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The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos.

Publication ,  Journal Article
Rosas, LG; Thiyagarajan, S; Goldstein, BA; Drieling, RL; Romero, PP; Ma, J; Yank, V; Stafford, RS
Published in: J Acad Nutr Diet
April 2015

BACKGROUND: Latino immigrants have high rates of obesity and face barriers to weight loss. OBJECTIVE: To evaluate the effectiveness of a case-management (CM) intervention with and without community health workers (CHWs) for weight loss. DESIGN: This was a 2-year, randomized controlled trial comparing two interventions with each other and with usual care (UC). PARTICIPANTS/SETTING: Eligible participants included Latinos with a body mass index of 30 to 60 and one or more heart disease risk factors. The 207 participants recruited during 2009-2010 had a mean age of 47 years and were mostly women (77%). At 24 months, 86% of the sample was assessed. INTERVENTION: The CM+CHW (n=82) and CM (n=84) interventions were compared with each other and with UC (n=41). Both included an intensive 12-month phase followed by 12 months of maintenance. The CM+CHW group received home visits. MAIN OUTCOME MEASURES: Weight change at 24 months. STATISTICAL ANALYSES: Generalized estimating equations using intent-to-treat. RESULTS: At 6 months, mean weight loss in the CM+CHW arm was -2.1 kg (95% CI -2.8 to -1.3) or -2% of baseline weight (95% CI -1% to -2%) compared with -1.6 kg (95% CI -2.4 to -0.7; % weight change, -2%, -1%, and -3%) in CM and -0.9 kg (95% CI -1.8 to 0.1; % weight change, -1%, 0%, and -2%) in UC. By 12 and 24 months, differences narrowed and CM+CHW was no longer statistically distinct. Men achieved greater weight loss than women in all groups at each time point (P<0.05). At 6 months, men in the CM+CHW arm lost more weight (-4.4 kg; 95% CI -6.0 to -2.7) compared with UC (-0.4 kg; 95% CI -2.4 to 1.5), but by 12 and 24 months differences were not significant. CONCLUSIONS: This study demonstrated that incorporation of CHWs may help promote initial weight loss, especially among men, but not weight maintenance. Additional strategies to address social and environmental influences may be needed for Latino immigrant populations.

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Published In

J Acad Nutr Diet

DOI

ISSN

2212-2672

Publication Date

April 2015

Volume

115

Issue

4

Start / End Page

537 / 50.e2

Location

United States

Related Subject Headings

  • Weight Loss
  • Waist Circumference
  • United States
  • Treatment Outcome
  • Sex Factors
  • Poverty
  • Obesity
  • Middle Aged
  • Male
  • Humans
 

Citation

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Rosas, L. G., Thiyagarajan, S., Goldstein, B. A., Drieling, R. L., Romero, P. P., Ma, J., … Stafford, R. S. (2015). The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos. J Acad Nutr Diet, 115(4), 537-50.e2. https://doi.org/10.1016/j.jand.2014.10.020
Rosas, Lisa Goldman, Sreedevi Thiyagarajan, Benjamin Alan Goldstein, Rebecca Lucia Drieling, Priscilla Padilla Romero, Jun Ma, Veronica Yank, and Randall Scott Stafford. “The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos.J Acad Nutr Diet 115, no. 4 (April 2015): 537-50.e2. https://doi.org/10.1016/j.jand.2014.10.020.
Rosas LG, Thiyagarajan S, Goldstein BA, Drieling RL, Romero PP, Ma J, et al. The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos. J Acad Nutr Diet. 2015 Apr;115(4):537-50.e2.
Rosas, Lisa Goldman, et al. “The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos.J Acad Nutr Diet, vol. 115, no. 4, Apr. 2015, pp. 537-50.e2. Pubmed, doi:10.1016/j.jand.2014.10.020.
Rosas LG, Thiyagarajan S, Goldstein BA, Drieling RL, Romero PP, Ma J, Yank V, Stafford RS. The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos. J Acad Nutr Diet. 2015 Apr;115(4):537–50.e2.
Journal cover image

Published In

J Acad Nutr Diet

DOI

ISSN

2212-2672

Publication Date

April 2015

Volume

115

Issue

4

Start / End Page

537 / 50.e2

Location

United States

Related Subject Headings

  • Weight Loss
  • Waist Circumference
  • United States
  • Treatment Outcome
  • Sex Factors
  • Poverty
  • Obesity
  • Middle Aged
  • Male
  • Humans