Table 1.

CBPR studies on diet, nutrition, and weight management among African Americans.

Study	Sample	Design	Results	Limitations
Ammerman et al. (18)	≥1,300 members of 60 African American churches in 8 North Carolina counties	Cluster randomized controlled trial of a 12-month multilevel (individual, social, organizational, and community) nutrition intervention	Outcome evaluation results from this community-university partnership have not been published.
Campbell et al. (19)	2,519 adult members of 50 African American churches in 10 counties in North Carolina	20-month cluster randomized trial of a multilevel (individual, social, community) intervention. The main outcome was consumption of 7 fruit and vegetable items according to National Cancer Institute 5-a-Day criteria. CBPR principles were followed.	At the 2-year follow-up, members of the intervention group consumed 0.85 (SE= 0.12) servings per day more than the delayed intervention group (P<0.0001). The largest increases were seen among people 66 years or older, those with education beyond high school, and those who attended church frequently.	Use of self-reported outcome measures assessed using a brief food frequency questionnaire
Choudhry et al. (20)	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
Dodani & Fields (21)	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
Freedman et al. (22)	Predominantly low-income, urban, African American youth (n=65, average age 11 yrs), parents, guardians, and staff at four Boys and Girls Clubs in Nashville, TN.	Uncontrolled study of a multi-component environmental (farmers' market, Super Shopper voucher program, and Youth Leader Board) intervention designed to increase access to fresh fruits and vegetables	34 farmers' markets occurred, resulting in 1,101 sales transactions of 5,750 units of fruits and vegetables. Financial vouchers were used to purchase 63% of the produce. All of the youth Super Shoppers came to a market at least once and made more purchase transactions than adults (P<0.05).	Lack of a comparison group, uncertain generalizability
Goldfinger et al. (23)	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
Harmon et al. (24)	23 adult members of two African American churches in Columbia, SC; one intervention church (mean age of participants = 62 yrs, 60% female) and One comparison church (mean age 60 yrs,76.9% female)	Faith-based participatory study of a 12-week educational intervention designed to increase consumption of fruits and vegetables	At two months, a nonsignificant (P=0.07) increase in fruit and vegetable consumption was observed in the intervention group but this was not maintained at the conclusion of the study.	Small sample size, non-randomized design, use of self-reported outcome measures
Landry, et al. (25)	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. (26)	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 and the weight of 8 (11%) of the participants remained the same (P=0.0009).	Lack of a randomized controlled design, uncertain generalizability
Scarinci et al. (27)	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 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. (28)	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. (29)	35 African American women (ages 25-64 yrs) at churches in 3 rural counties of South Carolina	Pre-post test	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.	Non-randomized design, small sample size, uncertain generalizability
Ries et al. (30)	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 significantly more minutes of physical activity per week (138 minutes) than comparison participants (86 minutes, P<0.05). No difference was 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. (31)	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. Analysis of 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. (32)	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 % body fat (P<0.03) than the control groups. An increase in physical fitness (P<0.10) was also observed.	Limited number of male participants, uncertain generalizability
Kim et al. (33)	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). No significant difference was observed 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

BMI - body mass index, CBPR - community-based participatory research, lbs – pounds, SE – standard error, WIC – Women, Infants, and Children Program