Changes in body weight,C-reactive protein,and total adiponectin in non-obese women after 12 months of a small-volume,home-based exercise program

OBJECTIVE:

Our objective was to evaluate the effects of small-volume, home-based exercise combined with slight caloric restriction on the inflammatory markers C-reactive protein and adiponectin.

METHODS:

In total, 54 women were randomly assigned to one of two groups for exercise intervention: the control or home-based exercise groups. Weight, waist and hip circumferences, and inflammatory markers were measured at baseline and after 6 and 12 months. Women allocated to the home-based exercise group received a booklet explaining the physical exercises to be practiced at home at least 3 times per week, 40 minutes per session, at low-to-moderate intensity. All participants received dietary counseling aimed at reducing caloric intake by 100-300 calories per day, with a normal distribution of macro-nutrients (26-28% of energy as fat). Clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT01206413","term_id":"NCT01206413"}}NCT01206413

RESULTS:

The home-based exercise group showed a significantly greater reduction in weight and body mass index at six months, but no difference between groups was observed thereafter. With regard to the inflammatory markers, a greater but non-statistically significant reduction was found for C-reactive protein in the home-based exercise group at six months; however, this difference disappeared after adjusting for weight change. No differences in adiponectin were found at the 6- or 12-month follow-up.

CONCLUSION:

Small-volume, home-based exercise did not promote changes in inflammatory markers independent of weight change.     

Bridging the transition from cancer patient to survivor: Pilot study results of the Cancer Survivor Telephone Education and Personal Support (C-STEPS) program

Objective

To develop a feasibility study of a theory-driven telephone counseling program to enhance psychosocial and physical well-being for cancer survivors after treatment.

Methods

Participants (n = 66) were recruited from two Colorado hospitals with self-administered questionnaires at baseline and two weeks post-intervention. The one group, intervention only design included up to six thematic telephone counseling sessions over three months. Topics included nutrition, physical activity, stress management, and medical follow-up. Primary outcomes were cancer-specific distress, self-reported fruit and vegetable consumption and physical activity.

Results

Of 66 subjects, 46 completed at least one counseling module and the follow-up assessment (70% retention rate). Mean satisfaction was 9 out of 10, and all participants would recommend C-STEPS to other survivors. Cancer-specific distress (Impact of Event Scale – Intrusion subscale) decreased for entire study population (p < 0.001) and stress management session participants (p < 0.001). Fruit and vegetable consumption increased for nutrition and exercise session participants (p = 0.02) and the entire sample (p = NS). Physical activity increased in the entire group (p = 0.006) and for nutrition and exercise session participants (p = 0.01).

Conclusion and practice implications

C-STEPS is a feasible telephone counseling program that transcends geographic barriers, demonstrating the potential to decrease distress and promote coping and healthy lifestyles among cancer survivors.     

Home-based asthma education of young low-income children and their families

OBJECTIVE: To conduct a controlled trial of a home-based education program for low-income caregivers of young children with asthma. METHODS: Participants were randomized to treatment-eight weekly asthma education sessions adapted from the Wee Wheezers program (n = 49)-or usual care (n = 46). Baseline and 3- and 12-month follow-up data were gathered from caregivers and from children's medical records. RESULTS: Treatment was associated with less bother from asthma symptoms, more symptom-free days, and better caregiver quality of life at follow-up for children 1-3, but not those 4-6, years of age. Treatment and control groups did not differ in caregiver asthma management behavior or children's acute care utilization. CONCLUSIONS: This home-based asthma education program was most effective with younger children; perhaps their caregivers were more motivated to learn about asthma management. Targeting psychosocial factors associated with asthma morbidity might also enhance the efficacy of asthma education for these families.     

Efficacy of a home-based training program for older adults using elastic tubing

The purpose of this study was to investigate the efficacy of, and the adherence to, a 12-week home-based progressive resistance training program for older adults utilizing elastic tubing. Sixty-two adults (mean age, 71.2 years) qualified to participate in the study. Subjects were randomly assigned to either the exercise (E) (n=31) or non-exercise (NE) group (n=31). Pre-and post-testing included isokinetic (1.05 rad · s ^–1) concentric/eccentric knee extension/flexion strength testing and flexibility measures of the hip, knee, and ankle. The E group trained three times per week, performing one to three sets of 10–12 repetitions for each of 12 resistance exercises. The exercises involved muscles of both the lower and upper body. Within the E group, 25 of the 31 subjects (80.6%) completed the study. Of the E subjects completing the study adherence to the three training sessions per week was 90% (range 72%–100%). Training resistances used during workouts increased significantly with the average estimated increase being 82% (P<0.001). The E group also demonstrated significant (P<0.05) increases in isokinetic eccentric knee extension (12%) and flexion (10%) strength. No other significant changes were observed between E and NE groups. These results suggest that home-based resistance training programs utilizing elastic tubing can serve as a practical and effective means of eliciting strength gains in adults over the age of 65.     

Use of an educational computer program before genetic counseling for breast cancer susceptibility: effects on duration and content of counseling sessions.

PURPOSE: Patients seeking genetic testing for inherited breast cancer risk are typically educated by genetic counselors; however, the growing demand for cancer genetic testing will likely exceed the availability of counselors trained in this area. We compared the effectiveness of counseling alone versus counseling preceded by use of a computer-based decision aid among women referred to genetic counseling for a family or personal history of breast cancer. METHODS: We developed and evaluated an interactive computer program that educates women about breast cancer, heredity, and genetic testing. Between May 2000 and September 2002, women at six study sites were randomized into either: Counselor Group (n = 105), who received standard genetic counseling, or Computer Group (n = 106), who used the interactive computer program before counseling. Clients and counselors both evaluated the effectiveness of counseling sessions, and counselors completed additional measures for the Computer Group. Counselors also recorded the duration of each session. RESULTS: Baseline characteristics did not differ significantly between groups. Participants and counselors both rated the counseling sessions as highly effective, whether or not the sessions were preceded by computer use. Computer use resulted in significantly shorter counseling sessions among women at low risk for carrying BRCA1/2 mutations. In approximately half of the sessions preceded by clients' computer use, counselors indicated that clients' use of the computer program affected the way they used the time, shifting the focus away from basic education toward personal risk and decision-making. CONCLUSION: This study shows that the interactive computer program "Breast Cancer Risk and Genetic Testing" is a valuable adjunct to genetic counseling. Its use before counseling can shorten counseling sessions and allow counselors to focus more on the clients' individual risks and specific psychological concerns. As the demand for counseling services increases, a program such as this can play a valuable role in enhancing counseling efficiency.     

Age-Related Differences in Predictors of Adherence to Rehabilitation After Anterior Cruciate Ligament Reconstruction

OBJECTIVE: To examine whether the relationships between psychological factors and rehabilitation adherence after knee surgery differ as a function of age. DESIGN AND SETTING: Participants completed inventories of self-motivation, social support, athletic identity, and psychological distress before anterior cruciate ligament (ACL) reconstruction. After surgery, participants recorded their completion of home rehabilitation exercises and cryotherapy, and the sport rehabilitation professionals providing their treatment reported on the patients' attendance at, and adherence during, rehabilitation sessions. SUBJECTS: Sixty-one individuals with acute ACL tears. MEASUREMENTS: The Self-Motivation Inventory, Social Support Inventory, Athletic Identity Measurement Scale, Brief Symptom Inventory, and Sport Injury Rehabilitation Adherence Scale were used to measure self-motivation, social support, athletic identity, psychological distress, and adherence, respectively, during rehabilitation sessions. RESULTS: Hierarchic regression analyses indicated that age moderated the relationships between (1) self-motivation and home exercise completion, (2) social support and home exercise completion, (3) athletic identity and home exercise completion, and (4) athletic identity and home cryotherapy completion. CONCLUSIONS: The prospective moderating relationships for between psychological factors and indices of adherence to home-based rehabilitation activities indicate the need to consider developmental issues when examining psychological aspects of sport-injury rehabilitation.     

Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial

OBJECTIVE: To determine the feasibility and acceptability of a restorative yoga intervention for the treatment of hot flushes in postmenopausal women. METHODS: A pilot trial in 14 postmenopausal women experiencing > or =4 moderate to severe hot flushes per day or > or =30 moderate to severe hot flushes per week. The intervention consisted of eight restorative yoga poses taught in a 3-h introductory session and 8 weekly 90-min sessions. Feasibility was measured by recruitment rates, subject retention and adherence. Acceptability was assessed by subject interview and questionnaires. Efficacy measures included change in frequency and severity of hot flushes as recorded on a 7-day diary. RESULTS: Recruitment was accomplished as planned. The majority of study subjects (93%) completed the trial. Of those who completed the trial, 92% attended seven or more of the eight yoga sessions. The majority of the subjects were satisfied with the study and 75% continued to practice yoga 3 months after the study. Mean number of hot flushes per week decreased by 30.8% (95% CI 15.6-45.9%) and mean hot flush score decreased 34.2% (95% CI 16.0-52.5%) from baseline to week 8. No adverse events were observed. CONCLUSIONS: This pilot trial demonstrates that it is feasible to teach restorative yoga to middle-aged women without prior yoga experience. The high rates of subject retention and satisfaction suggest that yoga is an acceptable intervention in this population. Our results indicate that a larger, randomized controlled trial to explore the efficacy of restorative yoga for treatment of menopausal symptoms would be safe and feasible.     

Initiation and Maintenance of Exercise Behavior in Older Women: Predictors from the Social Learning Model

The purpose of the present study was to determine the extent to which modifiable social learning constructs predicted long-term adherence to an exercise program in older individuals. Participants were 189 women aged 59 to 78 years and diagnosed with low bone density. Exercise behavior was assessed at 3-month intervals. Self-efficacy, readiness for change, orientation toward exercise, social support in general, and support specifically for exercise were measured at baseline and at 12-month follow-up. Analyses indicated that initial adoption of exercise behavior was best predicted by readiness to change. Maintenance was predicted by self-efficacy for exercise, and exercise behavior at 12 months was predicted by social support for exercise. The results were seen as supportive of the stages and processes of change model of health behavior change. Implications of the findings for interventions to enhance adoption and maintenance of exercise programs by older women are discussed.     

Return of postural control to baseline after anaerobic and aerobic exercise protocols

CONTEXT: With regard to sideline concussion testing, the effect of fatigue associated with different types of exercise on postural control is unknown. OBJECTIVE: To evaluate the effects of fatigue on postural control in healthy college-aged athletes performing anaerobic and aerobic exercise protocols and to establish an immediate recovery time course from each exercise protocol for postural control measures to return to baseline status. DESIGN: Counterbalanced, repeated measures. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Thirty-six collegiate athletes (18 males, 18 females; age = 19.00 +/- 1.01 years, height = 172.44 +/- 10.47 cm, mass = 69.72 +/- 12.84 kg). INTERVENTION(S): Participants completed 2 counterbalanced sessions within 7 days. Each session consisted of 1 exercise protocol followed by postexercise measures of postural control taken at 3-, 8-, 13-, and 18-minute time intervals. Baseline measures were established during the first session, before the specified exertion protocol was performed. MAIN OUTCOME MEASURE(S): Balance Error Scoring System (BESS) results, sway velocity, and elliptical sway area. RESULTS: We found a decrease in postural control after each exercise protocol for all dependent measures. An interaction was noted between exercise protocol and time for total BESS score (P = .002). For both exercise protocols, all measures of postural control returned to baseline within 13 minutes. CONCLUSIONS: Postural control was negatively affected after anaerobic and aerobic exercise protocols as measured by total BESS score, elliptical sway area, and sway velocity. The effect of exertion lasted up to 13 minutes after each exercise was completed. Certified athletic trainers and clinicians should be aware of these effects and their recovery time course when determining an appropriate time to administer sideline assessments of postural control after a suspected mild traumatic brain injury.     

Healthy Beat Acupunch exercise program: Validation and feasibility study for older adults with reduced physical capacity or probable sarcopenia

Objectives: This research aims to validate the Healthy Beat Acupunch (HBA) exercise program, determine the feasibility of the HBA exercise program protocol and gain an understanding of the effects on well-being for older adults with sarcopenia. Design, Setting & Intervention: Validation of the HBA exercise program was conducted using two rounds of Delphi communication among eight experts. A one-group, pre-post experimental study was conducted with 17 older adults with probable sarcopenia and/or low gait speed at an Australian retirement village. The HBA exercise program lasted 40 min per session, three sessions per week for four weeks. Outcome Measures: Muscle mass, muscle strength, gait speed and health-related quality of life were assessed before and after the intervention. The HBA exercise program was evaluated via a questionnaire and individual interviews. Results: Experts validated the HBA exercise program and deemed it to be simple, safe, suitable and helpful for practice by older adults with sarcopenia. Participants enjoyed the HBA exercise program, planned to continue and would recommend to friends. Frequency, duration and size of the exercise class were appropriate, and they appreciated the trainer's support and directions when mastering the exercise motions. Improvement in participants’ gait speed was found post-exercise intervention (p<.005). Conclusion: The HBA exercise program is appropriate for practice by older adults, particularly those with reduced physical capacity and probable sarcopenia with possible benefits of improved gait speed. Future studies need to consider and overcome the limitations (i.e. study design, sample size) and challenge (participant recruitment) encountered in this research.     

Rehabilitation outcomes following percutaneous coronary interventions (PCI)

This prospective study evaluated the effect of an individualized, comprehensive, home-based cardiac rehabilitation program combining exercise training with risk factor modification and psychosocial counseling on risk factors, psychological well-being, functional capacity, and work resumption in 99 post-percutaneous coronary interventions (PCI) patients randomized to control (standard care plus telephone follow-up, n=49) or intervention (individualized, comprehensive, home-based cardiac rehabilitation, n=50) groups. Data were collected at time 1 (T(1)) during hospital admission, time 2 (T(2)) approximately 2 months post-PCI, and time 3 (T(3)) approximately 12 months post-PCI. Results suggest that the allocation to an individualized, comprehensive, home-based cardiac rehabilitation program provided more advantageous outcomes. At both follow-ups, the intervention group showed within-group improvement in serum cholesterol levels (P<0.02; P<0.01) and exercise participation (P<0.001; P<0.001) with differences in exercise participation favoring the intervention group (P<0.01) at T(2). Repeated measures ANOVA showed significant improvements over time in body mass index (BMI) (P<0.01), psychological well-being (P<0.001), and functional capacity (P<0.001) for both groups. More patients in the intervention group had returned to work at T(2) (P<0.001) and did so more quickly (P<0.01). These findings suggest that an individualized, comprehensive, home-based cardiac rehabilitation program improves risk factor profiles and work resumption patterns for patients following PCI.     

Treatment of sinus tachycardia with heart-rate feedback

A 23-year-old male with a history of sinus tachycardia was treated with heart-rate feedback in eight sessions. From a pretreatment average of 103 beats per minute (BPM) as recorded in two separate baseline sessions, the heart rate dropped to 66 BPM in the last treatment session. At follow-up the heart rate seemed stabilized within the normal range, averaging 68 BPM after 1 month and 73 BPM after 12 months. Simultaneous EMG recordings of m. frontalis suggest a generalized effect of this treatment. Results are discussed in terms of somatic and respiratory mediation.     

Changes in screening behaviors and attitudes toward screening from pre‐test genetic counseling to post‐disclosure in Lynch syndrome families

The purpose of this study was to examine colonoscopy adherence and attitudes toward colorectal cancer (CRC) screening in individuals who underwent Lynch syndrome genetic counseling and testing. We evaluated changes in colonoscopy adherence and CRC screening attitudes in 78 cancer‐unaffected relatives of Lynch syndrome mutation carriers before pre‐test genetic counseling (baseline) and at 6 and 12 months post‐disclosure of test results (52 mutation negative and 26 mutation positive). While both groups were similar at baseline, at 12 months post‐disclosure, a greater number of mutation‐positive individuals had had a colonoscopy compared with mutation‐negative individuals. From baseline to 12 months post‐disclosure, the mutation‐positive group demonstrated an increase in mean scores on measures of colonoscopy commitment, self‐efficacy, and perceived benefits of CRC screening, and a decrease in mean scores for perceived barriers to CRC screening. Mean scores on colonoscopy commitment decreased from baseline to 6 months in the mutation‐negative group. To conclude, adherence to risk‐appropriate guidelines for CRC surveillance improved after genetic counseling and testing for Lynch syndrome. Mutation‐positive individuals reported increasingly positive attitudes toward CRC screening after receiving genetic test results, potentially reinforcing longer term colonoscopy adherence.     

Community asthma education program for parents of urban asthmatic children

OBJECTIVES: To demonstrate the effectiveness of community asthma education provided by peers in the urban community. METHOD: A convenience sample of 267 self-referred, primarily African-American parents or primary caregivers of asthmatic children aged 18 months to 16 years completed a five-session education program. Program efficacy was evaluated at baseline, immediately postinstruction, and at three-, six-, and 12 months retention. Outcomes included three questionnaires measuring asthma self-management knowledge, control and quality of life. RESULTS: Immediately following program completion, participants demonstrated improvements in asthma knowledge (13% increased proportion correct, p < 0.01), ability to control their child's asthma 16% increased score, p < 0.01), and asthma quality of life (7% increased score, p < 0.01). Retention of knowledge with steady improvement of control and quality of life was observed up to one year postinstruction, as compared with immediate postprogram scores (p = 0.09 and 0.05, respectively). CONCLUSIONS: A community-based asthma educational program for caregivers should be an important component of childhood asthma management. The complexities of asthma management are best taught in educational programs that are easily accessible, provide a comfortable environment for participants, and are taught by peers.     

Web-Based Cognitive Training: Patient Adherence and Intensity of Treatment in an Outpatient Memory Clinic

Background

Cognitive training has been playing an increasing role in the treatment of patients with cognitive deficits. This type of intervention, namely its intensity, can be optimized by incorporating information technology-based systems.

Objective

The intent of the study was to determine the treatment intensity and patient adherence to home-based cognitive training strategies (Web-based cognitive training).

Methods

A cohort of 45 patients with neurologic and psychiatric diseases attending an outpatient memory clinic (average age 50.7 years, SD 17.0; average education 7.8 years, SD 4.9) was followed over 18 months. Participants were challenged to use a Web-based cognitive training system, “COGWEB”, on a daily basis, and fulfilled at least four weeks of training supervised remotely. Additionally, 11 patients attended face-to-face sessions.

Results

The average duration of continuous cognitive training was 18.8 weeks (SD 18.9). Each patient performed on average 363.5 minutes/week (SD 136.6). At 6-month follow-up, 82.8% complied with their treatment plan. The average proportion of complete weeks was 0.75 (SD 0.22). Patients with dementia trained more intensively (444.6 minutes/week), followed by patients with static brain lesion (414.5 minutes/week; P=.01). The group that held face-to-face sessions performed more training overall (481.4 vs 366.9 minutes/week), achieving a stronger expression and statistical significance in the last week of training (652.6 versus 354.9 minutes/week, P=.027).

Conclusions

Overall, the weekly training intensity was high. Patients with dementia and static lesions performed more cognitive training. Face-to-face sessions were associated with higher intensities. The combination of classical methods with information technology systems seems to ensure greater training intensity.     

The effect of telephone versus print tailoring for mammography adherence

OBJECTIVE: The purpose of this intervention was to increase mammography adherence in women who had not had a mammogram in the last 15 months. METHODS: A prospective randomized intervention trial used four groups: (1) usual care, (2) tailored telephone counseling, (3) tailored print, (4) tailored telephone counseling and print. Participants included a total of 1244 women from two sites-a general medicine clinic setting serving predominately low-income clientele and a Health Maintenance Organization (HMO). Computer-tailored interventions addressed each woman's perceived risk of breast cancer, benefits and/or barriers and self-efficacy related to mammography screening comparing delivery by telephone and mail. RESULTS: Compared to usual care all intervention groups increased mammography adherence significantly (odds ratio 1.60-1.91) when the entire sample was included. CONCLUSIONS: All interventions groups demonstrated efficacy in increasing mammography adherence as compared to a usual care group. When the intervention analysis considered baseline stage, pre contemplators (women who did not intend to get a mammogram) did not significantly increase in mammography adherence as compared to usual care. PRACTICE IMPLICATIONS: Women who are in pre contemplation stage may need a more intensive intervention.     

Feasibility and Effectiveness of a Web-Based Positive Psychology Program for Youth Mental Health: Randomized Controlled Trial

Background

Youth mental health is a significant public health concern due to the high prevalence of mental health problems in this population and the low rate of those affected seeking help. While it is increasingly recognized that prevention is better than cure, most youth prevention programs have utilized interventions based on clinical treatments (eg, cognitive behavioral therapy) with inconsistent results.

Objective

This study explores the feasibility of the online delivery of a youth positive psychology program, Bite Back, to improve the well-being and mental health outcomes of Australian youth. Further aims were to examine rates of adherence and attrition, and to investigate the program’s acceptability.

Methods

Participants (N=235) aged 12-18 years were randomly assigned to either of two conditions: Bite Back (n=120) or control websites (n=115). The Bite Back website comprised interactive exercises and information across a variety of positive psychology domains; the control condition was assigned to neutral entertainment-based websites that contained no psychology information. Participants in both groups were instructed to use their allocated website for 6 consecutive weeks. Participants were assessed pre- and postintervention on the Depression Anxiety Stress Scale-Short form (DASS-21) and the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS).

Results

Of the 235 randomized participants, 154 (65.5%) completed baseline and post measures after 6 weeks. Completers and dropouts were equivalent in demographics, the SWEMWBS, and the depression and anxiety subscales of the DASS-21, but dropouts reported significantly higher levels of stress than completers. There were no differences between the Bite Back and control conditions at baseline on demographic variables, DASS-21, or SWEMWBS scores. Qualitative data indicated that 49 of 61 Bite Back users (79%) reported positive experiences using the website and 55 (89%) agreed they would continue to use it after study completion. Compared to the control condition, participants in the Bite Back condition with high levels of adherence (usage of the website for 30 minutes or more per week) reported significant decreases in depression and stress and improvements in well-being. Bite Back users who visited the site more frequently (≥3 times per week) reported significant decreases in depression and anxiety and improvements in well-being. No significant improvements were found among Bite Back users who demonstrated low levels of adherence or who used the website less frequently.

Conclusions

Results suggest that using an online positive psychology program can decrease symptoms of psychopathology and increase well-being in young people, especially for those who use the website for 30 minutes or longer per week or more frequently (≥3 times per week). Acceptability of the Bite Back website was high. These findings are encouraging and suggest that the online delivery of positive psychology programs may be an alternate way to address mental health issues and improve youth well-being nationally.

Trial Registration

Australian New Zealand Clinical Trials Registry: ACTRN1261200057831; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362489 (Archived by Webcite at http://www.webcitation.org/6NXmjwfAy).     

团体心理咨询对社会性发展迟滞大学生面部表情识别的随机对照研究

目的:探讨团体心理咨询对提高社会性发展迟滞大学生面部表情识别能力的有效性及可行性。方法:选取24名社会性发展迟滞大学生[大学生社会性发展水平评定量表(SCSSD)总分<9分]完成面部表情识别任务,将其随机分到团体心理咨询组(咨询组)和对照组,每组各1人。咨询组接受9次团体心理咨询(每周1次,每次2 h),对照组处于常态。结果:团体心理咨询后,咨询组对高兴、惊奇、悲伤、愤怒、恐惧面部表情图片和正负性表情图片识别的正确率均高于对照组(均P<0.05)。组内比较结果发现,咨询组在团体心理咨询后对高兴、惊奇、悲伤、愤怒、恐惧及正负性面部表情图片识别正确率均高于团体心理咨询前(均P<0.05);对照组基线与干预后各项评分差异均无统计学意义(均P>0.05)。结论:团体心理咨询可以提升社会性发展迟滞大学生面部表情的识别能力。     

Preparing clients for alcoholism treatment: effects on treatment participation and outcomes

In this study, 126 clients (87 men, 39 women) entering outpatient alcoholism treatment were assigned randomly to 1 of 3 preparatory conditions: a role induction (RI) session, a motivational interview (MI) session, or a no-preparatory session control group (CG). Clients assigned to the MI preparatory condition attended more treatment sessions and had fewer heavy drinking days during and 12 months after treatment relative to CG clients. Clients assigned to MI, relative to CG clients, also had more abstinent days during treatment and during the first 3 months posttreatment, although this difference was not maintained through the remainder of the 12-month follow-up period. Clients assigned to the RI condition showed no significant advantage over those in the CG condition.     

Reach-out: a family-based diabetes prevention program for African American youth

Objective: To pilot test and assess the feasibility of a culturally grounded approach to adolescent overweight and diabetes prevention.Study Design: Reach-Out, a family-based nutrition and exercise program for overweight African American youth aged 9 to 12 years and their families, is led by lay health leaders and conducted in a community setting on Chicago's south side (Illinois). Age-appropriate interactive sessions focus on skills building, problem solving, and setting goals during 14 weekly sessions, with monthly meetings thereafter. Pre-post comparisons were made for 29 families (62 subjects) using physical (body mass index [BMI], blood pressure, waist circumference), biochemical (glucose, insulin, lipid levels) and behavioral data. Statistical analyses included mixed-effects linear models and logistic regression.ResultsChildren's mean BMI z score fell from 2.46 at baseline to 2.38 at 14 weeks and 2.39 at 1 year (p =.02), while parents' BMI remained stable. Children reported increased walking (p = 0.07) and exhibited a corresponding rise in mean serum high-density lipoprotein cholesterol from 49.4 to 54.2 (p <.001). Qualitative assessment showed that participants enjoyed the program but felt the program could be improved by making the sessions even more interactive.Conclusion: A community-based program for overweight minority youth and families can successfully address overweight, with the potential to decrease diabetes risk in youth.