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Evaluating Individual-Level Programs

Interventions focused on individual behavioral change may provide education, training, and services to individuals. Examples of rural obesity interventions that have been evaluated to assess individual behavioral change are provided.

Program: Martinsville-Henry County Coalition for Health and Wellness and Activate
Summary: Eight Coalition and Activate programs used community coalitions to create healthier environments, disseminate health promotion programs, and improve access to healthcare. The evaluation assessed program reach and effectiveness in achieving knowledge and behavior change among participants in the initiative.

  • Evaluation goal: Assess program reach and effectiveness in achieving knowledge and behavior change among program participants
  • Target population: Participants are primarily underserved and uninsured Martinsville-Henry County residents
  • Design: Non-experimental
  • Evaluation methods: Key informant interviews and pre- and post-test surveys to measure knowledge and behavior change among participants; analysis of changes in access to healthcare services by examining enrollment and referral trends over time
  • Evaluation findings: The evaluation identified individual-level health benefits
  • Source: Transformation of a rural community for active living
    Smith, M.L., Bazzarre, T.L., Frisco, J., Jackman, B.A., & Ory, M.G.
    Family & Community Health 2011; 34(2): 163-72

Program: The Treatment of Obesity in Underserved Rural Settings, Randomized trial, north-central Florida
Summary: Between 2003 and 2007, a trial was conducted to demonstrate the effectiveness of extended care programs that include face-to-face or telephone follow-up sessions to help participants maintain weight loss in rural communities. Participants completed an initial lifestyle program focused on weight-loss, and then were randomized to participate in an extended care component (telephone or face-to-face counseling) or an education control group. Participants completed a six-month and 18-month assessment.

  • Evaluation goal: Assess effectiveness of extended-care programs designed to improve maintenance of lost weight
  • Target population: 234 obese women, ages 50-75 years, from medically underserved rural areas in north-central Florida
  • Design: Experimental
  • Evaluation methods: Participants were stratified by county and Body Mass Index (BMI) and randomly assigned to participate in telephone or face-to-face counseling or an education control group; weight loss was measured at the initial phase (0 to 6 months) and the extended care phase (6 to 18 months)
  • Evaluation findings: Extended care delivered either by telephone or in face-to-face sessions improved maintenance of lost weight one year after randomization compared with education alone
  • Source: Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial
    Perri, M.G., Limacher, M.C., Durning, P.E., Janicke, D.M., Lutes, L.D., Bobroff, L.B., Dale, M.S., Daniels, M.J., Radcliff, T.A., & Martin, A.D.
    Archives of Internal Medicine 2008; 168(21): 2347-54