Impact of the Take Charge Course
Gains in health status were achieved both during the 8 week course and into the second year following class completion (Table 2). The average weight lost during the 8 week course was 4 pounds (n=16; p<0.05; range= +5 to –18 pounds). Longer-term weight loss is available for follow-up periods ranging from 3 months post graduation to 2 years later (mean follow-up period =11 months). Using the last known weight as compared to baseline, there was an average 14 pound weight loss (n=16; p<0.01; range= +13 to –52). The ratio of weight reducers to weight gainers during the class period was 2.25:1 and in the follow-up period was 4.3:1. Group support and food-related content were rated most important by participants in the class. English and Spanish speaking participants ranked support, cooking information, and health information similarly high in importance. Although exercise and relaxation were seen as much less important components of the course, according to long-term follow-up interviews, exercise practices increased following the course. One third of the respondents wanted instruction on exercises appropriate to their disabilities (joint problems, hip pain, pacemaker, use of a cane). Most participants continued using class recipes and techniques for reducing fat.

Drop-outs (attended 2-5 sessions) were surveyed to see whether objections to the class caused their limited attendance. Explanations for low attendance were personal and unrelated to the course. In spite of lower attendance, these participants were able to list concepts they learned from the course and behaviors they changed as a result of their participation.

Take Charge instructors realized early in the course that eating habits of patients did not result from a lack of information but instead reflected larger psychosocial issues. The course was not designed to cure eating disorders, but by combining motivational activities with health education was able to successfully circumvent emotional factors that led to the unhealthy diet choices of many of the patients.

The evaluation interviewers summarized participant response to the intervention as “effusively happy.” This satisfaction is credited in large part to empowerment derived from the social support and self-esteem enhancing activities. The instructors credit the wholistic approach of the Take Charge course for impacting the lives of participants beyond its primary aim of encouraging patients to adopt healthy diets. For many participants, the class provided the impetus to pursue new careers and fulfill old aspirations, from enrolling in piano classes to starting a home business. Some Alumni members returned to teach subsequent classes, taking over teaching responsibilities from the instructors. The alumni instructors were recruited for their natural leadership and commitment to the class; all had completed high school, some had additional training or education. These alumni instructors served as role models for participants, enhanced the cultural content of the class, and validated the impact of the course, making their involvement invaluable.