Table 1: Behavioral lifestyle interventions reporting weight maintenance outcomes for african american women (1990–2011) ( ).

Author and year of publicationQuality ranking scoreStudy design, setting, and length of trialParticipant characteristics††Maintenance phase characteristicsFrequency, delivery, and dose (time), of maintenance componentsMean baseline weight (kg) (±SD/SE) Weight change following intensive intervention phase
mean (±SD/SE) weight (kg)
Weight change (kg) from baseline during maintenance phase follow-up (SD/SE)Adherence to maintenance sessions/components
retention (%)

Kumanyika et al. (2002)‡‡ [44] Trials of Nonpharmacologic Intervention in the Elderly (TONE) 11Design: 
RCT 

Setting: 
Academic Medical Centers 

 Length of Trial: 
Up to 34 month
(all overweight participants randomized to a weight loss treatment arm) 

Weight loss/Sodium
AAW: 21 
CW: 43 

Weight loss
AAW: 25 
CW: 50 

Mean Age (y): 
AAW: 65.5 (±4.8)
CW: 65.8 (±4.5) 

Income: NDR 

Education: 
College graduate: 
AAW: 25.6%
CW: 41.8%  
Health status: 
Hypertensive
BMI > 27.8 kg/m2
Formal Theoretical Framework: 
SCT 

Cultural Adaptations: 
Yes, attention to cultural diversity, staff training, and printed materials 

Duration of maintenance phase: 
7–28 months (varied by participant) 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Didactic nutrition
PA (self) 
Behavioral Modification Strategies
(i) Self-monitoring of food intake, food-related behaviors, and PA
(ii) Goal-setting Problem solving
Relapse prevention [55]
Frequency, Delivery, and Dose: 
Months 7-8
Biweekly group or individual session
Dose: 60 min
(4 sessions total) 

Months 9+
Monthly group or
individual sessions Dose: 60 min (up to 17 sessions) 

Monthly phone or mail-based contact (up to 17 contacts) [55]
Weight loss/Sodium
AAW: 84.0 (±6.9) kg
CW: 82.7 (±9.7) kg 

Weight loss
AAW: 82.9 (±9.3) kg
CW: 82.3 (±9.0) kg

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Weight loss/Sodium
AAW: −3.9 (±3.6) kg
CW: −3.9 (±3.9) kg 

Weight loss
AAW: −3.3 (±2.8) kg 
CW: −5.8 (±3.5) kg
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
12 month Fu
Weight loss/Sodium
AAW: −4.0 kg
CW: −3.7 kg 

Weight loss
AAW: −3.9 kg
CW: −5.9 

18 month Fu
Weight loss/Sodium
AAW: −3.6 kg
CW: −3.3 kg 

Weight loss
AAW: −3.8 kg
CW: −5.0 kg 

Proxy for end of trial (24 month Fu) Weight loss/Sodium
AAW: −2.6 kg
CW: −2.7 kg 

Weight loss
AAW: −3.5 kg
CW: −4.6 kg
Adherence to maintenance sessions/components: NDR 

Retention: 
Weight loss/Sodium
AAW: 62% 
CW: 88% 

Weight loss
AAW: 48% 
CW: 66%

Kumanyika et al. (2005)
[3]
Healthy Eating and Lifestyle Program (HELP)


























11
































Design: 
RCT

Setting: 
Academic Medical Center

Length of Trial: 
15 or 21 months (cohort dependent)



















AAW:
( AAW Phase 2 completers)

Group HELP maintenance
AAW:
Mean Age (y): 
47.4 (±11.1) 
Education: 
>HS = 80%

Self-HELPmaintenance
AAW:
Mean Age (y): 
46.2 (±8.6) 
Education: 
>HS = 61% 

Clinic only
AAW:
Mean Age (y): 
46.1 (±10.1) 
Education: 
>HS = 67% 

Income: 
NDR 

Health status: 
BMI 30–50 kg/m2
Medically cleared 
Formal Theoretical Framework: 
SCT

Cultural Adaptations: 
Yes, study logo; 
adapted materials specific to AA; 
inclusion of AA interventionist

Duration of maintenance phase: 
18 months (cohorts 1 and 2)
12 months (cohorts 3 and 4)  

Criteria for entry into WL Maintenance Phase: 
Attended postphase 1 data collection 

Components Targeted at WL Maintenance: 
Didactic Nutrition
PA (self and occasional S weekend group walks) 
Behavioral Modification Strategies 
(i) Self-monitoring of food intake and PA 
(ii) Goal-setting 
(iii) Problem solving 
(iv) Relapse prevention 
Frequency, Delivery, and Dose: 
Group HELP maintenance
Months 79
biweekly group class
Dose 60 min
(6 total classes)

Months 10+
once monthly group class
Dose: 60 min (8 classes total for cohorts 1 and 2; 3 classes total for cohorts 3 and 4)
Group walking held occasionally
Individualized nutrition, PA or behavioral consultations upon request
3 clinic visits
(cohorts 1 and 2)
2 clinic visits
(cohorts 3 and 4) Self -HELP
Maintenance

Self-help kit (local restaurant and fitness guide, diaries, pedometer)
1 in-person group meeting 
Teams formed to promote peer support
Once monthly call
Group walking held occasionally
3 clinic visits (cohorts 1 and 2)
2 clinic visits (cohorts 3 and 4) 

Clinic only
3 clinic visits (cohorts 1 and 2) 
2 clinic visits (cohorts 3 and 4)
100.8 (±15.9) kg
































Group HELP maintenance 
−1.6 kg
(±3.3) kg

Self-HELP maintenance
−2.0 (±4.1) kg

Clinic only
−1.6 (±3.7) kg 






















12 month Fu
NDR

End of Trial (12 or 18 month Fu depending on cohort)
Group HELP maintenance
−0.8 (±4.4) kg

Self-HELP maintenance
−1.3 (±5.5) kg

Clinic only
−1.4 (±5.7) kg
















Adherence to maintenance sessions/components:

Group HELP
Mean attendance 40% at biweekly classes
Mean attendance 31% at monthly classes

Self-HELP
35–55% of participants were successfully reached for the monthly phone-based contact

  Retention: 
66%
(all treatments)

  












Svetkey et al. (2008)‡‡ [56]
Weight Loss Maintenance Trial (WLM) 
Post-intervention weight change crudely calculated from data presented in the manuscript 


















  


11
Design: 
RCT 

Setting: 
Academic Medical Centers 

Length of Trial: 
36 months

(Randomized to phase II) 

Self-directed maintenance
AAW: 90
CW: 131
Technology maintenance
AAW: 90
CW: 130 

Personal contact maintenance
AAW: 87
CW: 126 

Mean Age (y): 
AAW: 53 (±9.0)
CW: 57 (±9.0) [8]
Income: 
AAW: 
42% $60,000/y
CW: 
71% $60,000/y [8] 

Education: 
College degree or higher:
AAW: 56%
CW: 72% [8]
Health status: 
BMI 25–45 kg/m2
Hypertensive and/or dyslipidemic
Formal Theoretical Framework: SCT 

Cultural Adaptations: 
Yes, Minority Implementation committee, AA cultural-training for all interventionists, cultural sensitivity training, development of specific strategies for enhancing intervention effectiveness for AA [57] 

Duration of maintenance phase: 
30 months 

Criteria for entry into WL Maintenance Phase: 
4 kg loss during IWL phase 

Components Targeted at WL Maintenance: 
Continue calorie control/DASH diet pattern
Didactic Nutrition
PA (self, goal: 225 min/wk)
Behavioral Modification Strategies
(i) Self-monitoring, food intake, weight, and PA
(ii) Problem-solving
(iii) Goal-setting Relapse prevention
MI
Frequency Delivery, and Dose: 
Self-directed maintenance
One individual in-person session and printed materials 

Technology maintenance
Unlimited access to an interactive web-site 
Dose: encouraged to log on at least once per week 

Personal contact maintenance
Once monthly individual in-person or phone-based sessions
Dose: 5–15 minutes and every 4th month 45–60 minutes
(30 sessions total)
AAW: 94.8 (±15.2) kg
CW: 89.5 (±15.2) kg
AAW: −7.1 kg
CW: −8.0 kg
12 month Fu
NDR 

18 month Fu
NDR 

End of Trial (36 month Fu) Self-directed
(based on adjusted values)
AAW: −1.8 
(se = 0.6) kg
CW: −2.2 
(se = 0.6) kg 

Technology
(based on adjusted values)
AAW: −1.3 
(se = 0.6) kg
CW: −3.0 
(se = 0.6) kg 

Personal contact
(based on adjusted values)
AAW: −2.2 
(se = 0.6) kg
CW: −3.9 
(se = 0.6) kg 


Adherence to maintenance sessions/components: 

Self-directed maintenance
NA 

Technology maintenance
77% logged on at least 1/week 

Personal contact maintenance
91% of attendance at offered sessions 

Self-report frequency weighing/week
AAW: 3.0 (0.1)
CW: 2.6 (0.1) 

Retention: 
Self-directed maintenance
94% (all participants) 

Technology maintenance
93% (all participants) 

Personal contact maintenance
94% (all participants)   

West et al. (2008) [11]
Diabetes Prevention Program (DPP)  
Data reported for the IL arm only
11Design: 
RCT 

Setting: 
Academic Medical Centers 

Length of Trial: 
36 months


IL intervention arm
AAW: 120 
CW: 381 

Age (y): 
AAW: 77.4% > 40 y
CW: 75.6% > 40 y 

Income: 
NDR 

Education: 
NDR 

Health status: 
Impaired glucose tolerance
Formal Theoretical Framework: 
SCT 

Cultural Adaptations: 
Yes, case managers of same ethnic group, print materials tailored for ethnic group, literacy adaptations 

Duration of Maintenance phase: 
24 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Continued adherence to Fat and Calorie Control
Didactic Nutrition
PA (S and self: goal, 150 min/wk)
Behavioral Modification Strategies
(i) Self-monitoring food intake and PA
(ii) Goal-setting
Individual “Tool-box”
Frequency, Delivery, and Dose: 
At least one bimonthly individual, in-person session
Dose: 15–45 minutes 

Contacted at least once by phone in between sessions (However, coaches could meet with individuals as often as needed) 

Group-based courses (3/year) 

Maintenance campaigns to promote adherence (3-4/year) [59]
AAW: 82.0 (±14.8) kg
CW: 95.1 (±21.2) kg
AAW: −4.7 (±5.1) kg 
CW: −7.5 (±5.6) kg
12 month Fu
AAW: 
−4.4 ± 6.0 kg 
CW: −7.8 ± 7.4 kg 

18 month Fu
AAW: −3.9 ± 6.1 kg
CW: −6.6 ± 8.2 kg 

End of maintenance phase (36 month Fu)
AAW: −2.1 ± 6.3 kg 
CW: −4.2 ± 7.5
Adherence to maintenance sessions/components: 
Mean 50.3 (±21.8) sessions (all IL participants)
[58] 

Retention: 
AAW: 64%
CW: 69%

Kumanyika et al. (2009)
[50]
Supporting Healthy Activity and Eating Right Everyday study (SHARE)
11Design: 
RCT 

Setting: 
Academic Medical Center 

Length of Trial:
24 Months
Family High Support
AAW:
Mean Age (y): 
47.3 (±7.3) 
Income: NDR
Education: 
>HS = 86% 

Family Low Support
AAW:
Mean Age (y): 
50.2 (±8.2) 
Income: NDR
Education: 
>HS = 77% 

Individual High Support
AAW:
Mean Age (y): 
48.2 (±7.7) 
Income: NDR
Education: 
>HS = 83% 

Individual Low Support
AAW: 

Mean Age (y):
46.8 (±6.6)
Income: NDR
Education:
>HS = 71% 

Health status: 
Healthy or medically cleared
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
Yes, AA program counselors, culturally-based content, community-based field trips 

Duration of maintenance phase: 
18 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Calorie control
Didactic Nutrition
PA (S and self, goal 180 min/wk)
Behavioral Modification
Strategies

(i) Self-monitoring PA
(ii) Problem solving
Frequency, Delivery, and Dose: 
Months 712
Biweekly groups sessions
Dose: 90 minutes
2-3 in-person individual sessions
Dose: 45–60 minutes
(14-15 session total) 

Months 1324
Once monthly group sessions
Dose: 90 minutes
Three in-person individual sessions
Dose: 45–60 (15 sessions total) 

Quarterly newsletter (6 newsletters)
Family High Support
103.1 (±11.3) kg 

Family Low Support
106.5 (±16.3) kg 

Individual High Support
102.9 (±21.2) kg 

Individual Low Support
97.3 (±16.1)
Family High Support
−5.1 (±4.4) kg 

Family Low Support
−5.0 (±4.8) kg 

Individual High Support
−3.8 (±5.4) kg 

Individual Low Support
−3.4 (±4.1)
12 month Fu
Family High Support
−5.9 (±5.2) kg

Family Low Support
−6.4 (±6.5) kg 

Individual High Support
−4.4 (±5.6) kg 

Individual Low Support
−2.1 (±3.7) kg 

18 month Fu
Family High Support
−4.8 (±6.7) kg 

Family Low Support
−5.1 (±6.3) kg 

Individual High Support
−3.6 (±7.0) kg 

Individual Low Support
−3.0 (±3.6) kg 

End of Trial (24 month Fu)
Family High Support
−3.0 (±6.1) kg 

Family Low Support
−3.1 (±6.6) kg 

Individual High Support
−1.1 (±7.23) kg 

Individual Low Support
−3.2 (±6.4) kg
Adherence to maintenance sessions/components: 

Months 7–12
Group
Sessions
Median 0–4 sessions attended across treatments 

Individual sessions Median 0-1 session across treatments 

Months 13–24
Group sessions
Median 0 sessions attended across treatments 

Individual sessions Median 0 sessions attended across treatments 

Retention: 
Family High Support
66% 

Family Low Support
68% 

Individual High Support
69% 

Individual Low Support
55%

Fitzgibbon et al. (2010)
[60]
11Design: 
RCT 

Setting: 
University 

Length of Trial: 
18 months

I: 107 AAW
C: 106 AAW 

Mean Age (y): 
I: 46.4 (±8.4)
C: 45.5 (±8.4) 

Median Income: 
$42,500/y 

Education (y): 
I: 14.6 (±2.0)
C: 15.1 (±1.9) 

Health status: 
BMI 30–50 kg/m2
Healthy or medically cleared
(Disease prevalence: NDR) 



Formal Theoretical Framework: 
SCT 

Cultural Adaptations: 
Yes, attention to food and activity cultural preferences, AA peer mentors, religion and spirituality intertwined into messaging.

Duration of maintenance phase: 
12 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
General calorie fat control, increased fiber, FV
Frequency, Delivery, and Dose: 
Months 7–12
Twice weekly group S 
PA 
Dose: 60 minutes 

Once weekly didactic session (took place prior to one of the S PA sessions)
Dose: 30 minutes
(48 sessions total) 

Once monthly MI session
Dose: 20–30 minutes
(6 sessions total)
I: 104.3 (±15.6) kg

C: 105.8 (±17.8) kg



















I: −3.0 (±4.9) kg

C: +0.2 (±3.7) kg
12 month Fu
NDR 

End of maintenance
(18 month Fu)
I: −2.3 (±7.4) kg 
C: +0.5 (±4.7) kg
Adherence to maintenance sessions/components: 
Percentage of maintenance classes attended = 27% 

30% of participants attended at least half of the offered maintenance classes 

Retention: 
I: 87%
C: 92%

Martin et al. (2008)‡‡ [61]10Design: 
RCT 

Setting: 
Community Clinic 

Length of Trial: 
18 months
I: 68 AAW 
C: 69 AAW 

Mean Age (y): 
I: 40.8 (±12.7) 
C: 42.6 (±11.4) 

Income: 
<$16,000/y 
Education: 
Graduated HS 
I: 83% 
C: 74% 

Health status: 
Healthy and medically cleared 
(Disease prevalence: NDR)
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
Yes, menus and recipes books 
Duration of maintenance phase: 
12 months  

Criteria for entry into WL Maintenance Phase: 
None  

Components Targeted at WL Maintenance: 
Self-directed 
Frequency, Delivery, and Dose: 
Three clinic visits for follow-up assessments by research staff 
(I and C) 
Dose: NDR 
I: 101.2 (±20.6) kg 
C: 103.4 (±18.0) kg
I: −1.4 kg
C: +0.3 kg
12 month Fu
I: −1.4 (±3.7) kg 
C: −0.3 (±3.6) kg 

End of Trial (18 month Fu)
I: −0.5 (±3.3) kg 
C: +0.1 (±3.8) kg  
Adherence to maintenance sessions/components: 
NDR 

Retention: 
63% (I and C)  

Djuric et al. (2009)
[62]
Weight change at end of trial crudely calculated from data presented in the manuscript 

















10




























Design: 
RCT, pilot 

Setting: 
University 

Length of Trial: 
18 months 




















I (spirituality and dietary counseling maintenance): 
12 AAW 
C (dietary counseling only maintenance): 
12 AAW 

Mean Age (y): 
I: 55.0 
C: 56.0 

Income: 
I: <$30,000/year = 25% 
C: <$30,000/year = 25% 

Education: 
I: College graduate: 67% 
C: College graduate: 50% 

 Health status: 
Breast cancer survivors 
BMI 30–45 kg/m2
Formal Theoretical Framework: 
SCT 

Cultural Adaptations: 
Yes, spirituality 

Duration of maintenance phase: 
12 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Calorie/Portion and Fat Control
Didactic Nutrition
PA (self, goal 150 min/wk)
Behavioral Modification Strategies
(i) Self-monitoring of food intake and activity
Spirituality counseling 
(I only) 

Frequency, Delivery, and Dose: 
I  (spirituality and dietary counseling maintenance)
Months 7–18
Dietary counseling,
1 individual in-person session at month 12, otherwise once monthly phone based sessions
Dose: NDR
(12 sessions total) 

Months 7–9
Spirituality counseling
Once weekly individual phone-based sessions
(up to 12 sessions) ߙ
Months 10–12 biweekly individual phone-based sessions
(up to 6 sessions) 

Months 13–18
Once monthly individual phone-based sessions 
(up to 6 sessions) 
Dose: 17–45 minutes/call 

C (dietary counseling only maintenance) 
Months 7–18
Dietary Counseling,
one individual in-person session at month 12, otherwise once monthly phone based sessions 
Dose: NDR 
(up to 12 sessions) 

I and C:
Months 718 once monthly mailed newsletter
(12 newsletters)
I: 93.8 (±11.3) kg 
C: 94.9 (±14.8) kg 
  
























I: −1.0 (±6.5) kg 
C: −2.6 (±5.1) kg
12 month Fu
NDR 

End of Trial (18 month Fu)
I: −0.7 kg 
C: −2.2 kg
Adherence to maintenance sessions/components: 
I  (spirituality and dietary counseling maintenance)
Spirituality counseling calls ranged from 2–26 completed per participant 

Retention: 
92% (all participants)

Kumanyika et al. (1991)
[13]
Hypertension Prevention Trial (HPT)
9Design: 
RCT 

Setting: 
Academic Medical Centers 

Length of Trial: 
36 months

(weight loss tx arms only) 
AAW: 28 
CW:43 

Age (y): 
25–49 (all participants) 

Income: 
NDR 

Education: 
College graduate: 48% (all participants) 

Health status: 
Healthy, normotensive
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
NDR 

Duration of maintenance phase: 
30 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Didactic Nutrition
Behavioral Modification Strategies 
Frequency Delivery, and Dose: 
Months 736 Bimonthly individual/group sessions 
Dose: NDR 
(15 sessions offered) 

Bimonthly mailed newsletter 
(15 newsletters sent) 
[63]  



AAW: 77.2 (±9.9) kg
CW: 78.0 (±10.9) kg
AAW: −2.6 (±3.9) kg
CW: −4.7 (±4.3) kg
12 month Fu
AAW: −1.4 ± 2.9 kg 
CW: −3.3 ± 5.7 kg 

18 month Fu
AAW: 
−0.03 ± 4.7 kg 
CW: 
−1.7 ± 5.8 kg 

End of Trial (36 month Fu)
AAW: +2.6 ± 4.7 kg 
CW: −1.2 ± 7.2 kg 






Adherence to maintenance sessions/components: 
NDR 

Retention: 
AAW: 93% 
CW: 93%

Kumanyika et al. (1991)
[13]
Trials of Hypertension (TOHP)
9Design: 
RCT 

Setting: 
Academic Medical Centers 

Length of Trial: 
18 months

(weight loss arms only) 
AAW: 33 
CW: 48 

Age (y): 
30–54 (all participants) 

Income: 
NDR 

Education: 
College graduate: 50% (all participants)
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
NDR 

Duration of maintenance phase: 
12 months 

Criteria for entry into WL Maintenance Phase: 
None 
   Components Targeted at WL
Frequency, Delivery, and Dose: 
Varied by participant but could include one or a combination of: 
(a) monthly informal group sessions 
(b) group weigh-in 
(c) individual weigh-in 
(d) individual counseling Dose: NDR [64]
AAW: 79.9 (±10.0) kg 
CW: 79.7 (±10.8) kg
AAW: −1.9 (±3.5) kg 
CW: −4.9 (±4.8) kg
12 month Fu
AAW: −1.1 ± 4.1 kg 
CW: −3.6 ± 5.2 kg 

End of Trial (18 month Fu)
AAW: 
−0.02 ± 4.1 kg 
CW: −2.5 ± 6.3 kg
Adherence to maintenance sessions/components: 
90% participation (including make-up, all participants) 

Retention: 
AAW: 97% 
CW: 100%

Stevens et al. (2001)
[65]
Trial of Hypertension Prevention II (TOHPII)
9Design: 
RCT 

Setting: 
Academic Medical Centers 

Length of Trial: 
36 months
I: 64 AAW 
C: 49 AAW 

Mean Age (y): 
I: 43.4 (±6.1) (all participants) 
C: 43.3 (±6.1) (all participants) 

Income: NDR and Education: NDR 

Health Status: 
Systolic 
BP < 140 mmHg 
Diastolic BP 83–89 
BMI: 24.4 to 37.4 kg/m2 (all women)
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
NDR 

Duration of maintenance phase: 
32 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Didactic Nutrition
PA (SD) (30–45, four to five days per week)
Behavioral Modification Strategies
(i) Goal-setting
(ii) Problem-solving
(iii) Self-monitoring of food intake and PA 

Frequency, Delivery, and Dose: [66] 

Months 5–7: biweekly group sessions 6 biweekly group sessions 

Months 8–1.
7: once monthly group sessions 

Months 18+: biweekly individual contact (phone, face to face, and mail) 

Attendance at 3 of 6 minimodules yearly (each module was 3–6 group session)  
I: 84.1 (±11.9) kg (all women) 

C: 82.9 (±10.9) kg 
(all women)
I: AAW: −2.1 (CI: −3.0 to −1.3) kg
CW: −3.6 (CI: −4.4 to −2.8) kg 

C:
AAW: +0.3 (CI: −0.6 to +1.2) kg
CW: +0.2 (CI: −0.4 to +0.7) kg
12 monthFu
NDR 

18 month Fu
 I: 
AAW: −0.4 (CI: −1.6 to 0.9) kg 
CW: −1.7 (CI: −2.6 to −0.7) kg 

C: 
AAW: +0.4 (CI: −0.8 to 1.6) kg 
CW: 0.4 (CI: −0.3 to 1.2) kg 

36 month Fu
I: 
AAW: +0.5 (CI: −1.1 to 2.0) kg 
CW: 0.8 (CI: 0.3 to 1.9) kg 

C: 
AAW: +1.7 (CI: 0.2 to 3.1) kg 
CW: 1.4 (CI: 0.3 to 2.5) kg
Adherence to maintenance sessions/components: 
Months 6–18: median sessions attended, 11 

Months 19–36: median sessions attended, 7.5 

Retention: 

I: 
AAW: 97% 
CW: 98% 

C: 
AAW: 100% 
CW: 97%

Yancey et al. (2006)
[67]
9Design: 
RCT 

Setting: 
Community, Urban 

Length of Trial: 
12 months

AAW 
I: 188 
C: 178 

Mean Age (y): 
I: 58.0 (±0.9) 
C: 60.1 (±0.5) 

Income: 
I: $40,000–59,000 
C: $40,000–59,000 

Education (y): 
I: 15.06 (±2.16) 
C: 14.98 (±2.24) 

Health status: 
NDR
Formal Theoretical Framework: 
Social Ecological Model 

Cultural Adaptations: 
Yes, trial specific to black women, chosen study site, AA instructors 

Duration of maintenance period: 
10 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Self-directed
Free fitness club 
membership (I and C)
Frequency, Delivery, and Dose: 
No contact
I: 81.5 kg ( ) 
C: 82.7 kg ( )
I: +0.05 kg 
C: +0.3 kg
End of maintenance
(12 month Fu)

I: +1.4 kg 
C: +1.02 kg
Adherence to maintenance sessions/components: 
NDR 

Retention: 
I: 72% 
C: 72%

West et al. (2007)
[14]
Weight change crudely extrapolated from Figure 1 in the manuscript
9Design: 
RCT 

Setting: 
University 

Length of Trial: 
18 months
MI group
AAW: 43 
CW: 66 

Attention control group
AAW: 41 
CW: 67 

Mean Age (y): 
53 ± 10 (all participants) 

Education: 
College education or higher: 35% (all participants) 

Income: 
NDR 

  Health Status: 
Type 2 Diabetes (no insulin use) 
BMI 27–50 kg/m2





Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
NDR 

Duration of maintenance phase: 
12 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Calorie and fat control
Didactic Nutrition
PA (self, goal 150 min/wk)
Behavioral Modification Strategies
(i) Goal-setting
(ii) Problem-solving
(iii) Self-monitoring of food intake and PA
(iv) Stimulus control
(v) Relapse prevention
MI or Attention Control sessions
Frequency, Delivery, and Dose: 
Months 7–12 Biweekly group sessions 
Dose: NDR 
(12 sessions total) 

Months 712
Two individual MI or Attention Control sessions 
Dose: 45 minutes per session 
(5 sessions total) 

Months 1318
Once monthly group session 
Dose: NDR 
(6 sessions total)  



MI group
97 (±17) kg 
(all participants) 

Attention control group
97 (±15) kg 
(all participants)
MI group
AAW: −3.4 kg 
CW: −5.3 kg 

Attention control group
AAW: −2.9 kg 
CW: −3.4 kg
12 month Fu
MI group
AAW: −2.9 kg 
CW: −5.9 kg 

Attention control group
AAW: −1.8 kg 
CW: −3.3 kg 

End of maintenance phase (18 month Fu)
MI group
AAW: −1.9 kg 
CW: −4.4 kg 

Attention control group
AAW: −1.0 kg 
CW: −2.0 kg
Adherence to maintenance sessions/components: 

Group sessions
712 months
57% attendance 
1318 months
48% attendance 

Food diaries submitted
7–12 months
7 ± 9 diaries 

1318 months
5 ± 9 diaries 

Retention: 
93% (all participants)

Rickel et al. (2011)‡‡
[15]
Treatment of Obesity in Underserved Rural Settings (TOURS) 

Weight change crudely calculated from data presented in the manuscript
9Design: 
RCT 

Setting: 
Community, rural 

Length of Trial: 
18 months

AAW: 43 
CW: 181 

Mean Age (y): 
AAW: 58.0 (±0.9) 
CW: 60.1 (±0.5) 

Income: 
AAW: <$50,000/y: 70% 
CW: <$50,000/y: 66% 

Education: 
High school degree or less 
AAW: 28% 
WW: 39% 

Health status: 
BMI > 30.0 kg/m2
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
Southern-focused 

Duration of maintenance phase: 
12 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Calorie control
Didactic Nutrition
PA (self, goal 30 min/day walking)
Behavioral Modification Strategies 
(i) Problem solving 
(ii) Self-monitoring
[68]
Frequency, Delivery, and Dose: 
All treatment groups received handouts describing how to use problem solving to deal with obstacles related to WL maintenance 

Extended care maintenance
Phone-based counseling
Biweekly individual phone-based 
counseling sessions
Dose: 15–20 minutes 
(26 sessions) 

OR 

Face to Face counseling
Biweekly in-person group session
Dose: 60 minutes 
(26 sessions)
AAW: 99.9 (±2.6) kg 
CW: 95.8 (±1.1)
AAW: −6.8 (±0.80) kg 
CW: −10.7 (±0.38) kg
12 month Fu
NDR 

End of Trial (18 month Fu)
Extended care maintenance
AAW: −4.9 kg 
CW: −9.2 kg 

Control
AAW: −5.5 kg 
CW: −6.5 kg
Adherence to maintenance sessions/components: 

Record keeping (hours)
Phone-based
16.0 (±18.1) hours 
Face to face
15.7 (±18.9) hours 
Control
10.4 (±15.7) hours 

Counseling time
Phone-based
10.2 (±12.4) hours 
Face to face
21.3 (±16.0) hours 
Control
NA 

Retention: 
96% (all participants)

McNabb et al. (1993) [69] 7Design: 
NRCT, pilot 

Setting: 
Community Clinic, Urban 

Length of Trial: 
12 months

I: 13 AAW 
C: 10 AAW 

Mean Age (y): 
I: 57 
C: 62 

Income: 
NDR 

Education: 
I: Completed 
HS: 89% 
C: Completed 
HS: 85% 

Health status: 
Type 2 Diabetes 
120% IBW
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
Yes, trial specific to AA women 

Duration of maintenance period: 
7.5 months 
Components Targeted at WL Maintenance: 
Self-directed 

Criteria for entry into WL Maintenance Phase: 
None 
Frequency, Delivery, and Dose: 
No contact 















I: 93.5 (±17.8) kg 
C: NDR
I: −4.1 kg 
C: NDR
End of trial (12 month Fu)
I: −4.4 kg 
C: +1.4 kg
Adherence to maintenance sessions/components: 
NDR 

Retention: 
I: 77% 
C: 100%

Tsai et al. (2010) [16]  







7








Design: 
RCT, pilot 

Setting: 
University Clinic, Urban 

Length of Trial: 
12 months

( women) 
I: AAW: 18 

C: AAW: 19 

Mean Age (y): 
AAW: 48.3 (±12.8) 

Income: 
NDR
Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
NDR 

Duration of maintenance phase: 
6 months
Frequency, Delivery, and Dose: 
2 in-person PCP visits 
Dose: 2-3 minutes devoted to discussing weight control 
(I and C)
I: AAW: 
98.7 ± 16.4 kg 
CW: 
76.2 ± 10.3 kg 

C: 
AAW: 
99.6 ± 14.3 kg 
CW: 
100.9 ± 20.0 kg
I: AAW: −4.5 kg 
CW: −6.6 kg 

C: 
AAW: +0.5 kg 
CW: +2.1 kg 


End of trial (12 month Fu):
I: 
AAW: −1.6 kg 
CW: −3.2 kg 

C: 
AAW: −0.2 kg 
CW: −1.1 kg 
Adherence to maintenance sessions/components: 
NDR 

Retention: 
94% (all participants)  


Banks-Wallace (2007)
[70]
Weight change crudely calculated from Table 1 in the manuscript
5Design 
UCT, pilot 

Setting 
NDR 

Duration of Trial: 
18 months
AAW 

Mean Age (y): 
50.3 

Income: 
62% < $24,000 

Education: 
Completed HS: 100% 

Health status: 
Hypertensive 




Formal Theoretical Framework: 
NDR 

Cultural Adaptations: 
Yes, trial specific to AA women 

Duration of Maintenance Phase: 
6 months 

Criteria for entry into WL Maintenance Phase: 
None 

Components Targeted at WL Maintenance: 
Self-directed
Frequency, Delivery, and Dose: 
No contact
93.7 (±13.1) kg −8.5 kg End of trial (18 month Fu)
+11.7 kg
Adherence to maintenance sessions/components: 
NDR 

Retention: 
71%

Total quality ranking score = [(Design: RCT = 4; pilot RCT = 3; nonrandomized controlled trial = 2; single group design = 1) + (Primary intervention focus on weight control: 1 = No; 2 = Yes) + (Inclusion of a formal maintenance program: 1 = No; 2 = Yes) + (Cultural Adaptations: 1 = no adaptations; 2 = limited to recruitment of AA participants; 3 = studies reporting adapting intervention-related content and other adaptations such as cultural sensitivity staff training)].
††Data reported for AAW or CW only unless indicated otherwise.
Weight change by sex/ethnicity obtained from main study author for AAW completers only.
‡‡Intention to treat or multiple imputations analysis.
AAW: african american women; BMI: body mass index; BP: blood pressure; C: control; CI: confidence interval; CW: caucasian women; DASH: dietary approaches to stop hypertension; FU: follow-up; HS: high school; I: intervention; IBW: ideal body weight; IL: intensive lifestyle; MI: motivational interviewing; NA: not applicable; NDR: no data reported; NRCT: non-randomized controlled trial; PA: physical activity; PCP: primary care physician; S: supervised; SD: standard deviation; SCT: social cognitive theory; SE: standard error; UCT: uncontrolled trial; WL: weight loss; Y: years.