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Effectiveness of tailored lifestyle interventions, using web-based and print-mail, for reducing blood pressure among rural women with prehypertension: main results of the Wellness for Women: DASHing towards Health clinical trial.
- Source :
- International Journal of Behavioral Nutrition & Physical Activity; 2014, Vol. 11, p1-32, 32p, 1 Diagram, 4 Charts
- Publication Year :
- 2014
-
Abstract
- Background Lifestyle modification is recommended for management of prehypertension, yet finding effective interventions to reach rural women is a public health challenge. This community-based clinical trial compared the effectiveness of standard advice to two multi-component theory-based tailored interventions, using web-based or print-mailed delivery, in reducing blood pressure among rural women, ages 40–69, with prehypertension. Methods 289 women with prehypertension enrolled in the Wellness for Women: DASHing towards Health trial, a 12-month intervention with 12-month follow-up. Women were randomly assigned to groups using a 1:2:2 ratio, comparing standard advice (30-minute counseling session) to two interventions (two 2-hour counseling sessions, 5 phone goal-setting sessions, strength-training video, and 16 tailored newsletters, web-based or print-mailed). Linear mixed model methods were used to test planned pairwise comparisons of marginal mean change in blood pressure, healthy eating and activity, adjusted for age and baseline level. General estimating equations were used to examine the proportion of women achieving normotensive status and meeting health outcome criteria for eating and activity. Results Mean blood pressure reduction ranged from 3.8 (SD = 9.8) mm Hg to 8.1 (SD = 10.4) mm Hg. The 24-month estimated marginal proportions of women achieving normotensive status were 47% for web-based, and 39% for both print-mailed and standard advice groups, with no group differences (p = .11 and p = .09, respectively). Web-based and print-mailed groups improved more than standard advice group for waist circumference (p = .017 and p = .016, respectively); % daily calories from fat (p = .018 and p = .030) and saturated fat (p = .049 and p = .013); daily servings of fruit and vegetables (p = .008 and p < .005); and low fat dairy (p < .001 and p = .002). Greater improvements were observed in web-based versus standard advice groups in systolic blood pressure (p = .048) and estimated VO<subscript>2</subscript>max (p = .037). Dropout rates were 6% by 6-months, 11.4% by 24 months, with no differences across groups. Conclusions Rural women with prehypertension receiving distance-delivery theory-based lifestyle modifications can achieve a reduction of blood pressure and attainment of normotensive status. [ABSTRACT FROM AUTHOR]
- Subjects :
- PHYSICAL fitness
BEHAVIOR modification
BLOOD pressure
CHI-squared test
COMBINED modality therapy
CONFIDENCE intervals
COUNSELING
DIET
FAT content of food
GOAL (Psychology)
HEALTH behavior
INGESTION
INTERVIEWING
PATIENT education
POSTAL service
PROBABILITY theory
QUESTIONNAIRES
RESEARCH funding
RURAL conditions
TEACHING aids
WORLD Wide Web
SAMPLE size (Statistics)
STATISTICAL power analysis
BODY mass index
RANDOMIZED controlled trials
TREATMENT effectiveness
OXYGEN consumption
DATA analysis software
WAIST circumference
DESCRIPTIVE statistics
RESISTANCE training
ODDS ratio
PREHYPERTENSION
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 14795868
- Volume :
- 11
- Database :
- Complementary Index
- Journal :
- International Journal of Behavioral Nutrition & Physical Activity
- Publication Type :
- Academic Journal
- Accession number :
- 100309674
- Full Text :
- https://doi.org/10.1186/s12966-014-0148-2