Strong Hearts, Healthy Communities: A Community-Based Randomized Trial for Rural Women.
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OBJECTIVE: The aim of this study was to evaluate a multilevel cardiovascular disease (CVD) prevention program for rural women. METHODS: This 6-month, community-based, randomized trial enrolled 194 sedentary rural women aged 40 or older with BMI25 kg/m2 . Intervention participants attended 6 months of twice-weekly exercise, nutrition, and heart health classes (48 total) that included individual-, social-, and environment-level components. An education-only control program included didactic healthy lifestyle classes once a month (six total). The primary outcome measures were change in BMI and weight. RESULTS: Within-group and between-group multivariate analyses revealed that only intervention participants decreased BMI (-0.85 units; 95% CI: -1.32 to -0.39; P=0.001) and weight (-2.24 kg; 95% CI: -3.49 to -0.99; P=0.002). Compared with controls, intervention participants decreased BMI (difference: -0.71 units; 95% CI: -1.35 to -0.08; P=0.03) and weight (1.85 kg; 95% CI: -3.55 to -0.16; P=0.03) and improved C-reactive protein (difference: -1.15 mg/L; 95% CI: -2.16 to -0.15; P=0.03) and Simple 7, a composite CVD risk score (difference: 0.67; 95% CI: 0.14 to 1.21; P=0.01). Cholesterol decreased among controls but increased in the intervention group (-7.85 vs. 3.92 mg/dL; difference: 11.77; 95% CI: 0.57 to 22.96; P=0.04). CONCLUSIONS: The multilevel intervention demonstrated modest but superior and meaningful improvements in BMI and other CVD risk factors compared with the control program.
Seguin, R. A., Paul, L., Folta, S. C., Nelson, M. E., Strogatz, D., Graham, M. L., ... Parry, S. A.
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Seguin, Rebecca A||Paul, Lynn||Folta, Sara C||Nelson, Miriam E||Strogatz, David||Graham, Meredith L||Diffenderfer, Anna||Eldridge, Galen||Parry, Stephen A
