Design of a home-based intervention for Houston-area African-American adults with asthma: Methods and lessons learned from a pragmatic randomized trial

Abstract Background Minority adolescents are at highest risk for obesity and extreme obesity; yet, there are few clinical trials targeting African American adolescents with obesity. Purpose The purpose of the study was to develop an adaptive family-based behavioral obesity treatment for African American adolescents using a sequential multiple assignment randomized trial (SMART) design. Methods Fit Families was a SMART where 181 African American adolescents (67% female) aged 12–17 were first randomized to office-based versus home-based behavioral skills treatment delivered from a Motivational Interviewing foundation. After 3 months, nonresponders to first phase treatment were rerandomized to continued home-based behavioral skills treatment or contingency management with voucher-based reinforcement for adolescent weight loss and for caregiver adherence to the program. All interventions were delivered by community health workers. The primary outcome was treatment retention and percent overweight. Results All adolescents reduced percent overweight by −3.20%; there were no significant differences in percent overweight based on treatment sequence. Adolescents receiving home-based delivery in Phase 1 and contingency management in Phase 2 completed significantly more sessions than those receiving office-based treatment and continued skills without CM (M = 8.03, SD = 3.24 and M = 6.62, SD = 2.95, respectively). The effect of contingency management was strongest among older and those with lower baseline confidence. Younger adolescents experienced greater weight reductions when receiving continued skills (−4.90% compared with −.02%). Conclusions Behavioral skills training can be successfully delivered to African American adolescents with obesity and their caregivers by community health workers when using a home-based service model with incentives. More potent interventions are needed to increase reductions in percent overweight and may need to be developmentally tailored for younger and older adolescents.

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Differential impact of a nurse-led, home-based intervention for optimal secondary cardiac prevention on recurrent hospitalization in men and women: the Young @ Heart multicentre, randomized trial

European Heart Journal ◽

10.1093/eurheartj/eht309.p3359 ◽

2013 ◽

Vol 34 (suppl 1) ◽

pp. P3359-P3359 ◽

Cited By ~ 1

Author(s):

S. Stewart ◽

M. J. Carrington ◽

S. Goldstein ◽

P. Scuffham

Keyword(s):

Randomized Trial ◽

Differential Impact ◽

Men And Women ◽

Home Based ◽

Home Based Intervention ◽

Recurrent Hospitalization

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Cultural Familiarity of Figurative Expressions From Three Music Genres and African American Adults

Contemporary Issues in Communication Science and Disorders ◽

10.1044/cicsd_43_f_238 ◽

2016 ◽

Vol 43 (Fall) ◽

pp. 238-254

Author(s):

Alaina S. Davis ◽

Wilhelmina Wright-Harp ◽

Jay Lucker ◽

Joan Payne ◽

Alfonso Campbell

Keyword(s):

African American ◽

African American Adults ◽

Music Genres ◽

Figurative Expressions

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Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig2.110 ◽

2017 ◽

Vol 2 (2) ◽

pp. 110-116

Author(s):

Valarie B. Fleming ◽

Joyce L. Harris

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Healthcare Access ◽

Communication Disorders ◽

Healthcare Systems ◽

Prevention Education ◽

Education Management ◽

African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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