Five-A's Physical Activity Counseling Intervention for Overweight, Rural Women

Tuesday, 13 July 2010

Jane Anthony Peterson, PhD, ARNP
School of Nursing, University of Missouri Kansas City, Kansas City, MO

Learning Objective 1: describe the Five—A’s counseling approach that is designed to promote physical activity and weight management in overweight women.

Learning Objective 2: identify strategies to decrease the health risks for sedentary, overweight rural women.

Purpose: Overweight and obesity are epidemic. Rural women have higher rates of overweight/obesity than their urban counterparts. Overweight/obesity increases the risk for many chronic diseases. Rural communities have limited resources to promote physical activity and weight loss/management. Negative health consequences are linked to overweight and obesity; therefore, innovative approaches to increase physical activity and weight management among rural women are needed.

The Stay Alive with Five—A’s (5—A’s) program, a primary care intervention, was pilot tested in a sample of rural women between the ages of 18-65 years.  The 5—A’s program is conceptualized in social support, stages of behavior change, and self-efficacy utilizing the Five A’s counseling approach. The primary goal of this study was to increase physical activity, promote weight loss, and reduce disease risks in rural women. Secondary goals were to identify key behavioral factors that resulted in health behavior change(s).

Methods: To test the feasibility of the 5—A’s program, 25 rural women participated in a 12- month primary care and community-based physical activity and weight management intervention. Primary outcomes were time spent in physical activity, cardiorespiratory fitness, serum glucose and lipids, waist circumference, body mass index, percent body fat, and blood pressure. Secondary outcomes were the extent behavioral mechanisms of social support, stage of behavior change and self-efficacy promoted physical activity.
Results: Preliminary results utilizing paired T-tests indicate participants increased moderate intensity physical activity from a mean of 96 minutes/week at baseline to 163 minutes in 6 months. Improvements in social support and self-efficacy for physical activity were noted.

Conclusion: Positive trends in increased physical activity and weight management were found after utilizing the 5—A’s intervention. Nurses can build on the inherent support provided in primary care clinics and collaborate with community partners to promote physical activity and weight management in rural women.