title: Evaluating a community-based walking intervention for hypertensive older people in Taiwan: a randomized controlled trial.
abstract: OBJECTIVE
  To study the effect of a community-based walking intervention on blood pressure among older people.
  
  
  METHODS
  The study design was a randomized controlled trial conducted in a rural area of Taiwan between October 2002 and June 2003. A total of 202 participants aged 60 years and over with mild to moderate hypertension was recruited. Participants randomized to the intervention group (n=102) received a six-month community-based walking intervention based on self-efficacy theory. A public health nurse provided both face-to-face and telephone support designed to assist participants to increase their walking. Control group participants (n=100) received usual primary health care. Primary outcome was change in systolic blood pressure and secondary outcomes were exercise self-efficacy, self-reported walking and diastolic blood pressure.
  
  
  RESULTS
  At six-month follow-up the mean change in systolic blood pressure was a decrease of 15.4 mmHg and 8.4 mmHg in the intervention and control group, respectively. The difference in mean change between the two groups was -7.0 mmHg (95% CI, -11.5 to -2.5 mmHg, p=0.002). Improvement in exercise self-efficacy scores was greater among intervention group participants (mean difference 1.23, 95% CI, 0.5 to 2.0, p=0.001). Intervention group participants were more likely to report walking more (p<0.0005) but no differences were observed in diastolic blood pressure (p=0.19).
  
  
  CONCLUSIONS
  Among hypertensive older people, a six-month community-based walking intervention was effective in increasing their exercise self-efficacy and reducing systolic blood pressure.
authors.affiliation: Department of Nursing, Tzu Chi College of Technology, No. 880, Jen-Kuo Road,, Section 2, Hualien, 970, Taiwan. lllee@tccn.edu.tw
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Lee
authors.forename: Antony
authors.initials: A
authors.lastname: Arthur
authors.forename: Mark
authors.initials: M
authors.lastname: Avis
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D003153:Community Health Services; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011637:Public Health Nursing; D019035:Rural Health Services; D020377:Self Efficacy; D013624:Taiwan; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*