Guide to Health: Nutrition and Physical Activity Outcomes of a Group-Randomized Trial of an Internet-Based Intervention in Churches.

Background: Theory-based interventions accessible to large groups of people are needed to induce favorable shifts in health behaviors and body weight. Purpose: The aim was to assess nutrition; physical activity; and, secondarily, body weight in the tailored, social cognitive Guide to Health (GTH) Internet intervention delivered in churches. Methods: Participants (N �= �1,071; 33% male, 23% African American, 57% with body mass index�≥�25, 60% sedentary, Mdn age �=� 53 years) within 14 Baptist or United Methodist churches were randomized to the GTH intervention only (GTH-Only; 5 churches), with church-based supports (GTH-Plus; 5 churches), or to a waitlist (control; 4 churches). Verified pedometer step counts, measured body weight, fat, fiber, and fruit and vegetable (F&V) servings from food frequency and supermarket receipts were collected at pretest, posttest (7 months after pretest), and follow-up (16 months after pretest). Results: Participants in GTH-Only increased F&V at post (≍�1.50 servings) compared to control (≍ �0.50 servings; p� =� .005) and at follow-up (≍�1.20 vs.�≍ �0.50 servings; p m� =� .038) and increased fiber at post (≍�3.00�g) compared to control (≍ �1.5�g; p �=� .006) and follow-up (≍ �3.00�g vs.�≍�2.00�g; p� =� .040). GTH-Plus participants compared to control increased steps at post (≍ �1,500 steps/day vs.�≍�400 steps/day; p �= �.050) and follow-up (≍ 1,000 steps/day vs. ≍ - 50 steps/day; p �= .010), increased F&V at post (≍�1.5 servings; p� = �.007) and follow-up (≍�1.3 servings; p �= �.014), increased fiber at post (≍�3.00 g; p� =� .013), and follow-up (≍�3.00; p� =� .050) and decreased weight at post (≍ - 0.30�kg vs.�≍�+�0.60�kg; p �= �.030). Conclusions: Compared to control, both GTH treatments improved nutrition at posttest, but church supports improved physical activity and nutrition at posttest and follow-up, suggesting environmental supports may improve Internet-based interventions. [ABSTRACT FROM AUTHOR]