184565 Lifestyle intervention, behavioral changes, and improvement in cardiovascular risk profiles: California WISEWOMAN Project

Tuesday, October 28, 2008: 3:14 PM

Toshi Hayashi, PhD , California Heart Disease and Stroke Prevention Program, California Department of Public Health, Sacramento, CA
Maureen Farrell, RN, FNP, MHA , California Heart Disease and Stroke Prevention Program, WISEWOMAN Program, California Department of Public Health, Sacramento, CA
David A. Rocha, BA , Cancer Detection Section, WISEWOMAN Program, California Department of Public Health, Sacramento, CA
Marianne Hernandez, MS , California Heart Disease and Stroke Prevention Program, WISEWOMAN Program, California Department of Public Health, Sacramento, CA
Serra M. Fox, BS , Cancer Detection Section, WISEWOMAN Program, California Department of Public Health, Sacramento, CA
Background: Research has shown that cardiovascular disease (CVD) risk can be effectively reduced by lifestyle changes. This presentation summarizes the results of the California Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program, a within-site randomized clinical trial of lifestyle intervention on CVD risk factors, funded by the Centers for Disease Control and Prevention.

Methods: Participants were low income, under- or un-insured Hispanic women aged 40-64 with clinically measured CVD risk in Los Angeles and San Diego County in California. Community health workers provided behavioral assessment and counseling using an evidenced-based, culturally appropriate tool, Vida Saludable, Corazón Contento, developed by the University of North Carolina. Participants were randomized into either an enhanced intervention group (EIG, n=552), who received three lifestyle counseling sessions over six months, or a minimum intervention group (MIG, n=541) who received only usual care.

Results: Both groups were assessed for changes in height, weight, blood pressure, total cholesterol, high-density lipoprotein, and health-related behavior at the follow-up session approximately 12 months later. EIG on average showed greater improvement than MIG in a) the estimated reduction of 10-year coronary heart disease risk (based on an equation from the Framingham Heart Study), and b) the number of healthy nutritional and physical activity behaviors, according to participants' self report.

Conclusion: Despite many barriers encountered by low income Hispanic women, lifestyle intervention can lead to behavioral changes and an associated reduction in estimated heart disease risk.

Learning Objectives:
1. Describe the components of a lifestyle intervention to decrease cardiovascular disease risk. 2. Identify what types of behavioral changes are associated with reductions of CVD risk. 3. Identify barriers to a healthy lifestyle encountered by low income Hispanic women.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Hayashi has served as Chief of the Special Unit for Technical Assistance for California Department of Public Health since 2000. He has performed surveillance, statistical analyses, and evaluation studies for numerous public health programs, including childhood asthma intervention, breast cancer early detection, long term financing, and cardiovascular disease prevention. He has served as the WISEWOMAN data manager since January 2006.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Evidence-Based Public Health Practice
See more of: Epidemiology