BackgroundNearly 60% of black women are obese. Despite their increased risk of obesity and associated chronic diseases, black women have been underrepresented in clinical trials of weight loss interventions, particularly those conducted in the primary care setting. Further, existing obesity treatments are less effective for this population. The promotion of weight maintenance can be achieved at lower treatment intensity than can weight loss and holds promise in reducing obesity-associated chronic disease risk. Weight gain prevention may also be more consistent with the obesity-related sociocultural perspectives of black women than are traditional weight loss approaches.Methods/DesignWe conducted an 18-month randomized controlled trial (the Shape Program) of a weight gain prevention intervention for overweight black female patients in the primary care setting. Participants include 194 premenopausal black women aged 25 to 44 years with a BMI of 25–34.9 kg/m2. Participants were randomized either to usual care or to a 12-month intervention that consisted of: tailored obesogenic behavior change goals, self-monitoring via interactive voice response phone calls, tailored skills training materials, 12 counseling calls with a registered dietitian and a 12-month YMCA membership.Participants are followed over 18 months, with study visits at baseline, 6-, 12- and 18-months. Anthropometric data, blood pressure, fasting lipids, fasting glucose, and self-administered surveys are collected at each visit. Accelerometer data is collected at baseline and 12-months.At baseline, participants were an average of 35.4 years old with a mean body mass index of 30.2 kg/m2. Participants were mostly employed and low-income. Almost half of the sample reported a diagnosis of hypertension or prehypertension and 12% reported a diagnosis of diabetes or prediabetes. Almost one-third of participants smoked and over 20% scored above the clinical threshold for depression.DiscussionThe Shape Program utilizes an innovative intervention approach to lower the risk of obesity and obesity-associated chronic disease among black women in the primary care setting. The intervention was informed by behavior change theory and aims to prevent weight gain using inexpensive mobile technologies and existing health center resources. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk population sample in need of evidence-based treatment strategies.Trial registrationThe trial is registered with clinicaltrials.gov NCT00938535.

In this article, we examine, through the framework of the Technology Acceptance Model (TAM), some of the features that inform user acceptance of a digital library system implementation at agricultural universities in two developing countries: Kenya and Peru. This is a study not only examining factors contributing to adoption of this offline digital library, but also a cross-site comparison, meant to examine the functionality in the developing world of a theoretical model developed in and based on conditions in the developed world. As we unravel predictors of technological acceptance of a digital library implementation in the developing world, we simultaneously investigate a broader question: not just questions regarding improved research in the developing world, but on it as well.We analyze data from both sites on overall measures of perceived ease of use and perceived usefulness (two constructs of the TAM), and on individual measures making up the overall measures. We found the TAM to work well in describing factors that affect usage of digital libraries in developing countries, with perceived usefulness as the main predictor of intent to use this system (The Essential Electronic Agricultural Library, or TEEAL), and with relevance as the major constituent driver of perceived usefulness. Overall, we also found particular predictors of perceived usefulness and perceived ease of use that are consistent across cultures (relevance, trust, and ease of access), while other constructs (social norm, domain knowledge, visibility, and self-efficacy) demonstrated predictive power in only one setting. While post-hoc analyses gave several clues as to drivers of these differences, this study cannot definitively address what causes differences in predictive power between sites. What is clear, however, is that application of the TAM to IT implementation in developing countries must be guided more by the specificities of local circumstances than by the performance of the TAM in highly-developed countries.

While Nollywood, Nigeria's video industry, is largely separate from dominant global cultural industry networks of production inputs and distribution, it is an industry that is still globally linked in a number of ways. In this article, I investigate the nature and layout of these connections via interviews with those populating these networks, from key Nollywood producers to shop owners thousands of miles from Lagos. I conclude that, instead of the formal links of dominant cultural industry networks, these links are mostly via alternative global networks, forged on the flipside of -or the gaps between -the connections that link the Network Society. Some formal international institutions have a presence, but these are largely mediated through Nollywood's situation in global cultural industry networks. I argue that this renders Nollywood as situated in an alternative media capital, central to alternative networks, while too informal to integrate into dominant networks, and it is from this position that we can best understand Nollywood's position in global media flows.

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