A Cluster Randomized Trial of a Community-Based Intervention Among African-American Adults: Effects on Dietary and Physical Activity Outcomes

  • Leah FrerichsEmail author
  • Kiana Bess
  • Tiffany L. Young
  • Stephanie M. Hoover
  • Larissa Calancie
  • Mysha Wynn
  • Shirley McFarlin
  • Crystal W. Cené
  • Gaurav Dave
  • Giselle Corbie-Smith


Evidence of the effectiveness of community-based lifestyle behavior change interventions among African-American adults is mixed. We implemented a behavioral lifestyle change intervention, Heart Matters, in two rural counties in North Carolina with African-American adults. Our aim was to evaluate the effect of Heart Matters on dietary and physical activity behaviors, self-efficacy, and social support. We used a cluster randomized controlled trial to compare Heart Matters to a delayed intervention control group after 6 months. A total of 143 African-American participants were recruited and 108 completed 6-month follow-up assessments (75.5%). We used mixed regression models to evaluate changes in outcomes from baseline to 6-month follow-up. The intervention had a significant positive effect on self-reported scores of encouragement of healthy eating, resulting in an increase in social support from family of 6.11 units (95% CI [1.99, 10.22]) (p < .01). However, intervention participants also had an increase in discouragement of healthy eating compared to controls of 5.59 units (95% CI [1.46, 9.73]) among family (p < .01). There were no significant differences in changes in dietary behaviors. Intervention participants had increased odds (OR = 2.86, 95% CI [1.18, 6.93]) of increased frequency of vigorous activity for at least 20 min per week compared to control participants (p < .05). Individual and group lifestyle behavior counseling can have a role in promoting physical activity levels among rural African-American adults, but more research is needed to identify the best strategies to bolster effectiveness and influence dietary change. Trial Registration: Clinical Trials, NCT02707432. Registered 13 March 2016.


Cardiovascular diseases Healthy diet Exercise Social support African American Adult 


Funding Information

This study was funded by the National Heart Lung and Blood Institute (Grant Numbers R01HL120690 & K24HL105493-09; PI Giselle Corbie-Smith). This project was also supported by NIH/NCRR Colorado CTSI Grant Number UL1 RR025780 and University of North Carolina CTSI Grant Number UL1TR002489. Dr. Frerichs was supported by the National Heart Lung and Blood Institute (Grant Number 5K01HL138159; PI Frerichs). The funding bodies had no role in the design, collection, analysis, interpretation, nor writing of the study. Its contents are the authors’ sole responsibility and do not necessarily represent official NIH views.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Copyright information

© Society for Prevention Research 2020

Authors and Affiliations

  • Leah Frerichs
    • 1
    Email author
  • Kiana Bess
    • 2
  • Tiffany L. Young
    • 3
    • 4
  • Stephanie M. Hoover
    • 2
  • Larissa Calancie
    • 2
  • Mysha Wynn
    • 5
  • Shirley McFarlin
    • 6
  • Crystal W. Cené
    • 7
  • Gaurav Dave
    • 2
    • 7
  • Giselle Corbie-Smith
    • 2
    • 7
    • 8
  1. 1.Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Center for Health Equity Research, Department of Social MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.The North Carolina Translational Research and Clinical Sciences InstituteUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Lenell & Lillie Consulting, LLCNew BernUSA
  5. 5.Project Momentum, Inc.Rocky MountUSA
  6. 6.James McFarlin Community Development, Inc.Rocky MountUSA
  7. 7.Department of Medicine, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  8. 8.Department of Social Medicine and Medicine, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA

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