title: Heart-to-Heart: promoting walking in rural women through motivational interviewing and group support.
abstract: BACKGROUND
  Walking can significantly increase cardiorespiratory fitness and thereby reduce the incidence of heart disease in women. However, there is a paucity of research aimed at increasing walking in rural women, a high-risk group for heart disease and one for which exercise strategies may pose particular challenges.
  
  
  OBJECTIVE
  This study tested Heart-to-Heart (HTH), a 12-week walking program, designed to increase fitness through walking in rural women. Heart-to-Heart integrated individual-oriented strategies, including motivational interviewing, and group-based strategies, including team building.
  
  
  METHODS
  Forty-six rural women were randomized to either HTH or a comparison group. The primary outcome of cardiorespiratory fitness and secondary outcomes of self-efficacy and social support were measured preintervention and post-intervention. Group differences were analyzed with repeated-measures analysis of variance.
  
  
  RESULTS
  Women in HTH group had a greater improvement in cardiorespiratory fitness (P =.057) and in social support (P =.004) compared with women in the comparison group. Neither group of women experienced a change in exercise self-efficacy (P =.814).
  
  
  CONCLUSIONS
  HTH was effective in improving cardiorespiratory fitness in a sample of rural women. Further research is needed to refine HTH and determine the optimal approach in rural women to increase their walking.
authors.affiliation: Family and Child Nursing, University of Washington, Seattle, WA 98195-7262, USA. perryc@u.washington.edu
authors.forename: Cindy K
authors.initials: CK
authors.lastname: Perry
authors.forename: Anne G
authors.initials: AG
authors.lastname: Rosenfeld
authors.forename: Jill A
authors.initials: JA
authors.lastname: Bennett
authors.forename: Kathleen
authors.initials: K
authors.lastname: Potempa
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009042:Motivation; D012424:Rural Population; D012649:Self Concept; D012944:Social Support; D016138:Walking