Comparative effectiveness trial comparing MyPlate to calorie counting for mostly low-income Latino primary care patients of a federally qualified community health center: study design, baseline characteristics.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Nutrition Policy*; Diet, Healthy/*psychology ; Health Promotion/*methods ; Hispanic or Latino/*psychology ; Poverty/*psychology; Adult ; Black or African American/psychology ; California ; Community Health Centers ; Community Health Workers ; Comparative Effectiveness Research ; Energy Intake ; Female ; Humans ; Male ; Middle Aged ; Overweight/diet therapy ; Overweight/psychology ; Primary Health Care/methods ; Quality of Life ; Research Design

Background: Primary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation.
Methods: A comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation.
Analysis: Baseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression.
Results: Two thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m ² ; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality.
Conclusions: The two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality.
Trial Registration: NCT02514889 , posted on 8/4/2015.

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CER-130601150 Patient-Centered Outcomes Research Institute; UL1TR001881 National Institutes of Health

Keywords: Behavior change; Community health workers; Latino; Nativity; Obesity treatment; Primary care; Satiation; Satiety

ClinicalTrials.gov NCT02514889

Date Created: 20190726 Date Completed: 20191010 Latest Revision: 20221207

20240513

PMC6651946

10.1186/s12889-019-7294-z

31340800