Evidence mapPaperPMID 39770974Full record

Trial reportNutrients2024

Heterogeneity in Health Outcomes in the Strong Hearts, Healthy Communities-2.0 Multilevel Intervention in a Community-Randomized Trial: An Exploratory Study of Moderators.

Chad D Rethorst, Margaret M Demment, Seungyeon Ha, Sara C Folta, Meredith L Graham, Galen D Eldridge, Rebecca A Seguin-Fowler

Erratum issuedAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Nutrients, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Chad D RethorstInstitute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA.ORCID 0000-0002-8168-2829
Margaret M DemmentInstitute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA.
Seungyeon HaStatistical Consultation Center, Texas A&M University, College Station, TX 77843, USA.ORCID 0000-0002-7460-9447
Sara C FoltaFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.ORCID 0000-0002-4366-5622
Meredith L GrahamInstitute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA.ORCID 0000-0001-8989-1417
Galen D EldridgeInstitute for Advancing Health Through Agriculture, Texas A&M University, Dallas, TX 75252, USA.
Rebecca A Seguin-FowlerInstitute for Advancing Health Through Agriculture, Texas A&M University, College Station, TX 77840, USA.ORCID 0000-0002-5115-2341

Funding

NHLBI NIH HHS R01 HL120702U.S. Department of Agriculture, National Institute of Food and Agriculture 1013938
6 · The paper itself

Abstract

BACKGROUND/

objectivesMultilevel interventions have demonstrated efficacy in improving obesity and other related health outcomes. However, heterogeneity in individual responses indicates the need to identify the factors associated with responses and non-responses to multilevel interventions. The objective of this report is to identify the potential sources of heterogeneity through the exploration of the moderation effects of participant characteristics (sociodemographic and baseline physical/mental health) in the Strong Hearts, Healthy Communities-2.0 (SHHC-2.0) intervention.

methodsSHHC-2.0 is a 24-week multilevel intervention to improve people's diet and physical activity evaluated using a cluster-randomized, controlled trial design conducted with women aged 40 and older living in rural communities with an elevated risk of cardiovascular disease, defined as having a BMI > 30, or a BMI 25-30 plus < 1 weekly occurrence of 30 min of physical activity during leisure time. Linear mixed models were used to compare the between-group changes in the outcomes (weight, systolic blood pressure, hemoglobin A1c [HbA1c], and triglycerides), with an interaction term included for each potential moderator.

resultsWithin the sociodemographic characteristics, there were no differences in effectiveness by age, income, or baseline BMI status, however the participants with a high school education or less experienced greater weight loss. Among their health history, only a history of hypertension was associated with differential outcomes; those with a history of hypertension demonstrated a greater reduction in systolic blood pressure. The participants with elevated depressive symptoms demonstrated greater weight loss and a greater reduction in the HbA1c level.

conclusionsSHHC-2.0 was effective across a wide range of participants. The identified moderators (i.e., education level) may inform the future tailoring of the SHHC intervention to optimize the outcomes among participant subgroups, while more broadly, our findings can serve to inform the development and dissemination of multilevel interventions.

Indexed as

ExerciseAdultAgedBlood PressureBody Mass IndexCardiovascular DiseasesFemaleGlycated HemoglobinHealth PromotionHumansMiddle AgedObesityRural PopulationTriglyceridesWeight LossGlycated HemoglobinTriglyceridescardiovascular diseasedietmental healthmoderation analysismultilevel interventionnutritionobesityphysical activity

Identifiers

PMID39770974
PMCPMC11678296

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.