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A 2-Year Holistic Health and Stress Intervention: Results of an RCT in Clergy.

Publication ,  Journal Article
Proeschold-Bell, RJ; Turner, EL; Bennett, GG; Yao, J; Li, X-F; Eagle, DE; Meyer, RA; Williams, RB; Swift, RY; Moore, HE; Kolkin, MA; Hough, HJ ...
Published in: Am J Prev Med
September 2017

INTRODUCTION: This study sought to determine the effect of a 2-year, multicomponent health intervention (Spirited Life) targeting metabolic syndrome and stress simultaneously. DESIGN: An RCT using a three-cohort multiple baseline design was conducted in 2010-2014. SETTING/PARTICIPANTS: Participants were United Methodist clergy in North Carolina, U.S., in 2010, invited based on occupational status. Of invited 1,745 clergy, 1,114 consented, provided baseline data, and were randomly assigned to immediate intervention (n=395), 1-year waitlist (n=283), or 2-year waitlist (n=436) cohorts for a 48-month trial duration. INTERVENTION: The 2-year intervention consisted of personal goal setting and encouragement to engage in monthly health coaching, an online weight loss intervention, a small grant, and three workshops delivering stress management and theological content supporting healthy behaviors. Participants were not blinded to intervention. MAIN OUTCOME MEASURES: Trial outcomes were metabolic syndrome (primary) and self-reported stress and depressive symptoms (secondary). Intervention effects were estimated in 2016 in an intention-to-treat framework using generalized estimating equations with adjustment for baseline level of the outcome and follow-up time points. Log-link Poisson generalized estimating equations with robust SEs was used to estimate prevalence ratios (PRs) for binary outcomes; mean differences were used for continuous/score outcomes. RESULTS: Baseline prevalence of metabolic syndrome was 50.9% and depression was 11.4%. The 12-month intervention effect showed a benefit for metabolic syndrome (PR=0.86, 95% CI=0.79, 0.94, p<0.001). This benefit was sustained at 24 months of intervention (PR=0.88; 95% CI=0.78, 1.00, p=0.04). There was no significant effect on depression or stress scores. CONCLUSIONS: The Spirited Life intervention improved metabolic syndrome prevalence in a population of U.S. Christian clergy and sustained improvements during 24 months of intervention. These findings offer support for long-duration behavior change interventions and population-level interventions that allow participants to set their own health goals. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01564719.

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Published In

Am J Prev Med

DOI

EISSN

1873-2607

Publication Date

September 2017

Volume

53

Issue

3

Start / End Page

290 / 299

Location

Netherlands

Related Subject Headings

  • Weight Reduction Programs
  • Time Factors
  • Stress, Psychological
  • Quality of Life
  • Public Health
  • Protestantism
  • Program Evaluation
  • Prevalence
  • Patient Reported Outcome Measures
  • North Carolina
 

Citation

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Chicago
ICMJE
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Proeschold-Bell, R. J., Turner, E. L., Bennett, G. G., Yao, J., Li, X.-F., Eagle, D. E., … Toole, D. C. (2017). A 2-Year Holistic Health and Stress Intervention: Results of an RCT in Clergy. Am J Prev Med, 53(3), 290–299. https://doi.org/10.1016/j.amepre.2017.04.009
Proeschold-Bell, Rae Jean, Elizabeth L. Turner, Gary G. Bennett, Jia Yao, Xiang-Fang Li, David E. Eagle, Rachel A. Meyer, et al. “A 2-Year Holistic Health and Stress Intervention: Results of an RCT in Clergy.Am J Prev Med 53, no. 3 (September 2017): 290–99. https://doi.org/10.1016/j.amepre.2017.04.009.
Proeschold-Bell RJ, Turner EL, Bennett GG, Yao J, Li X-F, Eagle DE, et al. A 2-Year Holistic Health and Stress Intervention: Results of an RCT in Clergy. Am J Prev Med. 2017 Sep;53(3):290–9.
Proeschold-Bell, Rae Jean, et al. “A 2-Year Holistic Health and Stress Intervention: Results of an RCT in Clergy.Am J Prev Med, vol. 53, no. 3, Sept. 2017, pp. 290–99. Pubmed, doi:10.1016/j.amepre.2017.04.009.
Proeschold-Bell RJ, Turner EL, Bennett GG, Yao J, Li X-F, Eagle DE, Meyer RA, Williams RB, Swift RY, Moore HE, Kolkin MA, Weisner CC, Rugani KM, Hough HJ, Williams VP, Toole DC. A 2-Year Holistic Health and Stress Intervention: Results of an RCT in Clergy. Am J Prev Med. 2017 Sep;53(3):290–299.
Journal cover image

Published In

Am J Prev Med

DOI

EISSN

1873-2607

Publication Date

September 2017

Volume

53

Issue

3

Start / End Page

290 / 299

Location

Netherlands

Related Subject Headings

  • Weight Reduction Programs
  • Time Factors
  • Stress, Psychological
  • Quality of Life
  • Public Health
  • Protestantism
  • Program Evaluation
  • Prevalence
  • Patient Reported Outcome Measures
  • North Carolina