Improving the Reach of a CBPR Developed Obesity Program Among Disavantaged Women

Indiana University Indianapolis, Indianapolis IN

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Abstract

DESCRIPTION (provided by applicant): Take Charge Lite is a state-of-the-art lifestyle weight management program that was designed following the principles of community-based participatory research (CBPR). Take Charge Lite is operational in six community health centers serving over 40,000 socio-economically disadvantaged non-Hispanic black, Hispanic, and non-Hispanic white adults. Nationally, federally approved community health centers serve over 14 million disadvantaged patients annually. Basic public health principles emphasize that the "impact" of an intervention is a product of both its "efficacy" and its "reach". Reach is sometimes referred to as the penetration of the intervention. It is defined as the proportion and characteristics of the target population that is exposed to the intervention. By improving our understanding of the factors that influence reach among minority and socio-economically disadvantaged individuals, the proposed study would offer avenues to reducing health disparities. The proposed study addresses questions of reach by leveraging the real-world laboratory of the ongoing community health center- based Take Charge Lite weight management program. The specific aims of this project are to identify patient, primary care provider, and program factors that affect 1) receipt of a weight management program prescription and 2) enrollment in a weight management program. We target middle-aged (30-64) Mexican-American, non-Hispanic black, and non-Hispanic white women who are Class I, II, or III obese. Our middle-age focus captures the years with the highest obesity prevalence and may be the most opportune time for chronic illness and disability prevention. Our investigation will be guided by the principles of social marketing. Aim 1 will be accomplished through analysis of audio-recorded patient-provider encounters with post-visit interviews of participating providers and patients. Aim 2 will be accomplished by in-home patient interviews with patients who received a weight management program prescription and either enrolled, explored but did not enroll, or did not explore and did not enroll. Our data collection will be based on quota samples of Mexican-American, non-Hispanic black, and non-Hispanic white patients. Ultimately, applying the principles of social marketing, findings will be used to identify and test changes that could improve the reach of prevention programs for disadvantaged patients. PUBLIC HEALTH RELEVANCE: Obesity is a serious health issue in the U.S. and rates of obesity are highest among ethnic minority women. This project will help identify ways that clinic-based weight management programs can better assist minority women to manage their weight.