Community Trial of a Faith-Based Lifestyle Intervention to Prevent Diabetes Among African-Americans

About 75 % of African-Americans (AAs) ages 20 or older are overweight and nearly 50 % are obese, but community-based programs to reduce diabetes risk in AAs are rare. Our objective was to reduce weight and fasting plasma glucose (FPG) and increase physical activity (PA) from baseline to week-12 and to month-12 among overweight AA parishioners through a faith-based adaptation of the Diabetes Prevention Program called Fit Body and Soul (FBAS). We conducted a single-blinded, cluster randomized, community trial in 20 AA churches enrolling 604 AAs, aged 20–64 years with BMI ≥ 25 kg/m² and without diabetes. The church (and their parishioners) was randomized to FBAS or health education (HE). FBAS participants had a significant difference in adjusted weight loss compared with those in HE (2.62 vs. 0.50 kg, p = 0.001) at 12-weeks and (2.39 vs. −0.465 kg, p = 0.005) at 12-months and were more likely (13 %) than HE participants (3 %) to achieve a 7 % weight loss (p < 0.001) at 12-weeks and a 7 % weight loss (19 vs. 8 %, p < 0.001) at 12-months. There were no significant differences in FPG and PA between arms. Of the 15.2 % of participants with baseline pre-diabetes, those in FBAS had, however, a significant decline in FPG (10.93 mg/dl) at 12-weeks compared with the 4.22 mg/dl increase in HE (p = 0.017), and these differences became larger at 12-months (FBAS, 12.38 mg/dl decrease; HE, 4.44 mg/dl increase) (p = 0.021). Our faith-based adaptation of the DPP led to a significant reduction in weight overall and in FPG among pre-diabetes participants.