ClinicalTrials.gg
Status unknownNCT03463213Updated Jun 6, 2018

SHE Tribe: An Intervention to Improve Health Behavior Among Women in Underserved Communities

An interventional study of SHE Tribe in Health Promotion, sponsored by University of North Texas Health Science Center. Status unknown at 1 site in United States. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-06-06.

Sponsored by University of North Texas Health Science Center · Not applicable, Interventional, and Prevention

The sponsor has not verified this record recently (last verified Jun 2018), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
240
Allocation
Not applicable
Ages
18 Years and older
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 421 studies in Health Behavior with a site in United States — 66 open to participants now, 86 under way, 1 of them phase 3. Health Behavior · United States.

Planned enrollment
152nd of 385
240 · median 130
Started
2018
with 24 others
No phase
363 of 421
58 open now
Registered
153rd of 421
by date

Among the 421 studies in Health Behavior with a site in United States, this one is the 152nd largest by planned enrollment of the 385 interventional ones that give a count, is one of 25 that started in 2018, is one of 363 with no phase, and was the 153rd registered.

Health Behavior

968 studies on the registry are indexed under Health Behavior; 166 are open to participants now.

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Open to participants now

66 of the 421 studies in Health Behavior with a site in United States are open now. Recruiting first, the newest first:

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Who these studies take

Of the 93 Health Behavior studies recruiting now, 39 (42%) set no upper age limit and 37 (40%) stop at 75 or younger; 25 take children under 18; 58 take healthy volunteers.

This study: 18 Years and older · female · healthy volunteers too.

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02

Study summary

While healthy lifestyle behaviors have been identified as instrumental to preventing chronic disease, programs to successfully promote healthy behavior adoption in underserved communities have had limited sustainable success. SHE Tribe is a culturally tailored, social network intervention created through CBPR to overcome previously identified barriers and improve health behavior among women in underserved communities.

Read the detailed description

The leading causes of death for women in the United States are heart disease, cancer, and stroke. Chronic diseases disproportionately affect underserved communities where race, poverty, education-level, healthcare access, and other social and environmental determinants intersect. African-American (AA) and Hispanic women are at particularly high risk for diabetes-related mortality 1 and are more likely than white women to be functionally impacted by chronic disease . Factors associated with increased disease risk include physical inactivity, poor nutrition, obesity, underutilization of health screenings, and high stress/allostatic load . While healthy lifestyle behaviors have been identified as instrumental to preventing chronic disease, programs to successfully promote healthy behavior adoption in underserved communities have had limited sustainable success, due in part to perceived relevance of program outcomes, lack of cultural tailoring, access to care, and lack of social support for health behavior change.

The Texas Center for Health Disparities received National Institute of Minority Health and Health Disparities funding to address women's chronic health conditions through community outreach and research strategies from 2012-2017. A workgroup of community members, former research and program participants, and University of North Texas Health Science Center faculty and staff utilized a Community-Based Participatory Research (CBPR) process to design SHE Tribe (She's Healthy and Empowered), a social-network based initiative to support healthy behavior adoption among women in underserved communities. This effort was based on earlier findings that women in underserved neighborhoods were often resistant to participating in a "disease-labeled" intervention (e.g., obesity prevention) and expressed a desire to practice wellness-oriented behaviors that have been adapted for their social and cultural groups. These findings were consistent with the growing body of literature indicating that being "healthy and strong" is perceived as more desirable than engaging in a program where the explicit expectation is to lose weight. As part of the development process, the workgroup sought to develop a sustainable, evidence-based approach that would appeal to underserved communities that are disproportionately impacted by chronic disease.

Components of SHE Tribe include evidence-based characteristics associated with the adoption and maintenance of health behaviors: a) incorporating social network to promote healthy activities, b) setting goals that are specific to the needs and interests of the individual , c) self-monitoring of desired behaviors, d) motivational interviewing-based dialogue that promotes intrinsic motivation to change, e) choosing small units of change for the purpose of habit formation, and f) combining practice and reflection to promote integration with existing life patterns and beliefs. The advantage of SHE Tribe over previous models is its explicit use of social networks and reliance on a broader set of activities that are consistent with a healthy lifestyle rather than disease. SHE Tribe was initially pilot-tested with a small cohort of 5 peer facilitators. Based on their feedback, it was then enhanced to include telephone or tablet-based assessment and tailored feedback at the beginning (baseline) and end of each 5-session cycle. The current version is being pilot-tested as a community-initiated project, and as such includes only a basic set of assessment tools that are necessary to make the intervention work. The purpose of this 2-year exploratory submission is to examine the effects of SHE Tribe on key health outcomes such as health self-management, coping, diet, activity, and social network health norms.

AIM 1. Determine whether SHE Tribe can be feasibly implemented with groups of women from communities at high risk for chronic health conditions. The research team will examine the characteristics of women recruited to SHE Tribe to determine whether the network-based recruitment is an effective method for reaching the underserved communities. This will include a review of audio-recorded sessions, session summary reports, and semi-structured interviews with participants and facilitators to understand the perceived value and adoption of different intervention components.

AIM 2. Examine how health behaviors are adopted by individuals and diffused through social networks. At the individual level: Using validated measures, the research team determine which goals are selected and the relationship between goal selection, key health outcomes, and activation of health behavior self-management. At the interpersonal level: Using a social network analysis instrument which measures participants' perceptions of identified individuals in their networks, the research team will examine the diffusion of healthy lifestyle norms.

The impact of this study will be the refinement of an intervention that supports sustainability and reach in underserved communities that are at high-risk for chronic diseases. The emphasis on a constellation of healthy behaviors and the use of peer facilitators will appeal to the cultural identities of women residing in underserved and/or high poverty communities.

03

Conditions studied

  • Health Promotion

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Keywords

  • health behavior
  • chronic disease prevention
  • healthy lifestyle
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Female
  • representative of underserved community (determined by race, ethnicity, socioeconomic status, and/or neighborhood)
  • 18 and older

Exclusion criteria

Exclusion Criteria:

  • Males
  • Children
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
240 participants (estimated)

Study arms

  • Experimental
    SHE Tribe

    SHE Tribe is a social network-based peer-facilitated intervention to promote adoption of health behaviors

    Behavioral: SHE Tribe

Interventions

  • BehavioralSHE Tribe

    Social network-based peer-facilitated intervention to promote adoption of health behavior

06

What researchers measure

Primary outcomes

  1. Change in Healthy Habits Tracking

    This tool includes 42 items representing tracking and monitoring behaviors, such as weighing oneself, keeping a food diary, etc... Each is answered with a yes/no (0/1) response. Scores range from 0 to 42. The questionnaire is administered at baseline and again at 8 weeks. The desired outcome is an increase in the total score between baseline and 8 weeks.

    Time frame: Baseline and 8 weeks.

Secondary outcomes

  1. Social Support for Diet and Physical Activity

    These 11 items are adapted from the Patient Assessment and Counseling for Exercise (PACE+ Women: Measurement Questionnaire). Scores range from 11 to 44, with higher scores indicating a greater social support for healthy lifestyle choices associated with diet and exercise.

    Time frame: Baseline and 8 weeks.

  2. Coping with stress

    These 10 questions include 5 subscales from the Brief COPE tool which measure use of emotional support, use of instrumental support, positive reframing, planning and religion. Each sub-scale score ranges from 0 to 4 with higher values reflecting better coping strategies.

    Time frame: Baseline and 8 weeks.

  3. Body Appreciation Scale (BAS-2)

    This is a 10 item scale measuring body positivity. Scores are based on mean values of all items.

    Time frame: Baseline and 8 weeks.

  4. Healthy Lifestyle Activation

    This tool includes 7 items that measure health-related efficacy, agency, and self-management. Each item is ranked on a scale of 1 to 10 with overall scores ranging from 7 to 70.

    Time frame: Baseline and 8 weeks.

  5. Fruit and vegetable consumption

    This item is from the Patient Assessment and Counseling for Exercise (PACE+ Women: Measurement Questionnaire) and measures self-reported days of purposeful physical activity (30 minutes or more) during a typical week. Scores range from 0 to 7 with higher values reflecting more frequent physical activity.

    Time frame: Baseline and 8 weeks.

  6. Physical activity days

    This item is from the Patient Assessment and Counseling for Exercise (PACE+ Women: Measurement Questionnaire) and measures self-reported daily consumption of fruit and vegetables servings.

    Time frame: Baseline and 8 weeks.

07

Study locations

1 of 1 sites recruiting
  • University of North Texas Health Science Center
    Fort Worth, Texas 76107, United States
    Recruiting
08

References and documents

Publications

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  • Kington RS, Smith JP. Socioeconomic status and racial and ethnic differences in functional status associated with chronic diseases. Am J Public Health. 1997 May;87(5):805-10. doi: 10.2105/ajph.87.5.805. PubMed 9184510 ↗
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  • Geronimus AT, Hicken M, Keene D, Bound J. "Weathering" and age patterns of allostatic load scores among blacks and whites in the United States. Am J Public Health. 2006 May;96(5):826-33. doi: 10.2105/AJPH.2004.060749. Epub 2005 Dec 27. PubMed 16380565 ↗
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  • Fitzgibbon ML, Tussing-Humphreys LM, Porter JS, Martin IK, Odoms-Young A, Sharp LK. Weight loss and African-American women: a systematic review of the behavioural weight loss intervention literature. Obes Rev. 2012 Mar;13(3):193-213. doi: 10.1111/j.1467-789X.2011.00945.x. Epub 2011 Nov 10. PubMed 22074195 ↗
  • Warsi A, Wang PS, LaValley MP, Avorn J, Solomon DH. Self-management education programs in chronic disease: a systematic review and methodological critique of the literature. Arch Intern Med. 2004 Aug 9-23;164(15):1641-9. doi: 10.1001/archinte.164.15.1641. PubMed 15302634 ↗
  • Samuel-Hodge CD, Johnson CM, Braxton DF, Lackey M. Effectiveness of Diabetes Prevention Program translations among African Americans. Obes Rev. 2014 Oct;15 Suppl 4:107-24. doi: 10.1111/obr.12211. PubMed 25196409 ↗
  • Brady TJ, Murphy L, O'Colmain BJ, Beauchesne D, Daniels B, Greenberg M, House M, Chervin D. A meta-analysis of health status, health behaviors, and health care utilization outcomes of the Chronic Disease Self-Management Program. Prev Chronic Dis. 2013;10:120112. doi: 10.5888/pcd10.120112. PubMed 23327828 ↗
  • Yancey AK, Ortega AN, Kumanyika SK. Effective recruitment and retention of minority research participants. Annu Rev Public Health. 2006;27:1-28. doi: 10.1146/annurev.publhealth.27.021405.102113. PubMed 16533107 ↗
  • Chin MH, Clarke AR, Nocon RS, Casey AA, Goddu AP, Keesecker NM, Cook SC. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J Gen Intern Med. 2012 Aug;27(8):992-1000. doi: 10.1007/s11606-012-2082-9. PubMed 22798211 ↗
  • Hibbard JH, Greene J, Becker ER, Roblin D, Painter MW, Perez DJ, Burbank-Schmitt E, Tusler M. Racial/ethnic disparities and consumer activation in health. Health Aff (Millwood). 2008 Sep-Oct;27(5):1442-53. doi: 10.1377/hlthaff.27.5.1442. PubMed 18780935 ↗
  • Green LW, Ottoson JM, Garcia C, Hiatt RA. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annu Rev Public Health. 2009;30:151-74. doi: 10.1146/annurev.publhealth.031308.100049. PubMed 19705558 ↗
  • Pearson ES. Goal setting as a health behavior change strategy in overweight and obese adults: a systematic literature review examining intervention components. Patient Educ Couns. 2012 Apr;87(1):32-42. doi: 10.1016/j.pec.2011.07.018. Epub 2011 Aug 17. PubMed 21852063 ↗
  • Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005 Apr;55(513):305-12. PubMed 15826439 ↗
  • Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011 Jan;111(1):92-102. doi: 10.1016/j.jada.2010.10.008. PubMed 21185970 ↗
  • Hill JO. Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. Am J Clin Nutr. 2009 Feb;89(2):477-84. doi: 10.3945/ajcn.2008.26566. Epub 2008 Dec 16. PubMed 19088151 ↗
  • Rodearmel SJ, Wyatt HR, Stroebele N, Smith SM, Ogden LG, Hill JO. Small changes in dietary sugar and physical activity as an approach to preventing excessive weight gain: the America on the Move family study. Pediatrics. 2007 Oct;120(4):e869-79. doi: 10.1542/peds.2006-2927. PubMed 17908743 ↗
  • Harmon BE, Forthofer M, Bantum EO, Nigg CR. Perceived influence and college students' diet and physical activity behaviors: an examination of ego-centric social networks. BMC Public Health. 2016 Jun 6;16:473. doi: 10.1186/s12889-016-3166-y. PubMed 27267371 ↗
  • Latkin CA, Knowlton AR. Social Network Assessments and Interventions for Health Behavior Change: A Critical Review. Behav Med. 2015;41(3):90-7. doi: 10.1080/08964289.2015.1034645. PubMed 26332926 ↗
  • Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009 Nov;28(6):690-701. doi: 10.1037/a0016136. PubMed 19916637 ↗
  • Stevanovic D. Quality of Life Enjoyment and Satisfaction Questionnaire-short form for quality of life assessments in clinical practice: a psychometric study. J Psychiatr Ment Health Nurs. 2011 Oct;18(8):744-50. doi: 10.1111/j.1365-2850.2011.01735.x. Epub 2011 May 5. PubMed 21896118 ↗
  • Tylka TL, Wood-Barcalow NL. The Body Appreciation Scale-2: item refinement and psychometric evaluation. Body Image. 2015 Jan;12:53-67. doi: 10.1016/j.bodyim.2014.09.006. Epub 2014 Oct 21. PubMed 25462882 ↗
  • Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR. The development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987 Nov;16(6):825-36. doi: 10.1016/0091-7435(87)90022-3. PubMed 3432232 ↗
  • Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26. doi: 10.1111/j.1475-6773.2004.00269.x. PubMed 15230939 ↗
  • Greene J, Hibbard JH. Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med. 2012 May;27(5):520-6. doi: 10.1007/s11606-011-1931-2. PubMed 22127797 ↗
  • Carver CS. You want to measure coping but your protocol's too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92-100. doi: 10.1207/s15327558ijbm0401_6. PubMed 16250744 ↗
  • Beaudreau SA, Spira AP, Stewart A, Kezirian EJ, Lui LY, Ensrud K, Redline S, Ancoli-Israel S, Stone KL; Study of Osteoporotic Fractures. Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women. Sleep Med. 2012 Jan;13(1):36-42. doi: 10.1016/j.sleep.2011.04.005. Epub 2011 Oct 26. PubMed 22033120 ↗
  • Carlson JA, Sallis JF, Wagner N, Calfas KJ, Patrick K, Groesz LM, Norman GJ. Brief physical activity-related psychosocial measures: reliability and construct validity. J Phys Act Health. 2012 Nov;9(8):1178-86. doi: 10.1123/jpah.9.8.1178. Epub 2011 Dec 27. PubMed 22207589 ↗
  • Miura S, Yamaguchi Y, Urata H, Himeshima Y, Otsuka N, Tomita S, Yamatsu K, Nishida S, Saku K. Efficacy of a multicomponent program (patient-centered assessment and counseling for exercise plus nutrition [PACE+ Japan]) for lifestyle modification in patients with essential hypertension. Hypertens Res. 2004 Nov;27(11):859-64. doi: 10.1291/hypres.27.859. PubMed 15824468 ↗
  • Calfas KJ, Sallis JF, Zabinski MF, Wilfley DE, Rupp J, Prochaska JJ, Thompson S, Pratt M, Patrick K. Preliminary evaluation of a multicomponent program for nutrition and physical activity change in primary care: PACE+ for adults. Prev Med. 2002 Feb;34(2):153-61. doi: 10.1006/pmed.2001.0964. PubMed 11817910 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started May 2018 (actual). Primary completion is estimated for Jun 2020, 25 months after the start.

Of 568 non-industry interventional studies with no phase under Health Behavior, half reached primary completion within 15 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 33. This study's planned 25 months is above that.

Counting every sponsor, half of 586 studies reached it within 15 months; a quarter within 5 and three quarters within 32.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 10, 2018
First posted
Mar 13, 2018
StartActual
May 16, 2018
Primary completionEst.
Jun 2020
CompletionEst.
Aug 2020
Last update
Jun 6, 2018
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 6, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03463213
Lead sponsor
University of North Texas Health Science Center
Collaborators
YMCA of Metropolitan Fort Worth, National Institute on Minority Health and Health Disparities (NIMHD)
Responsible party
Emily Spence-Almaguer (Associate Dean; Associate Professor, University of North Texas Health Science Center) — Principal investigator
First posted
Mar 13, 2018
Start date
May 16, 2018
Primary completion
Jun 2020 (estimated)
Completion
Aug 2020 (estimated)
Last update
Jun 6, 2018

Study contacts

Emily E Spence-Almaguer, PhD
Contact
emily.spence-almaguer@unthsc.edu
817-735-2323
Shlesma Chhetri, MPH
Contact
shlesma.chhetri@unthsc.edu
817-735-2378
Emily Spence-Almaguer, PhD
principal investigator · UNT Health Science Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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