Evaluating clinic and community-based lifestyle interventions for XXXX reduction in a low-income Latino neighborhood: Vivamos Activos Fair Oaks Program.

@entity1 @entity353 @entity28 @entity301 @entity413 @entity65
BACKGROUND: Obesity exerts an enormous health impact through its effect on @entity301 and its risk factors. Primary care-based and community-based intensive lifestyle counseling may effectively promote @entity353 . There has been limited implementation and evaluation of these strategies, particularly the added benefit of community-based intervention, in low-income Latino populations. DESIGN: The Vivamos Activos Fair Oaks project is a randomized clinical trial designed to evaluate the clinical and cost-effectiveness of two @entity28 reduction lifestyle interventions: clinic-based intensive lifestyle counseling, either alone (n = 80) or combined with community health worker support (n = 80), in comparison to usual primary care (n = 40). Clinic-based counseling consists of 15 group and four individual lifestyle counseling sessions provided by health educators targeting behavior change in physical activity and dietary practices. Community health worker support includes seven home visits aimed at practical implementation of @entity353 strategies within the @entity1 's home and neighborhood. The interventions use a framework based on Social Cognitive Theory, the Transtheoretical Model of behavior change, and techniques from previously tested lifestyle interventions. Application of the framework was culturally tailored based on past interventions in the same community and elsewhere, as well as a community needs and assets assessment. The interventions include a 12-month intensive phase followed by a 12-month maintenance phase. @entity1 are obese Spanish-speaking adults with at least one @entity65 factor recruited from a community health center in a low-income neighborhood of San Mateo County, California. Follow-up assessments occur at 6, 12, and 24 months for the primary outcome of percent change in body mass index at 24 months. Secondary outcomes include specific @entity65 , particularly blood pressure and fasting @entity413 levels. DISCUSSION AND CONCLUSIONS: If successful, this study will provide evidence for broad implementation of @entity28 interventions in minority populations and guidance about the selection of strategies involving clinic-based case management and community-based community health worker support. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT01242683.
