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Heart-Healthy Lenoir Lifestyle Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01433484
Recruitment Status : Completed
First Posted : September 14, 2011
Last Update Posted : November 20, 2017
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
University of North Carolina, Chapel Hill

Brief Summary:
This study aims to reduce cardiovascular disease (CVD) risk and disparities in risk by improving lifestyle factors which underlie the development of CVD. The first steps will involve conducting a comprehensive formative evaluation to assess individual, interpersonal, organizational, community, and policy factors relevant to CVD risk and risk reduction in Lenoir County. This will be followed by a community-based lifestyle intervention program designed to improve eating patterns, promote physical activity, and for those who are interested, support weight loss. A randomized trial comparing the effectiveness of two community based weight maintenance interventions will also be conducted. Community-wide policy and environmental change interventions will also be implemented to support the individual-level interventions, including partnerships with businesses to promote a healthy environment through innovative economic opportunities. In addition, this project will explore genetic factors associated with cardiovascular disease risk and treatment success.

Condition or disease Intervention/treatment Phase
Cardiovascular Disease Obesity Behavioral: Maintenance of Weight Loss--Control Behavioral: Maintenance of Weight Loss--Experimental Not Applicable

Detailed Description:

The lifestyle intervention will enroll 350 participants. The initial lifestyle component of this study, which lasts for 4-6 months, will be provided to all participants. Participants may chose from one of two intervention formats, each with 4 contacts: individual counseling with at least one face-to-face visit and the rest face-to-face or by phone or 4 group sessions. The dietary intervention will focus on improving fat and carbohydrate quality. For fat intake, the goals include 2-4 servings per day of polyunsaturated fat primarily from plant sources and minimal intake of trans fat. For carbohydrate intake, the goals include increased intake of whole grains, fruits and vegetables, and beans and reduced consumption of refined carbohydrates. The physical activity intervention will primarily focus on walking with a goal of 7500 to 10,000 steps per day or, for those who do not wish to use a pedometer, 30 minutes of walking a day. Muscle strengthening activities will also be recommended. At the 4-6 month follow-up measures, those who wish to take part in a weight loss study may do so and those who do not will continue in a maintenance of lifestyle intervention.

The investigators anticipate approximately 200 participants will take part in the weight loss component of this study, which consists of a 6 month intensive weight loss intervention. Participants may choose from two intervention formats: 16 weekly group sessions or 5 group sessions and 10 phone counseling sessions. The weight loss goal will be 5% of body weight. At the conclusion of this program, those who lose at least 8 pounds and are willing to take part in a 1 year maintenance of weight loss intervention will be RANDOMIZED to one of two maintenance of weight loss programs. One maintenance arm will receive monthly telephone contacts for one year, while the other arm will receive bi-monthly phone contacts.

Follow-up measures for all participants will be at approximately 6, 12, 18, and 24 months.

Another related part of the project will use a systems approach to develop models integrating clinical and genomic data. Researchers have developed and tested an approach referred to as the SAMARA (Supporting A Multidisciplinary Approach to Research in Atherosclerosis) Project that applies recent, major advances in biomedical and computational sciences at UNC to develop a deeper understanding of human CVD. The Heart-Healthy Lenoir Project will expand studies into the community, using this methodology to: 1) determine the prevalence of genomic risk signatures in high-risk community populations using genome-wide Single Nucleotide Polymorphism (SNP) analysis; 2) develop novel genomic models incorporating high-risk features in this population; and 3) determine whether genomic signatures can be used to predict responsiveness to interventions that underlie CVD disparities. Participants who consent to this component of the project will have a blood specimen obtained at baseline.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 339 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Community-Based Lifestyle Intervention to Reduce CVD Risk & Disparities in Risk
Study Start Date : September 2011
Actual Primary Completion Date : October 2014
Actual Study Completion Date : October 2014

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Maintenance of Weight Loss--Control
The control arm will receive bi-monthly telephone contacts during the one-year maintenance phase.
Behavioral: Maintenance of Weight Loss--Control
As the maintenance of weight loss randomized trial does not begin until a year after the start of this study, the intervention and control conditions are not yet specified. This will occur before randomization and this section will be updated before the first participant is randomized.

Experimental: Maintenance of Weight Loss--Experimental
The experimental arm will receive monthly telephone contacts for one year during the maintenance phase.
Behavioral: Maintenance of Weight Loss--Experimental

Primary Outcome Measures :
  1. Cohort study: fruit and vegetable intake at 6 months [ Time Frame: 6 months ]
    Fruit and vegetable intake will be measured by the Block fruit and vegetable sceener and by blood carotenoids

  2. Embedded randomized trial: maintenance of weight loss [ Time Frame: 1 year after maintenance of weight loss trial begins ]
    Weight will be measured by electronic scale

Secondary Outcome Measures :
  1. Physical activity [ Time Frame: 6m, 12m, 18m, 24 m ]
    Measured by questionnaire and pedometer

  2. Blood pressure [ Time Frame: 6, 12, 18, 24 months ]
    measured by automated device

  3. Blood lipids [ Time Frame: 12, 24 months ]
    total and HDL cholesterol measured by commercial lab

  4. A1c [ Time Frame: 6, 12, 24 months ]
    measured by commercial lab

  5. Fruit and vegetable intake at 6 months [ Time Frame: 12, 18, and 24 months ]
    Measured by Block fruit and vegetable screener

  6. Weight [ Time Frame: 6, 12, 18, 24 ]
    Measured by electronic scale

  7. Health related quality of life [ Time Frame: 6, 12, 24 months ]
    SF-12 instrument

  8. Genomic predictors of lifestyle change [ Time Frame: 6-, 12-, 18- and 24-month follow-up ]
    A systems approach to developing genomic models integrating clinical and genomic data.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  1. 18 years or older
  2. live in Lenoir County or a neighboring county in Eastern North Carolina
  3. anyone enrolled in the Lifestyle study is eligible to participate in the genomics component of the project.

Exclusion Criteria:

  1. non-English speaking
  2. treatment of psychosis
  3. alcohol or substance abuse within the two last years
  4. history of malignancy, other than non-melanoma skin cancer, unless surgically cured > 5 years ago or in remission/well treated and not likely to have a negative effect on the patient's health over the next 2 years
  5. estimated creatinine clearance less than 30 ml/min
  6. lack of access to phone
  7. advanced dementia
  8. participants who have been diagnosed with a myocardial infarction within the past three months will be excluded from the study if they are unable to obtain written medical clearance from their clinician to participate in the study

Additional Exclusion Criteria - Weight Loss Intervention:

  1. the investigators will not invite pregnant women to take part in the weight loss study.
  2. if a woman becomes pregnant while taking part in this part of the study, we will withdraw her from the weight loss study and invite her to continue in the lifestyle study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01433484

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United States, North Carolina
Heart Healthy Lenoir Project, Kinston Enterprise Center
Kinston, North Carolina, United States, 28501
Sponsors and Collaborators
University of North Carolina, Chapel Hill
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
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Principal Investigator: Thomas C. Keyserling, MD, MPH UNC-Chapel Hill
Additional Information:
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: University of North Carolina, Chapel Hill Identifier: NCT01433484    
Other Study ID Numbers: 10-0395LS
P50HL105184 ( U.S. NIH Grant/Contract )
First Posted: September 14, 2011    Key Record Dates
Last Update Posted: November 20, 2017
Last Verified: August 2015
Keywords provided by University of North Carolina, Chapel Hill:
cardiovascular disease
coronary heart disease
weight loss
Additional relevant MeSH terms:
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Cardiovascular Diseases