Table 1.

CBPR studies on physical activity among African Americans

Study	Sample	Design	Results	Limitations
Choudhry et al. (2011)	40 African American children (24 girls and 16 boys, 54% overweight or obese) ages 5–12 yrs on Chicago’s South Side	Pre-post test of a multicomponent intervention (environmental change, education on healthy eating and physical activity, and parent outreach) delivered during after-school care and at home	Post-intervention, BMI z scores decreased from 1.05 to 0.81 (P<0.001). Girls decreased their combined prevalence of overweight/obesity from 52% to 46%. The prevalence of overweight/obesity did not change among boys.	Small sample size, lack of a randomized controlled design, uncertain generalizability
Cowart et al. (2010)	22 adult church members at 6 Black churches in Syracuse, NY	Pre-post pilot test of a 12-week nutrition education/exercise-fitness program on weight loss and wellbeing delivered by lay health advocates	A comparison of assessment data with feedback from those attending 3 to 12 pilot program sessions suggested a pattern of beneficial changes in nutrition and exercise habits.	Small sample size, lack of a randomized controlled design, lack of a comparison group, potential confounding, uncertain generalizability. Only 11 of the 22 post-pilot surveys could be linked to the earlier assessments.
Dodani & Fields (2010)	40 adult members (mean age 46 yrs, 85.3% female, 19.5% overweight, 48.8% obese, and 31.7% morbidly obese) of a church in Evans County, GA	Pre-post test of a spiritually based lifestyle modification program (diet, nutrition, physical activity, weight control) for diabetes prevention	Of the 35 participants who attended at least 10 sessions and provided information required for the study, 48% lost at least 5% of their baseline weight, 26% lost 7% or more, and 14% lost over 10% of their baseline weight.	Small sample size, lack of a comparison group, uncertain generalizability
Goldfinger et al. (2008)	26 overweight and obese African American adult (mean age 68 yrs) members of a church in Harlem, NY	Pre-post test of a peer-led, community-based course on healthy eating and active living. The main outcome was change in weight	Participants lost a mean of 4.4 pounds at 10 weeks, 8.4 pounds at 22 weeks, and 9.8 pounds at 1 year	Small sample size, lack of a randomized controlled design, uncertain generalizability
Healey et al. (2013)	11 participants (8 women, 3 men; mean age 66.5 yrs) in Chicago’s South Side	Pre-post test of a physical activity training curriculum delivered by four physical activity promoters. The outcome measures were the 6-minute walk test, self - efficacy scores, and accelerometer measures for one week	There were no significant differences, except for a 91.6 meter increase in the 6-minute walk test distance.	Small sample size, lack of a randomized controlled design, potential confounding, uncertain generalizability
Kim et al. (2008)	73 participants (71% female, mean age 54.1 yrs, 100% African American) from rural churches in North Carolina	Quasi-experimental design with an intervention group and a delayed intervention control group	Small groups led by trained community members met weekly for 8 weeks and emphasized healthy nutrition, physical activity, and faith’s connection to health. The mean weight loss in the intervention group was 3.60 lbs., compared to 0.59 lbs. in the control group (P<0.001). The intervention was also associated with an increase in recreational physical activity (P<0.01). There was no significant difference in fruit and vegetable consumption.	Non-randomized design, small sample size, use of self-reported information about fruit and vegetable consumption and recreational physical activity, uncertain generalizability
Landry et al. (2015)	269 adults (94% African American, 85% female, mean age 44 yrs) in Hattiesburg, Mississippi	6-month, community-based, pre-post trial of an intervention consisting of motivational enhancement, social support, pedometer diary self-monitoring, and educational sessions. The outcome measures were steps per day, fitness, dietary intake, and psychosocial construct measures	For the dietary and physical activity outcome variables, temporal changes were observed only for sugar intake and steps per day. Sugar intake decreased by about 3 teaspoons and physical activity increased by about 2,010 steps per day	Lack of a randomized controlled design, uncertain generalizability, use of self-reported measures for dietary intake
Lasco et al. (1989)	70 obese African American residents (ages 18–59 yrs) of a neighborhood in Atlanta, GA	Pre-post evaluation of a multicomponent intervention (attitudes assessment, selection of a specific exercise class, and twice-weekly information on nutrition and community resources)	42 (60%) of the participants lost weight; the weight of 8 (11%) remained the same (P=0.0009).	Lack of a randomized controlled design, uncertain generalizability
Scarinci et al. (2014)	565 African American women ages 45–65 yrs in rural Alabama counties	Cluster randomized trial comparing two interventions: promotion of healthy eating and physical activity (“healthy lifestyle” arm) vs. promotion of breast and cervical cancer screening. CBPR principles were followed.	At the 12-month follow-up, participants in the “healthy lifestyle” arm showed significant positive changes (increased fruit/vegetable intake, decreased fried food consumption, increased physical activity). At 12 months, there was a 69% increase in the number of participants eating five or more servings of fruit and vegetables per day in the in the healthy lifestyle arm. At 24-months, these positive changes were maintained with healthy eating behaviors but not physical activity	Large differences in retention across intervention arms, use of self-reported outcome measures
Schulz et al. (2005)	Residents of Detroit’s East Side neighborhood	Case study description	Over a 2-year period, 18 community residents completed 2 eight-week project training sessions. After completion of the training, the community advocates implemented activities to prevent diabetes by promoting healthy diets and physical activity (walking club for seniors, community events focused on diabetes awareness for youth, older adults, residents of a shelter, and the community at large, healthy cooking demonstrations tailored to ensure cultural appropriateness).	Non-randomized design, lack of a comparison group, lack of a quantitative evaluation, uncertain generalizability
Parker et al. (2010)	35 African American women (ages 25–64 yrs) at churches in 3 rural counties of South Carolina	Pre-post test. Physical activity was assessed using the Yale Physical Activity Survey	Two different 10-week interventions (spiritually-based and nonspiritually-based) were pilot tested using a pre-post design. Both interventions led to significant reductions in BMI but the spiritually-based intervention (z = −1.97, P<0.01) led to greater reductions in BMI. For the spiritual group, statistically significant improvements were found in physical activity (z = −2.74, P<0.01)	Non-randomized design, small sample size, uncertain generalizability
Ries et al. (2014)	485 low-income, predominately minority women (63% African American) in rural North Carolina (mean age 47.5 yrs)	Quasi-experimental design. CBPR principles were followed to address obesity, poverty, and low levels of education	For both African Americans (P<0.05) and Whites (P<0.0001), intervention participants were more likely than comparison participants to move from contemplation to action/maintenance for the goal of increasing physical activity. For all participants, progression in stages of change mediated the intervention effect on physical activity, but not fruit and vegetable intake. Intervention group participants engaged in more minutes of physical activity per week (138 minutes) than comparison participants (86 minutes, P≤0.05). There was no difference observed between study groups in fruit and vegetable intake (P=0.33).	Use of self-reported information about diet and physical activity
Wilcox et al. (2013)	1,257 participants (mean ages 54.1 yrs, 99.4% African American, 27.1% overweight, 61.8% obese) who attended 74 African Methodist Episcopal churches in North Carolina	Cluster randomized controlled trial of a CBPR intervention (full-day committee training, full-day cook training, and 15 months of mailings and technical assistance calls) targeting healthy eating and physical activity	In intention-to-treat analyses conducted using analysis of variance, there was a significant intervention effect in self-reported leisure-time moderate-to-vigorous intensity physical activity (P=0.02) but no effect for dietary outcomes. Covariance analyses for participants who completed both pre- and post-measurements showed an intervention effect for moderate-to-vigorous intensity physical activity (P=0.03) and self-reported fruit and vegetable consumption (P=0.03).	High attrition, use of self-reported information about physical activity and diet
Woods et al. (2013)	106 adults (73% female, 90% African American, 80% some college or above) from five churches (3 intervention, 2 control) in Colorado	Cluster randomized trial of diet, nutrition, an physical activity intervention (small group educational sessions, demonstrations of healthy food preparation, physical activities) developed using CBPR principles	At 2-months follow-up, the intervention group showed greater decreases in weight (P<0.02), BMI (P<0.05), and percent body fat (P<0.03) than the control groups. There was also an increase in physical fitness (P<0.10).	Limited number of male participants, uncertain generalizability
Zoellner et al.(2007)	83 rural residents in Hollandale, Mississippi (99% African American, 97% women)	A quasi-experimental design was used to evaluate a 6-month intervention focused on promoting physical activity and health through walking teams led by coaches, self-monitoring, and monthly one-hour educational sessions	There were significant improvements in waist circumference (−1.4 inches), systolic blood pressure (−4.3 mmHg), and HDL-cholesterol (+7.9 mg/dL) (p<0.001). Self-reported walking per day was 44.8 (SD±52.2) minutes at enrollment and 65.9 (SD±89.7) minutes at 6-months (P=0.154).	Uncertain generalizability