The Use of Culturally-Relevant Recruitment Strategies in the Families

Improving Together (FIT) for Weight Loss Randomized Controlled Trial

Lauren E. Huffman, B.S.

Dawn K. Wilson, Ph.D.

E. Rebekah Siceloff, Ph.D.

Kassandra A. Alia, M.A.

University of South CarolinaDepartment of Psychology

Grant NICHD R01 HD072153

Obesity in the United States: Adolescents and Adults

CDC/NHIS, 2008

Overweight and Obesity by Child Age

1971

-74

1976

-80

1988

-94

1999

-00

2001

-03

2003

-04

2005

-06

0

4

8

12

16

20

2-5 yrs6-11 yrs12-17 yrs

Child Age

Per

cent

Overweight and Obesity by Adult Age

1971

-74

1976

-80

1988

-94

1999

-00

2001

-03

2003

-04

2005

-06

25

35

45

55

65

75

18-29 yrs30-44 yrs45-64 yrs

Adult Age

65-74 yrs

Per

cent

Figure 1.

Project FIT

• Parenting and motivational approach for weight loss in African American families• Target parent communication, autonomy-support , problem solving,

monitoring of youth

• 16-week Intervention• 8 weekly face-to-face group meetings• 8 week online program

• Specific calorie goals• 200 – 300 calorie reduction in energy intake• 100 – 200 calorie energy expenditure • Promote gradual weight loss

FIT Study DesignRandomization

#2 (Online

Program)

Randomization #1

(Group Face-to-Face Sessions)

Run-In Period

2 Week Orientation

Intervention Group

Online Intervention

Online Control

Control Group

Online Intervention

Online Control

Barriers to Participation in Health Promotion Trials

• Competing demands (time, financial, priorities)

• Perceived benefit of participating in research programs may not be clear

• Lack of cultural perspective

Resnicow, Braithwaite, Ahluwalia, & Dilorio (2001)

Culturally-Relevant Recruitment Strategies

• Surface-Level Strategies– Peripheral– Evidential– Constituent-involving

• Deep Structure/Sociocultural Strategies

Kreuter, Lukwago, Bucholtz, Clark, & Sanders-Thompson (2003)Resnicow, Baranowski, Ahluwalia, & Braithwaite (1999)

• Surface-Level Strategies– Flyers and brochures– Local events and festivals that

cater to a broad population

• Deep Structure Strategies– Healthcare partnerships– Church partnerships– Sociocultural events– Culturally-relevant ads

Applying these Recruitment Strategies to Project FIT

Methods: Coding

• Surface-Level Strategies– General community events– School referrals– Word of mouth– Other (included calls from flyers)

• Deep Structure Strategies– Community partnerships– Culturally-relevant ads– Sociocultural community events

Study Sample Characteristics

Characteristics of Adolescent Sample

Sex

Female (%) 95 (69.3)

Male (%) 42 (30.7)

Age

Mean (SD) 13.7 (1.7)

BMI

Mean (SD) 32.0 (6.0)

< 10k 10-24k 25-39k 40-54k 55-69k 70-84k >85k0

5

10

15

20

25

30

Annual Income

Perc

enta

ge o

f Fa

mil

ies

Annual Family Income

Percentage of Participants Based on Recruitment Strategy

Comm

unity

even

ts

Schoo

ls

Wor

d of m

outh

Other

Partn

ersh

ips

Cultu

rally

-Rele

vant

Ads

Socio

cultu

ral e

vent

s0%

5%

10%

15%

20%

25%

30%

35%

40%

Comparison of Demographic and Psychosocial Variables Across Groups

Child-Level Variables by Retention Status

Lost to Run-in Retained

Count (%)

Female 41 (77.4) 54 (64.3)

Male 12 (22.6) 30 (35.7)

Total 53 (38.7) 84 (61.3)

Mean (SD)

BMI 33.4 (7.7) 31.2 (6.2)

Age* 14.0 (1.7) 13.4 (1.7)

Self Efficacy for PA 3.4 (0.7) 3.5 (0.7)

Self Efficacy for Diet 3.2 (0.8) 3.2 (0.9)

Note. Baseline data for self-efficacy variables available for a portion of the total sample (n=88); PA=physical activity.*p = 0.05

Comparison of Demographic and Psychosocial Variables Across GroupsFamily-Level Variables by Retention Status

Lost to Run-in Retained

Yearly Family Income

< $10,000 12.5% 13.1%

$10,000-24,000 37.5% 22.6%

$25,000-39,000 12.5% 26.2%

$40,000-54,000 0.0% 10.7%

≥$55,000 37.5% 27.4%

Parent Education

9 to 11 Years 0.0% 3.6%

12 Years 25.0% 14.5%

Some College 37.5% 37.3%

4 Year College 12.5% 21.7%

Professional Degree 25.0% 22.9%

Note. Baseline data for income and education variables available for a portion of the total sample (n=88).

Summary• Using culturally-appropriate strategies can

address potential barriers to including minority populations in health research.

• Community partnerships and culturally relevant ads are effective recruitment strategies for reaching this population.

• Adolescent age may be a factor of influence in retention of families

Acknowledgements

• Principal Investigator– Dawn K. Wilson, Ph.D.

• Co-Investigators – Ken Resnicow, Ph.D.– Heather Kitzman-Ulrich,

Ph.D.– M. Lee Van Horn, Ph.D.– Ron Prinz, Ph.D. – Sara St. George, M.A.

• Staff and Graduate Assistants- Kassandra Alia, M.A.- Madison Hilliard- Franklin Jones- Carlyn Joseph- Tyler McDaniel, M.A.- Kaya Outen- E. Rebekah Siceloff, Ph.D.