) U.S. project was conducted in 14 predominantly Black communities in 10 states. Cardiovascular disease or diabetes was the priority focus of the initiative in each community, and obesity reduction was one of the targeted interventions in all of these communities. In 2009, the prevalence of obesity was 12.3 percentage points higher among Blacks in REACH US communities than that among non-Hispanic Whites in the nation. We found a statistically significant reduction in age-standardized prevalence of obesity in the REACH U.S. communities from 2009 through 2012, and the disparity reduced to 10.5 percentage points by 2012. No significant change in obesity prevalence was found among non-Hispanic White and non-Hispanic Black populations nationally, or in the 10 states where these REACH US communities were located. In addition, we created a matched control sample of non-Hispanic Blacks from the Behavioral Risk Factor Surveillance System national sample using propensity score matching. The age-standardized prevalence of obesity significantly decreased in REACH U.S. communities, but not in the comparison populations. In the propensity score matching analysis, from 2009 to 2012, the relative change was -5.3% in REACH U.S. communities, compared to +1.4% in matched controls.
MedicalResearch.com: What should readers take away from your report?
Response: Our study demonstrates the success of a large-scale community-wide intervention in reducing the prevalence of obesity in disadvantaged Black communities. Through building strong community-based coalitions; focusing on policy, systems, and environmental improvements; and providing culturally tailored interventions, health disparities can be reduced and the health status of groups most affected by health inequities can be improved.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research is needed to examine the effectiveness of community-based participatory interventions, such as the REACH model, in reducing other health disparities in other disadvantaged communities. Also, because the communities used various intervention strategies in multiple settings simultaneously, it was difficult to assess the impact of any specific approach. The field would benefit from future research examining the relative effectiveness of the various intervention strategies in specific settings.
MedicalResearch.com: Is there anything else you would like to add?
Response: The REACH U.S. project was a large-scale, community participatory intervention conducted in “real-world” settings at the general population level. Our ability to shift a whole population’s distribution of risk for disease will be more far-reaching with the implementation of effective mass strategies, such as REACH U.S.
The following video shows African American communities in action.
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