Pounds off with empowerment (POWER): a clinical trial of weight management strategies for black and white adults with diabetes who live in medically underserved rural communities.

Author: Mayer-Davis EJ, D'Antonio AM, Smith SM, Kirkner G, Levin Martin S, Parra-Medina D, Schultz R

Author affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA. mayer@gwm.sc.edu

Publication date & source: 2004.10, Am J Public Health., 94(10):1736-42.

Publication type: Clinical Trial; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.

OBJECTIVES: We evaluated lifestyle interventions for diabetic persons who live in rural communities. METHODS: We conducted a 12-month randomized clinical trial (n = 152) of "intensive-lifestyle" (modeled after the NIH Diabetes Prevention Program) and "reimbursable-lifestyle" (intensive-lifestyle intervention delivered in the time allotted for Medicare reimbursement for diabetes education related to nutrition and physical activity) interventions with usual care as a control. RESULTS: Modest weight loss occurred by 6 months among intensive-lifestyle participants and was greater than the weight loss among usual-care participants (2.6 kg vs 0.4 kg, P<.01). At 12 months, a greater proportion of intensive-lifestyle participants had lost 2 kg or more than usual-care participants (49% vs 25%, P<.05). No differences in weight change were observed between reimbursable-lifestyle and usual-care participants. Glycated hemoglobin was reduced among all groups (P<.05) but was not different between groups. CONCLUSIONS: Improvement in both weight and glycemia was attainable by lifestyle interventions designed for persons who had type 2 diabetes and lived in rural communities.