Six studies (five randomized controlled trials, and one non-randomized trial) evaluated various nutrition interventions to determine methods for improving nutrition outcomes among overweight or obese adults with varying socio-economic status, racial/ethnic groups or geographic locations. One of the studies found that motivational interviewing, although found effective in other studies with other target groups, was not effective in improving outcomes among African American women in a weight management intervention. Tailoring the intervention to the culture and language of the target population was a key feature of effective programs. 

• Methods
  • Group or one-on-one personal interaction, including education, counseling and support 
  • Faith-based interventions such as group prayer and Bible study
  • Following completion of the study, delayed interventions were provided to control groups
  • Skills teaching such as cooking classes and exercise classes
  • Enhancing access to fresh fruits and vegetables, gym facilities and exercise equipment
  • Addressing barriers such as provision of child care during the intervention and transportation 
  • Enhancement of self-efficacy and self-management skills, including methods for eliciting family and social support 
  • Use of community outreach workers and lay health leaders
  • Communication tools including video technology (including exercise videos and videotaped interviews with role models from the culture), telephone follow-up and written materials
• Providers 
  • Registered Dietitian case managers and educators, registered nurses, psychologists  
  • Peer educators and peer counselors
  • Trained lay health leaders from community churches
  • Exercise instructors
• Frequency and Duration
  • Interventions utilizing multiple sessions over extended time periods ranging from eight weeks to 12 months 
• Settings
  • Public health clinics, community centers, community health clubs and churches
  • Follow-up in clinic or community settings or by telephone. 

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

Twelve studies (six randomized controlled trials, four cross-sectional, one before-and-after and one qualitative) evaluated various nutrition intervention strategies to determine methods for improving nutrition outcomes among breastfeeding women with varying socio-economic status, racial or ethnic groups or geographic locations. Tailoring the intervention to the culture and language of the target population was a key feature of effective programs.

Characteristics of effective interventions included the following:

• Methods
  • Group or one-on-one personal interaction, including ongoing education
  • Skills teaching, support and counseling
  • Advocacy by community coalitions
  • Breast pump loans
  • Communication tools including video technology, telephone follow-up and written materials.
• Providers
  • Lactation consultants
  • Registered dietitians
  • Registered nurses
  • Peer counselors.
• Frequency and Duration
  • Perinatal, delivery and postpartum periods
  • Ongoing promotion efforts by community coalitions. 
• Settings
  • Hospital-based or located in Women, Infants and Children (WIC) clinics
  • Public health clinics or physician offices 
  • Follow-up in professional settings or during home visits.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

Twelve studies (seven randomized controlled trials, two before-and-after studies, two cohort studies and one cross-sectional study) evaluated various nutrition interventions to determine methods for improving nutrition outcomes among adults with diabetes at different socio-economic levels and from various racial/ethnic groups or geographic locations. Tailoring the intervention to the culture and language of the target population was a key feature of effective programs. 

• Methods:
  • Group or one-on-one personal interaction, including education
  • Skills teaching such as cooking classes and exercise interventions
  • Enhancement of self-efficacy and self-management skills
  • Group and individual support and counseling
  • Community advocacy including transportation services
  • Recruitment and retention efforts
  • Use of community outreach workers, such as Promotoras
  • Communication tools including video technology, automated telephone messages, telephone follow-up and written materials
• Providers: 
  • Certified diabetes educators, registered dietitians, registered nurses
  • Community health workers and peer counselors
• Frequency and Duration:
  • Interventions utilizing multiple sessions over extended time periods
  • Ongoing education and support in the post-intervention periods
• Settings:
  • Public health clinics, community centers and physician offices
  • Follow-up in professional settings or during home visits.  

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

Seven studies (six randomized controlled trials and one descriptive study) evaluated various nutrition interventions to determine methods for improving nutrition outcomes among adults with cardiovascular disease with varying socio-economic status, racial/ethnic groups or geographic locations. Tailoring the intervention to the culture and language of the target population was a key feature of effective programs. 

• Methods
  • Group or one-on-one personal interaction, including education, counseling and support 
  • Enhancement of self-efficacy and self-management skills, including methods of self-monitoring, problem-solving and eliciting family and social support 
  • Use of community outreach workers and lay health leaders
  • DASH dietary approaches
  • Communication tools including audio CDs, computer-based presentations, computer-based education models, learning aids with culturally appropriate health messages, telephone follow-up and written materials
• Providers 
  • Registered dietitians, registered nurses
  • Peer educators and peer counselors
  • Trained interventionists
• Frequency and Duration
  • Interventions utilizing multiple sessions over extended time periods ranging from two weeks to 18 months 
• Settings
  • Public health clinics, community centers
  • Community colleges 
  • Follow-up in clinic or community settings or by telephone.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.