Abstract
Background: From 2011-2014, 56.9% of African American women in the United States were obese. Poverty and urban neighbourhood environments contribute to the health disparities and prevalence of obesity in African American women. The limited resources, education, and widespread disparities in health risks and disease experience in low-income and minority communities make behaviour change challenging. Understanding which strategies facilitate behaviour change is important for improving the health of women in these communities.
Objective: The objective of this quasi-experimental, staggered start pilot study was to determine the differences in biometric changes, health behaviours, and overall health risk in low-income African-American women using either a self-guided workbook or lay health coaching approach to behaviour change in addition to a healthy lifestyle curriculum.
Methods: Utilizing a CBPR approach, a healthy lifestyles curriculum was designed to address health risks and education needs of women in a Midwest urban community. Thirty-four women received a 6-week, 90-minute pilot-curriculum with biometric screening, a health risk assessment, and 30-minutes of personalized feedback. The coaching group received bi-weekly personalized behaviour change sessions. Height, weight, waist circumference, and fasting glucose, triglycerides and cholesterol were measured. Participants completed a 53-item health risk assessment. Confidence in and readiness for behaviour change were measured. Knowledge scores were obtained for each educational session.
Results: Both groups decreased health risk and increased knowledge related to all topics except relapse prevention. There were significant differences in abdominal circumference changes between the coaching group (M= -2.605, SD= 2.372) and the workbook group (M= -0.433, SD= 3.294; F (1, 31) = 4.997, p= 0.032).
Conclusion: Personalized feedback from the health risk assessment in conjunction with the program immediately following the screening may have led to improvement in both groups. Lack of knowledge and skills in relapse prevention highlight the challenge of behaviour maintenance in communities with limited resources. The coaching and group education provided a social support and encouraging environment for behaviour change.
Citation
Miller E, Thompson V, Cooley R, Wyand R and Fichtner A. Lay Health Coaching Associated with Improvements in Abdominal Circumference and Reported Psychosocial Benefits in Low-Income African American Women: A Pilot Study. SM J Fam Med. 2017; 1(2): 1011.