Lessons Learned In a Small Group Program For Limited Income

• Published in: Journal of the American Dietetic Association Vol. 98; no. 9; p. A47
• Main Authors: Golzynski, D.L., Hoerr, S.L.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-1998
• ISSN: 0002-8223; 1878-3570
• DOI: 10.1016/S0002-8223(98)00475-1

Obesity prevalence, dietary risk for chronic disease, and sedentary behavior are highest in those with limited income, but interventions designed for middle income segments have not worked well in limited income settings. For this reason we developed a series of eight lessons based on our experience, the literature, and three focus groups held with the target population. Three trials of this weight management program have provided insights for promotion and recruitment, as well as lesson content. Site scheduling difficulties include conflicts on days that the site is planning to be closed (such as holidays or inservices), conflict with other programs offered at the site, and assuring that those hired for transportation or child care will show. Recruiting of participants must be highly publicized (including fliers, newsletter announcements, and personal letters or telephone calls) and should occur approximately one month in advance, then again one week in advance; a reminder telephone call the evening before, to those who signed up, is helpful. Word of mouth from former participants was the most effective recruitment method. Participants were intimidated by the requirement to keep two-day food and activity records; using food recalls was more accepted. Questionnaires and activities must be adapted specifically for a low-literacy audience. Most participants did not own a cookbook and were delighted to receive a free one. Hunting seasons and inclement weather can also cause a low turnout. Program leaders must be flexible to participant's personal crises and needs. We found that 9:00 a.m. is too early to begin (11:00 a.m. or later was better). Participants required a short break every 40-45
minutes. Providing a free lunch or snack for the participants was important for social development of the group. Each lesson began and ended with a group activity to encourage social support. These insights can help dietitians who are planning to do small group activities with limited income populations.