Puerto Rican Obesity Intervention for Men

N/ANot Yet RecruitingNCT06440551

Medical College of Wisconsin48 enrolled

Overview

The goal of this clinical trial is to address the high rates of overweight/obesity in Puerto Rican (PR) men. The main question it aims to answer is whether virtual culturally relevant classes supporting physical activity and healthy eating for Puerto Rican men at different levels of acculturation to the US culture, will help these men achieve clinically meaningful weight loss. The purpose of this project is to assess whether a virtual intervention tailored for Puerto Rican men that includes information about healthy eating, physical activity, sedentary behavior is feasible and acceptable compared to a general health (GH) intervention. It is also to determine whether this intervention leads to healthier eating, increased physical activity, less sedentary behavior (low activity), and clinically meaningful weight loss. Hypothesis 1: Test the feasibility (recruitment, retention, adherence, fidelity) and acceptability (treatment components, intervention leaders, telehealth modality, technology and equipment, intervention satisfaction, satisfaction with randomized study, and measures) of a randomized 4-month synchronous telehealth lifestyle intervention led by a community health promoter and behavioral health specialist, who will receive either: TeleSalud HE-PA/SB" or TeleSalud GH in 48 PR men. Hypothesis 2: Demonstrate proof -of-concept by achieving a clinically significant weight reduction of ≥ 5% of baseline weight in the TeleSalud HE-PA/SB intervention after 4 months and at the end of the 4-month maintenance compared to the TeleSalud General Health intervention. Researchers will compare this to a group that will receive information about general health topics - not healthy eating or physical activity. * Participants in both groups will meet via virtually for 4 months (twice per week for 3 months and once per week for 1 month). * Participants will then meet one per month for a maintenance session for the next 4 months.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Interventions

TeleSalud Healthy Eating- Physical Activity/Sedentary Behavior (HE-PA/SB)BEHAVIORAL

Participants will meet via telehealth for 4 months (twice a week for 3 months and then once per week for 1 month) for a TeleSalud HE-PA/SB Class, after which they will attend one maintenance meeting per month for 4 months. Weekly, Day 1 (Healthy Eating \& PA-SB Class): Participants will receive a 50-min. healthy eating class. Physical Activity- Sedentary Behavior (PA-SB) Class: By discussing barriers and strategies to overcome barriers, this will help to increase self-efficacy. We will engage in Latino-centered moderate impact (increasing to vigorous) aerobics with Latino or salsa movements and music for 45-50 minutes. Aspects of kickboxing aerobics will be integrated. Goal: Exercise a minimum of 150-250 min./ week of moderate intensity. Weekly, Day 2: PA-SB identical PA-SB to Day 1. Maintenance (Months 5-8): Meetings once/ month for 70 min. for HE/PA-SB class, including 25 min. to discuss diet and PA-SB barriers. Goal: Exercise a minimum of 150-250 min./week.

TeleSalud General Health InterventionBEHAVIORAL

Weekly: Participants will meet via telehealth for 4 months (twice a week for 3 months and then once per week for 1 month) for a TeleSalud General Heath Class, after which they will attend one maintenance meeting per month for 4 months. Participants will meet and discuss general health topics (not diet or PA). Examples of the general health topics are: Back Pain, Muscle Strains, Alcohol Use, Stress \& Coping, Oral and Dental Health, Safety Tips, Emergency Preparedness. The content is relevant to Latinos, and information is focused on Latino men. Maintenance (Months 5-8): Participants will meet via telehealth once/ month for 70 min. to discuss general health topics. To enhance motivation to complete the study and assessments, this group will receive a copy of the TeleSalud HE-PA/SB intervention manual and related materials after the maintenance period ends.

Eligibility

Sex: MALEMin age: 35 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion criteria: 1. Male of Puerto Rican descent over 35 years. 2. BMI ≥25 by anthropometrically measured weight and height. 3. Physically able to exercise (via the EASY tool \[106, 107\]; Appendix 2). If responses to the EASY indicate that medical clearance is needed, then able to receive medical clearance to participate in the study. 4. Has access to secure computer or tablet in a private location with reliable internet connection to support video streaming 5. Ability to understand and speak English. For those without a high-speed internet and private space to exercise, we will work with our community partners to identify a space with access to videoconferencing so they can attend the telehealth class. Exclusion: 1. Does not understand/speak English. 2. Plans to move from the Illinois or Wisconsin area during the study. 3. Currently in a formal weight management program. 4. Current or planned use of weight control or loss medication prescribed by a doctor. 5. Currently exercising \>1 time/week. 6. Unable to attend study times. 7. Serious medical problems or medications that would make protocol compliance difficult or dangerous, e.g., unable to engage in moderate \& eventually vigorous exercise, uncontrolled diabetes (A1C \> 9) or hypertension (systolic \>160 or diastolic \>100), hypoglycemia, heart attack in the past six months, unstable angina, life-threatening arrhythmias, cancer that required treatment in the last 5 years (except non-melanoma skin cancers that have been cured). Patients who have been treated for cancer in the past 5 years may require different diet and PA recommendations than individuals without treatment for cancer in the past 5 years. 8. In the EASY interview, if participant answers yes to the question that indicates they fall or always use an assisted device while walking. 9. Current alcohol abuse (\>35 alcoholic drinks/week); score of yes to \> 2 questions on the CAGE alcohol scale (Appendix 1) \[108\].

Outcomes

Primary Outcomes

Acceptability- Fidelity: Delivery

Delivery will be measured by an adherence checklist. It will monitor consistency and accuracy in the delivery of the intervention.

Time frame: 4 months, 8 months

Acceptability- Fidelity: Receipt

Receipt will be measured by participants' self-reports of understanding and knowledge acquisition of content for both groups.

Time frame: 4 months, 8 months

Acceptability- Fidelity: Enactment

Enactment will be measured by participants' self-report of changes in behavior based on targets of treatment (e.g., Healthy Eating, Physical Activity, and Sedentary Behavior, General Health.)

Time frame: 4 months, 8 months

Acceptability- Helpfulness of Treatment Components

Perceived helpfulness/ effectiveness of various treatment components (12 questions, on a 5- point Likert scale: not at all to extremely effective) will be assessed. The average of the treatment component questions will be used as the overall dependent measure of the acceptability of the treatment components.

Time frame: 4 months, 8 months

Acceptability- Helpfulness/ Effectiveness of the Intervention Leaders

Perceived helpfulness/ effectiveness of the intervention leaders (6 questions, on a 5-point Likert scale: not at alll to extremely helpful) will be assessed. The average of the questions will be used as the overall dependent measures of the acceptability of the intervention leaders.

Time frame: 4 months, 8 months

Acceptability- Intervention Satisfaction

Acceptability- Assessed by an intervention satisfaction questionnaire (14 questions, on a 5- point Likert scale: not at all satisfied to extremely satisfied).

Time frame: 4 months, 8 months

Acceptability- Perceived Helpfulness/ Effectiveness of the Telehealth Modality, Technology, and Equipment

Perceived helpfulness/ effectiveness of the telehealth modality, technology and equipment (3 questions, on 5-point Likert scale: not at all to extremely effective) will be assessed. The average of the telehealth components questions will be used as the overall dependent measure of the acceptability of the telehealth components.

Time frame: Baseline, 4 months, 8 months

Acceptability- Satisfaction with Random Assignment to Groups

Acceptability- Assessed by a questionnaire assessing satisfaction with being in a study with random assignment to groups (14 questions, on a 5-point Likert scale: not at all satisfied to extremely satisfied).

Time frame: Baseline, 4 months, 8 months

Dietary Intake: Number of Servings of Fruits

Changes in number of servings of fruits will be measured by the Automated Self-Administered 24- Hour (ASA24) Dietary Assessment Tool.

Time frame: Baseline, 4 months, 8 months

Dietary Intake: Number of Servings of Vegetables

Change in number of servings of vegetables will be measured by the Automated Self-Administered 24- Hour (ASA24) Dietary Assessment Tool.

Time frame: Baseline, 4 months, 8 months

Dietary Intake: Percent of Calories from Saturated Fat

Changes in percent of calories from saturated fat will be measured by the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool.

Time frame: Baseline, 4 months, 8 months

Dietary Intake: Total Energy Intake

Changes in total energy intake will be measured by the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool.

Time frame: Baseline, 4 months, 8 months

Feasibility- Adherence- Monthly Attendance

Feasibility- Adherence- Monthly: Will be measured by the frequency of attendance at each session on a monthly basis.

Time frame: 4 months, 8 months

Feasibility- Adherence- Number of Make-Up Sessions

Feasibility- Adherence- Number of Make-Up Sessions: Will be assessed by frequency/counts of number of make-up sessions.

Time frame: 4 months, 8 months

Feasibility- Adherence- Number of Missed Sessions Overall

Feasibility- Adherence- Number of Missed Sessions Overall: Will be assessed by frequency/ counts of the number of missed sessions overall (no make-up sessions).

Time frame: 4 months, 8 months

Feasibility- Adherence- Weekly Attendance

Feasibility- Adherence- Weekly Attendance: Will be measured by the frequency of attendance at each session on a weekly basis.

Time frame: 4 months, 8 months

Feasibility- Recruitment- Number Enrolled

Recruitment feasibility assessed by the number of participants enrolled.

Time frame: Pre-Intervention

Feasibility- Recruitment- Number of Contacts

Recruitment feasibility assessed by counts of the number of contacts.

Time frame: Pre-Intervention

Feasibility- Recruitment- Rate of Consenting

Recruitment feasibility assessed by the rate of consenting.

Time frame: Pre-Intervention

Feasibility- Recruitment- Rate of Enrollment

Recruitment feasibility assessed by the rate of enrollment.

Time frame: Pre-Intervention

Feasibility- Recruitment- Rate of Screening

Recruitment feasibility assessed by the rate of screening.

Time frame: Pre-Intervention

Feasibility- Recruitment- Recruitment Method

Feasibility assessed by tracking the method of recruitment.

Time frame: Pre-Intervention

Feasibility- Recruitment- Response Rate

Recruitment feasibility assessed by rate of response.

Time frame: Pre-Intervention

Feasibility- Recruitment- Type of Contact

Recruitment feasibility assessed by tracking the type of contact.

Time frame: Pre-Intervention

Feasibility- Retention- Number Completed the intervention

Retention assessed by counts and frequency of the number who completed the interventions.

Time frame: 4 months, 8 months

Feasibility- Recruitment- Number Screened

Recruitment feasibility assessed by the count of number of individuals screened.

Time frame: Pre-Intervention

Feasibility- Retention- Number of Classes Attended

Retention- assessed by counts of the number of classes attended.

Time frame: 4 months, 8 months

Feasibility- Retention- Percent Completed the Interventions

Retention assessed by the percent of participants who completed the interventions.

Time frame: 4 months, 8 months

Feasibility- Retention- Percent of Classes Attended

Retention assessed by percent of classes attended.

Time frame: 4 months, 8 months

Feasibility- Recruitment- Number Consented

Recruitment feasibility assessed by the number of participants who consented.

Time frame: Pre-Intervention

Objective Physical Activity (Accelerometer)

A triaxial wrist accelerometer (ActiGraph wGT3XBT) will measure objective physical activity. They will used the accelerometer during waking hours for 7 days on their non-dominant wrist.

Time frame: Baseline, 4 months, 8 months

Subjective Physical Activity (International Physical Activity Questionnaire)

The International Physical Activity Questionnaire long form- will measure sedentary and leisure and non-leisure time physical activity.

Time frame: Baseline, 4 months, 8 months

Subjective Sedentary Behavior (International Physical Activity Questionnaire)

The International Physical Activity Questionnaire long form- will measure sedentary and leisure and non-leisure time physical activity.

Time frame: Baseline, 4 months, 8 months

Secondary Outcomes

Body Mass Index

Body Mass Index (BMI) will be assessed by objectively measured height and weight.

Time frame: Baseline, 4 months, 8 months

Outcome Expectations for Diet Questionnaire

Outcome expectations will be assessed by the Outcome Expectations for Diet Questionnaire. This measure will be used to assess the various components of Social Cognitive Theory which are guiding the TeleSalud HE-PA/SB intervention.

Time frame: Baseline, 4 months, 8 months

Exercise Outcomes on the Outcomes Expectations Questionnaire

Outcome expectations for Exercise will be assessed by the Exercise Outcomes on the Outcomes Expectations Questionnaire. This measure will be used to assess the various components of Social Cognitive Theory which are guiding the TeleSalud HE-PA/SB intervention.

Time frame: Baseline, 4 months, 8 months

Self-Efficacy for Dietary Behaviors

Self-efficacy will be assessed by the Self-Efficacy for Dietary Behaviors. This measure will be used to assess the various components of Social Cognitive Theory which are guiding the TeleSalud HE-PA/SB intervention.

Time frame: Baseline, 4 months, 8 months

Exercise Confidence Survey

Self-efficacy will be assessed by the Exercise Confidence Survey. This measure will be used to assess the various components of Social Cognitive Theory which are guiding the TeleSalud HE-PA/SB intervention.

Time frame: Baseline, 4 months, 8 months

Social Support and Eating Habits Survey

Social Support will be assessed by the Social Support and Exercise Survey and the Social Support and Eating Habits Survey. These measures will be used to assess the various components of Social Cognitive Theory which are guiding the TeleSalud HE-PA/SB intervention.

Time frame: Baseline, 4 months, 8 months

Social Support and Exercise Survey

Puerto Rican Obesity Intervention for Men

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts