The StrongWomen-Healthy Hearts Program: Reducing Cardiovascular Disease Risk Factors in Rural Sedentary, Overweight, and Obese Midlife and Older Women

Objectives. We tested a community-based intervention designed to reduce cardiovascular disease risk in sedentary midlife and older women who were overweight or obese. Methods. In a randomized controlled trial conducted in 8 counties in Arkansas and Kansas, counties were assigned to the intervention (a 12-week twice-weekly heart health program) group or to the delayed-intervention control group. Ten to fifteen women were selected from each site, and participants' weight, waist circumference, diet, physical activity, and self-efficacy were measured before and after the intervention. Data were analyzed with multiple regressions. Results. Compared with the control group, participants in the intervention group had a significant decrease in body weight (-2.1 kg; 95% confidence interval [CI]=-3.2, -1.0), waist circumference (-2.3 in; 95% CI=-4.2, -0.5), and energy intake (-390 kcal/day; 95% CI=-598, -183); an increase in activity (+1637 steps/day; 95% CI=712, 2562); and an increase in self-efficacy for dietary and physical activity behaviors. Conclusions. Our results suggest that a community-based program can improve self-efficacy, increase physical activity, and decrease energy intake, resulting in decreased waist circumference and body weight among at-risk women. (Am J Public Health. 2009;99:1271-1277. doi:10.2105/AJPH.2008.145581)