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Guide to health: nutrition and physical activity outcomes of a group-randomized trial of an internet-based intervention in churches
Winett RA, Anderson ES, Wojcik JR, Winett SG, Bowden T
Annals of Behavioral Medicine 2007 Sep;33(3):251-261
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Theory-based interventions accessible to large groups of people are needed to induce favorable shifts in health behaviors and body weight. PURPOSE: The aim was to assess nutrition; physical activity; and, secondarily, body weight in the tailored, social cognitive Guide to Health (GTH) internet intervention delivered in churches. METHODS: Participants (n = 1,071; 33% male, 23% African American, 57% with body mass index >= 25, 60% sedentary, median age 53 years) within 14 Baptist or United Methodist churches were randomized to the GTH intervention only (GTH-only; 5 churches), with church-based supports (GTH-plus; 5 churches), or to a waitlist (control; 4 churches). Verified pedometer step counts, measured body weight, fat, fiber, and fruit and vegetable (F+V) servings from food frequency and supermarket receipts were collected at pretest, posttest (7 months after pretest), and follow-up (16 months after pretest). RESULTS: Participants in GTH-only increased F+V at post (approximately 1.50 servings) compared to control (approximately 0.50 servings; p = 0.005) and at follow-up (approximately 1.20 versus approximately 0.50 servings; p = 0.038) and increased fiber at post (approximately 3.00 g) compared to control (approximately 1.5 g; p = 0.006) and follow-up (approximately 3.00 g versus approximately 2.00 g; p = 0.040). GTH-plus participants compared to control increased steps at post (approximately 1,500 steps/day versus approximately 400 steps/day; p = 0.050) and follow-up (approximately 1,000 steps/day versus approximately -50 steps/day; p = -0.010), increased F+V at post (approximately 1.5 servings; p = 0.007) and follow-up (approximately 1.3 servings; p = 0.014), increased fiber at post (approximately 3.00A g; p = 0.013), and follow-up (approximately 3.00; p = 0.050) and decreased weight at post (approximately -0.30 kg versus approximately +0.60 kg; p = 0.030). CONCLUSIONS: Compared to control, both GTH treatments improved nutrition at posttest, but church supports improved physical activity and nutrition at posttest and follow-up, suggesting environmental supports may improve internet-based interventions.

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