Thursday, September 26, 2002

This presentation is part of : Recovery and Health Promotion

EFFECTS OF A COMMUNITY-BASED INTERVENTION TO INCREASE PHYSICAL ACTIVITY IN SEDENTARY WOMEN

Mary A. Nies, RN, PhD, FAAN, FAAHB, associate dean for research and professor1, Heather L. Chruscial, MA, PhD candidate1, Joseph T. Hepworth, PhD, research associate professor2, and Kenneth A. Wallston, PhD, professor2. (1) College of Nursing, Wayne State University, Detroit, MI, USA, (2) School of Nursing, Vanderbilt University, Nashville, TN, USA

Objective: The purpose of this study was to evaluate a counseling intervention administered by telephone that was designed to help sedentary women begin and maintain a walking program. Design: A randomized controlled trial design was used. Women were assigned to one of three groups: Intervention – telephone calls with counseling; Attention Control – telephone calls with no counseling; and No-attention Control – no telephone calls. Population, Sample, Setting, Years: Two urban communities, one from a northern and one from a southern region of the Unites States, constituted the population of interest and the setting in which the intervention took place. The sample consisted of 197 women between the ages of 30 and 60 (M=44.4, SD=7.5). Women were classified on the basis of income (high income >$50,000 and low income <$50,000 per year) and race (African American and European American) with the following distribution: high-income, African Americans (n=35); high-income, European Americans (n=58); low-income, African Americans (n=59); and low-income, European Americans (n=45). Data collection occurred at baseline and six months. Intervention Process and Outcome Variables: Intervention process variables were assessed in all women and included measures of perceived benefits of exercise, self-efficacy, goal setting, restructuring plans, relapse prevention, and social support. Outcome variables included self-reported number of minutes walked per day, the time it took to walk one mile, lung capacity, BMI, blood pressure, and mood. Methods: ANOVA was employed for each outcome variable to determine the influence of the intervention, race, income, and site. ANOVA was also used to assess the effects of the intervention on the intervention process variables. To determine whether change on the intervention process variables was related to change in the outcome measures, zero order correlations were computed. Findings: Women in the intervention group reported significantly more change in time walked each day than did control women (p<.05). There was a trend toward more improvement in reported feelings of vigor and fatigue for women in the intervention. These effects were not moderated by racial or income group. Within the intervention group, women showed significant improvement on reported minutes walked per day, the 1-mile walk test, lung capacity, blood pressure, and feelings of vigor and fatigue. Change on the intervention process variables was significantly related to change on outcome measures. Conclusions: Overall, the physical activity intervention appears to be beneficial in helping women to begin and maintain a walking routine. The effects of the intervention were present for both African American and European American women and for women from low and high-income groups. Women in the intervention group were able to significantly improve many physiological and psychological health outcomes over a 6-month period. Implications: A telephone counseling intervention, applicable to populations with increased health risks like minorities and low-income women, may offer a means of support and motivation for women to begin and sustain a walking program. Increasing physical activity in sedentary women should lead to long-term positive physiological and psychological outcomes.

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