Community-based partnership to evaluate the influence of an online physical activity intervention on weight maintenance for rural midlife women

Cardiovascular disease (CVD) is the leading cause of death in adult women. Rural women are more likely to have limited access to safe environments for physical activity, be physically inactive, and obese; which increases CVD risk.  Research suggests weight loss of 5-10% of initial body weight, if maintained, can result in clinically meaningful CVD-related health benefits.  Unfortunately, many individuals return to their original weight within five years. A community-based randomized six-month pilot study (partnership between a rural public health department and nursing researchers) promoted physical activity via theory-based online interventions to maintain weight loss.  Rural women aged 40-64 (n=52) who reported losing at least 5% of their body weight in the last 6 months participated. The majority (65%) had lost weight 3 or more times.  Rate of attrition differed significantly between the intervention group (n=14/25 completed) and a standard advice group (n=23/27 completed), which may demonstrate the difficulty in managing active participation in health behavior change interventions, particularly for rural women with limited environmental support for physical activity. Differences between groups (favoring the intervention group) were significant for systolic blood pressure (p=.004, η²=.215), weight (p=.044, η²=.114), and BMI (p=.033, η²=.127). Diastolic blood pressure (p=.079, η²=.088) and waist circumference (p=.094, η²=.081) showed moderate effects. Ninety-three percent of the intervention group maintained their weight over the 6-month study period, compared to 35% of the standard advice group (p=.057).  Further research is needed to develop targeted strategies to assist rural midlife women as they face challenges in weight loss and maintenance efforts.