Methods
Data Sources
We used the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) for this review. We searched Medline ( and Ovid) and Cochrane databases and DARE (Database of Abstracts of Reviews of Effects) to identify effective interventions in modifying dietary and physical activity behaviors among adult African Americans in the United States, January 2000 through December 2011.
Study Selection
Nineteen studies met our selection criteria, were confirmed by 2 reviewers, and were included in this review (Figure); 1 study reported dietary and physical activity components of the intervention in 2 separate articles, and another reported intervention results in 1 publication and recruitment and retention information in another. We restricted our search to articles published in English from January 1, 2000, through December 31, 2011. Articles were limited to the past 12 years to capture the most recent studies; earlier studies had been included in previous reviews. Research and publishing on the effect of diet and physical activity interventions among minority and underserved populations have increased during the past 12 years in the United States, providing adequate literature for review.
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Figure.
Data-filtering process used to select final 19 studies included in systematic review of interventions for improving nutrition and physical activity behaviors among adult African American populations, January 2000 through December 2011. Flow diagram for study selections adapted from PRISMA.(11) [A text description of this figure is also available.]
Data Extraction
Our initial search used a combination of the following key words: African American, nutrition, diet, physical activity, weight loss, and intervention. The inclusion criteria were 1) that the article addressed educational interventions in diet and physical activity with clinically relevant outcomes (eg, changes in weight, body mass index (BMI [kg/m]), body fat percentage, cholesterol, triglycerides, blood pressure) and 2) that the educational interventions included at least 1 direct or indirect instructional strategy to educate participants on how to increase daily physical activity and fruit and vegetable consumption or how inactivity and poor dietary patterns can negatively affect health. We excluded studies that dealt with nonadult populations or populations with pre-existing catabolic or other complicated disorders (eg, cancer, cirrhosis, HIV/AIDs, heart failure); studies that did not focus on African Americans; studies that provided no quantitative baseline or follow-up data; and studies that included no diet or physical activity education or intervention. Data were extracted by 1 reviewer and verified by a second. Information on the following components were collected: study settings, theoretical principles incorporated into the intervention design, study outcomes, intervention details, recruitment strategies, attendance and retention rates of the participants, sustainability of the achieved changes in health behaviors, and provision of physical activity and nutrition education.