Table 2. Summary of studies with pre-post design.

Pre-Post test study design (n = 27)
First author (year)	Description of sample used in analysis	Mean age (years)	LS7 metric(s)	Intervention	Results
Baker (2016)*	397 AA women and men in southeast Missouri	41.7	Blood pressure; BMI	“Men on the Move: Growing Communities (MOTMGC) “program provided nutrition education and expanded access to healthy food choices through 6 community gardens. The intervention also included the DASH+sodium diet, and distribution of produce to local stores and restaurants.	Compared to the control county, participants from the intervention county had statistically significant decline in BMI, reported consuming more fruits and vegetables, and used less sodium and fat in cooking. In the intervention county, there was a 4 mmHg reduction in systolic blood pressure and 2 mmHg in diastolic blood pressure compared to baseline.
Brewer (2019)*	50 AA from 5 Minnesota churches, 70% female	49.6	All	Participants engaged in a 10-week program using the Fostering African-American Improvement in Total Health [FAITH!] digital application. The mobile app was used for educational modules on cardiovascular health, interactive self-monitoring of diet and exercise behaviors, and a social networking discussion board to interact and share progress with other users.	There were statistically significant reductions in systolic blood pressure (-6.2 mmHg, p = 0.002) and diastolic blood pressure (-5.7 mmHg, p<0.001). There was also an increase in the number of fruit/vegetable servings per day (+1.1 servings/day, p<0.001) as well as the minutes per week of moderate intensity physical activity (+40 mins/week, p = 0.04).
Brewer (2017)	37 adult congregants from 3 churches in Rochester, Minnesota, 70% women	51.7	All	16 week educational series implementing Life’s Simple 7 (LS7) framework, adapted from “FAITH” nutrition program for lifestyle modification to decrease CVD risk. Participants received educational manuals and healthy cookbooks, as well as eight 90-minute biweekly sessions which included prayers, personal reflection, lectures, cooking and exercise activities.	There were statistically significant improvements in cardiovascular health status with an increased percent of participants meeting ideal or intermediate LS7 scores from 70% at baseline to 82% at 3 months post-intervention. Higher scores correlated with higher psychosocial measures ratings which assessed socioeconomic status, life outlook, self-reported health, self-efficacy, and family support. Also, cardiovascular health knowledge scores increased from 48% at baseline to 57% post-intervention.
Brown (2017)*	28 adult AA women from churches in Boston, MA. Participants had to be sedentary with BMI greater than 25.	50.5	Physical activity; diet; blood pressure; weight	6 month intervention with Change Club civic engagement curriculum. Weekly meetings with months 1–3 focused on planning and goal setting and months 3–6 focused on implementing action plans related to chosen community improvement project. Monitoring of weight, physical activity, dietary intake, cardiovascular fitness (VO2 max on 1 mile walk test), and BP throughout the program.	Participants met action steps and goals for chosen community projects. Pre and post civic engagement intervention changes included statistically significant improvement in finish time by 1.89 min for 1 mile cardiorespiratory fitness test and decrease in systolic blood pressure by 12.73 mmHg (p<0.001). No statistically significant improvements in other measures: dietary outcomes, physical activity, weight, waist circumference, and body fat percentage.
Cené (2013)	104 AA adults from 3 rural counties in North Carolina; participants had high risk for diabetes or self-reported diabetes	57	Blood pressure; blood glucose; BMI	“Power to Prevent Diabetes” curriculum: 12 sessions led by community health ambassadors which spanned 7.5 months and focused on behavior changes for diabetes control as well as food and activity tracking.	Diabetes knowledge increased from 64% at baseline to 80% at 6 months. Self reported physical activity in past week also increased from baseline. There were no statistically significant changes in goals and expectations about diabetes prevention, blood pressure, random blood glucose, or BMI from baseline to 6 months.
Darity (2007)*	2544 AA adult smokers	Not provided	Smoking status	Active intervention: community organizing strategies, direct interpersonal educational activities, and mass media. Passive intervention: mass media only (control group). Cross sectional surveys collected at baseline as well as 6 months, 12 months, and 18 months post intervention.	At 18 months follow up, the point prevalence rate of non-smoking in the active intervention group was 16.7% and 11.8% in the passive group (p = 0.012). The period prevalence of attempting to quite at least once was 33.8% in the active intervention group and 26.2% in the passive intervention group.
DeMarco (2016)	AA from a rural North Carolina church community: 17 youth (38% female, 65% healthy weight) and 23 adults (55% female, 74% obese)	Youth: 14.4; Adults: 53.5	Diet; BMI; Blood pressure	12-month church garden nutrition program with 36 total weekly study workshops led by community research director focused on hands-on gardening, nutrition education, and healthy recipe taste-testing.	There was limited impact on nutrition knowledge and behaviors with only youth having statistically significant improvement in gardening and farming attitudes. No statistically significant improvements in FV consumption, BMI, or blood pressure in youth or adults. Higher attendance was positively correlated with a reduction in BP in adults and positive gardening attitudes in youth.
Dodani (2010)*	40 AA church members in Augusta, Georgia with BMI ≥ 25 at high-risk for diabetes. 85% female	46	Weight	The “Fit Body and Soul” group lifestyle intervention was modified from Diabetes Prevention Program and included 12 one-hour, spiritually-based sessions. The program was delivered by church health advisors and pastors.	87.5% of participants attended 10 out of 12 sessions, of whom 88% lost more than 5% of baseline bodyweight.
Dulin-Keita (2015)*	184 AA adults from a public housing community in Birmingham, Alabama, 48% women.	45	Physical activity	HOPE VI (Housing Opportunities for People Everywhere) intervention aimed at public housing neighborhood revitalization to promote leisure physical activity by increasing neighborhood green spaces, play areas, walkways, bikepaths, and improving safety.	There was 77% retention of participants from baseline to 6 months post-HOPE VI. Improved neighborhood walkability increased the odds of neighborhood-based physical activity (P = 0.04). Perceived intervention-related safety improvements increased odds of physical activity by 19% (P = 0.04).
Forthofer (2019)[35]	293 participants from medically underserved communities in Sumter County, South Carolina. 67% AA and 86% female	49.5	Physical activity	Sumter County on the Move! Is a 6-month walking intervention. participants formed their own Walking groups consisting of 4–8 members of their existing social networks. The program also included skill-building workshops and participants received a handbook with local community maps and trails for physical activity.	There was significant improvement in goal setting as well as social support for physical activity. At 6 months, there was a decrease in self-reported minutes per day of sitting (p = 0.02) and increase in self-reported moderate physical activity (p = 0.03). However, objective measures of physical activity did not show statistically significant improvements.
Gitlin (2008)*	519 AA elderly participants; 86% female, 59.4% had at least 3 chronic conditions	73	Physical activity	6-week program aimed at management of common symptoms and promotion of healthy behaviors. Peer facilitators taught techniques to improve symptom management through exercise, nutrition, and stress reduction.	There were small but statistically significant improvement in exercise (P = 0.001). Outcomes did not differ by the number of sessions attended or type of chronic conditions.
Goldfinger (2008)*	26 overweight and obese AA church members from Harlem, 81% female	68	BMI; Diet; physical activity	10-week, peer-led, nutrition and physical activity course with key messages of portion control, filling half the plate with fruits and vegetables at each meal, drinking calorie-free beverages, cutting fat, making daily life more active and eating healthy on a budget.	Participants lost an average of 4.4 pounds (P< 0.001) at 10 weeks and 10 pounds at one-year follow-up (P = 0.001). There were also significant reductions in daily fat and an increase in fruit and vegetable intake. Although engagement in exercise did not increase significantly, amount of sedentary time decreased by more than 1 hour per day at 10 weeks (P = 0.034) and by 3 hours at 1 year (P<0.001).
Kim (2008)*	73 rural AA from rural North Carolina, 71% women	54	Weight; Physical activity; Diet	8 week WORD (Wholeness, Oneness, Righteousness, Deliverance) weight loss program which met weekly for 2 hours. Session were led by trained community members and incorporated faith with health education.	The intervention group lost a mean of 3 pounds (P = 0.001) and had a 2.5 cm decrease in hip circumference (P = 0.04) as compared to the control group. Treatment participants reported greater recreational physical activity from baseline to follow-up (P = 0.01). Improvements in diet were not statistically significant.
Liao (2015)*	16 AA communities and 14 comparison communities. The final study samples were 7984 respondents for years 2001–2002, 11,536 for 2002–2003, 11,594 for 2003–2004, 11,772 for 2004–2005, and 10,584 for 2006.	__	Diet	During the 5 year REACH (Racial and Ethnic Approaches to Community Health), there were various health education and promotion programs and social marketing interventions. Community coalitions advocated for policy changes to encourage retailers to sell healthy foods in disadvantaged areas. Neighborhood farmers markets, produce stands and community gardens were set up to increase access to affordable produce including fruits and vegetables.	5-year decrease in fruit juice consumption ranged from −14.3% in REACH 2010 communities to −25.5% in the comparison white population (P<0.001). Daily fruit consumption increased a similar amount in all groups (P <0.01). Vegetable consumption increased in REACH communities (+7.9%; P <0.001), but not in whites (−1.0%; P = 0.059) and blacks (−2.6%; P = 0.136) in the comparison states. Combined fruit and vegetable consumption increased in REACH communities (+7.4%; P <0.001). Little change was observed in the comparison white (+0.6%; P = 0.247) and black population (+0.4%; P = 0.784).
Lynch (2018)*	206 AA church members, 90% female	57.5	Diet; BMI; blood pressure	9-month church-based Abundant Living in Vibrant Energy (ALIVE) intervention consisted of bible study, small group nutrition education sessions, and church-wide activities. Sessions were delivered by trained pastors and other church leaders.	There was an increase from baseline daily vegetable intake by one serving (p < 0.001) as well as weight reduction of 1 kg post-intervention (p < 0.001). There were also significant reductions in blood pressure: systolic blood pressure decreased by 3.91 mmHg (p = 0.002) and diastolic blood pressure decreased by 2.18 mmHg (p = 0.001).
Mitchell (2013)*	48 female participants who were overweight or obese; 98% AA	69.6	BMI	Take Off Pounds Sensibly (TOPS) is a low cost, nationally available, peer-led, nonprofit weight loss program. The 52-week intervention included a one-year membership in TOPS, booklet with a six-week lesson plan, and one-year subscription to TOPS News. They also received a TOPS Wellness Toolkit (a weight management lifestyle guide and workbook, food diary, nutrition guide, achievement log, journal, and resistance bands).	At 52 weeks, 33% of participants lost 5% or more of their initial weight and 48% of participants were clinically weight stable (0–4.9% weight loss) and thus did not experience weight gain.
Mitchell (2018)*[36]	40 rural AA from the Black Belt region of Alabama	__	BMI; physical activity; blood pressure	The Living in Victory Everyday (LIVE) program was a 3 month nutrition and physical activity intervention consisting of group sessions twice per week. Group exercises were tailored to participants’ abilities and new techniques were taught to be performed at home as well. The diet component included educational sessions as well as grocery store tours for shopping on a budget, and healthy food tasting.	There was no statistically significant decreases in BMI and blood pressure post-intervention. Some measures of physical activity improved such as leg balance (p = 0.02) and speed of the 30-second chair stand test (p = 0.02). However, these changes did not impact average weekday sit time.
Parker (2010)*	29 overweight/obese AA women from two rural South Carolinian churches.	51.14	Blood Pressure; BMI; physical activity	10 week weight-loss education program with spiritually-based or nonspiritually-based intervention groups. Both curricula included content on diet, activities, and discussions with health providers. Spiritually-based program also included biblical scriptures.	Nonspiritual group (n = 9) indicated statistically significant reductions in weight (p = 0.05) and systolic blood pressure (p = 0.05). Results for the spiritual group (n = 19) indicated statistically significant reductions in weight (p<0.01), systolic blood pressure (p = 0.05), as well as BMI (p = 0.01) and improvement in physical activity (p<0.01).
Pinsker (2017)*	310 church members from 20 churches. 77% female	__	Diet; physical activity	12-week Body and Soul program, which includes demonstrations of healthy recipes and peer counseling using motivational approaches after services in 20 churches.	The average weekly servings of fruit (p < .001), and vegetables (p < .001) increased from baseline. Level of physical activity on a scale of 1 to 6 in the previous 2 weeks also increased from baseline to follow-up (p = .01).
Plescia (2008)*	908 to 1028 respondents per year over the 5 year period; 95% AA	Not provided	Physical activity; Smoking status; Diet	A multifaceted approach including a community coalition formation lay health advisor (LHA) program and policy and community environment change strategies over a 5-year period. Four main objectives for improving the community environment and public policy included: increasing community resources to remove barriers to healthy behavior, improving quality of care, initiating campaigns to change social norms, and engaging in political advocacy	Improvements were statistically significant for physical activity (P = .02) and smoking (P = .03) among women and for physical activity among middle-aged adults (P = .01). Lower baseline physical activity rates improved to levels comparable to those of African Americans statewide (2001, P < .001; 2005, P = .38), and comparable fruit and vegetable consumption rates became significantly higher (2001, P = .68; 2005, P < .001).
Rodriguez (2012)*	34 AA women with high rates of hypertension (79%), obesity (79%), and elevated waist circumference (94%).	48	Blood pressure; BMI	12-week culturally-tailored weight management intervention focused on nutrition and physical activity where participants received free gym memberships, weekly group sessions lasting 2 hours, group discussions, weigh-ins, blood pressure screenings, free heart-healthy meals during each session, and a supermarket visit to model healthy and affordable food choices.	Reduction of 8 mmHg in systolic blood pressure (p < 0.01) and 1.3 kg/m2 in BMI (p < 0.001) from baseline to follow-up. Although the prevalence of obesity was unchanged, women lost an average of 8.2 pounds during the intervention period (p <0.001).
Salihu (2016)*	49 low-income women (95.9% AA) in Tampa, Florida	31	Diet; physical activity; BMI; blood pressure	8-week Fortified Diet Intervention (FDI) consisting dietary, physical activity, and mental health components. Weekly sessions lasted 2 hours and were facilitated by community members and professionals. The control consisted of individualized information, including meal plans, healthy recipes, simple food substitutions, healthy snack and eating out options, and guidelines for healthy food preparations.	Both the physical fitness subscores (p = 0.002) and nutritional subscores (p = 0.001) increased in the FDI group. These subscores consisted of participant responses to a behavior rating instrument. Postintervention, there were no significant improvements in blood pressure or BMI. No significant improvements were noted in the control group for physical fitness or nutrition sub scores, blood pressure, and BMI.
Two Feathers (2005)*	151 AA and Latino adults with diabetes from 3 health care systems in Detroit, Michigan. 64% AA among whom 78% were women.	59	Blood glucose; Diet	The Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership diabetes lifestyle intervention aimed at improving diabetes self-care by promoting healthy eating, physical activity, and stress reduction. The curriculum was delivered through 5 group meetings every 4 weeks and was taught by trained community members in both English and Spanish.	Participants from the REACH intervention group had improved A1C values compared to baseline (P< 0.0001). There were also statistically significant improvement in diet including increased consumption of vegetables (P = 0.001), whole grains (P = 0.004), and reduced consumption of soda and sugary beverages (P<0.0001).
Yancey (2006)	700 staff, members, or clients from 35 non-profit agencies. 77% AA and 84.5% Female.	48.5	Diet; BMI; Physical activity	The 12 or 6 week intervention involved an organization wellness program consisting of fitness instruction, nutrition education, and physical activity promotion during weekly 30-minute training sessions.	Among the 12-week intervention group, fruit and vegetable intake increased significantly by 0.5 servings/day (P = .00), and body mass index decreased by 0.5 kg/m2 (P = .08). The numbers of days in which individuals participated in vigorous physical activity increased significantly among 6-week intervention participants (P = 0.00).
Yeary (2011)*	26 AA participants from 3 churches in Arkansas, 85% Female, Mean BMI 36.	51	Body weight	Community and academic partners adapted the Diabetes Prevention Program for rural AA church members. The 16-week intervention consisted of faith-based lessons with Bible study and group exercise. The weight goal was 7% reduction of initial body weight. The program provided dietary goals and physical activity targets to help promote the weight loss.	Participants lost an average of 2.34 kg after the 16-week intervention when compared to baseline. There were also significantly increased physical activity during the intervention period. Changes in dietary intake were not significant. Among participants in the 16-week program, weight loss was 4.04 kg in the engaged group (median, −3.13.kg; IQR, −6.71 kg to 0.05 kg) compared with 0.29 kg in the less engaged group (median, −0.14 kg; IQR, −1.54 to 0.64 kg).
Zoellner (2007)	83 participants from a rural Mississippi Delta community, 99% AA, 97% Female.	__	BMI; physical activity; blood pressure; blood glucose; cholesterol	This 6-month walking intervention led by supportive trained coaches from the community who promoted goal setting and encouraged walking. Five 1-hour sessions were also delivered during the intervention and focused on weight and dietary behaviors.	Of the 83 enrolled participants, 66 (80%) completed the intervention. Participants exhibited significant improvements in systolic blood pressure (-4.3 mmHg), and high-density lipoprotein (HDL) cholesterol (+7.9 mg/clL), (P < .001). There were no significant reductions in BMI. Although there was net increase from baseline in average minutes of self-reported walking, these changes were not significant.
Zoellner (2014)*	269 participants from Hattiesburg, Mississippi. 94% AA and 85% female.	44	Blood pressure; Diet	6-month intervention included motivational enhancement, social support from peer coaches, pedometer diary self-monitoring, and 90 minute monthly educational sessions led by trained community health professionals focused on the Dietary Approaches to Stop Hypertension (DASH) diet and physical activity.	After the 6 month lifestyle intervention, systolic BP (P = 0.0002) and diastolic BP (P<0.0001) were significantly reduced compared to baseline. Sugar intake also decreased significantly (P<0.0001).

*statistically significant outcomes in at least one measure used to assess LS7 metric(s).