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Strong Hearts, Healthy Communities: A Community‐Based Randomized Trial for Rural Women
Author(s) -
Seguin Rebecca A.,
Paul Lynn,
Folta Sara C.,
Nelson Miriam E.,
Strogatz David,
Graham Meredith L.,
Diffenderfer Anna,
Eldridge Galen,
Parry Stephen A.
Publication year - 2018
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22158
Subject(s) - medicine , randomized controlled trial , physical therapy , demography , gerontology , sociology
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 BMI ≥ 25 kg/m 2 . 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.