Provider counseling, health education, and community health workers: the Arizona WISEWOMAN project.
BACKGROUND
The Arizona Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) project used provider counseling, health education, and community health workers (CHWs) to target chronic disease risk factors in uninsured, primarily Hispanic women over age 50.


METHODS
Participants were recruited from two Tucson clinics participating in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Women were randomly assigned into one of three intervention groups: (1) provider counseling, (2) provider counseling and health education, or (3) provider counseling, health education, and CHW support. At baseline and 12 months (1998-2000), participants were measured for height, weight, waist and hip circumference, and blood pressure. Blood tests were conducted to check blood glucose, cholesterol, and triglyceride levels. At each time point, participants also completed 24-hour dietary recalls and questionnaires focusing on their physical activity levels.


RESULTS
A total of 217 women participated in baseline and 12-month follow-up. Three fourths were Hispanic. All three intervention groups showed an increase in self-reported weekly minutes of moderate-to-vigorous physical activity, with no significant differences between the groups. Significantly more women who received the comprehensive intervention of provider counseling, health education, and CHW support progressed to eating five fruits and vegetables per day, compared with participants who received only provider counseling or provider counseling plus health education.


CONCLUSIONS
All three interventions increased moderate-to-vigorous physical activity but not fruit and vegetable consumption. The intervention group with provider counseling, health education, and CHW support significantly increased the number of women meeting national recommendations for fruit and vegetable consumption.
Staten
Lisa K
LK
Division of Health Promotion Sciences, University of Arizona, Tucson, 85719, USA. staten@u.arizona.edu
Gregory-Mercado
Karen Y
KY
Ranger-Moore
James
J
Will
Julie C
JC
Giuliano
Anna R
AR
Ford
Earl S
ES
Marshall
James
J
D000368:Aged; D001130:Arizona / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D003376:Counseling / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000592:standards; D006293:Health Promotion / Q000592:standards; D006305:Health Status Indicators; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D011322:Primary Prevention / Q000592:standards; D040242:Risk Reduction Behavior; D013997:Time Factors; D016387:Women's Health; D014932:Women's Health Services / Q000592:standards