title: Clinical trial of tailored activity and eating newsletters with older rural women.
abstract: BACKGROUND
  Unhealthy diet and lack of physical activity increase rural midlife and older women's risk of chronic diseases and premature death, and they are behind urban residents in meeting Healthy People 2010 objectives.
  
  
  OBJECTIVE
  The objective of this study was to compare a tailored intervention based on the Health Promotion Model with a generic intervention to increase physical activity and healthy eating among rural women.
  
  
  METHODS
  In a randomized-by-site, community-based, controlled, clinical trial, Wellness for Women, 225 women aged 50 to 69 years were recruited in two similar rural areas. Over 12 months, women received by mail either 18 generic newsletters or 18 newsletters computer tailored on Health Promotion Model behavior-specific cognitions (benefits, barriers, self-efficacy, and interpersonal support), activity, and eating. Outcomes at 6 and 12 months included behavioral markers and biomarkers of physical activity and eating. Data were analyzed by repeated-measures analysis of variance and chi-square tests (alpha < .05).
  
  
  RESULTS
  Both groups significantly increased stretching and strengthening exercise and fruit and vegetable servings and decreased percentage of calories from fat, whereas only the tailored group increased moderate or greater intensity activity and decreased percentage of calories from saturated fat from baseline to 6 months. Both groups increased stretching and strengthening exercise, whereas only the tailored group increased moderate or greater intensity activity and fruit and vegetable servings and decreased percentage of calories from fat from baseline to 12 months. Both groups had several changes in biomarkers over the study. A higher proportion of women receiving tailored newsletters met Healthy People 2010 criteria for moderate or greater intensity activity, fruit and vegetable servings, and percentage of calories from fat at 12 months.
  
  
  CONCLUSIONS
  Mailed computer-tailored and generic print newsletters facilitated the adoption of change in both activity and eating over 6 months. Tailored newsletters were more efficacious in facilitating change over 12 months.
authors.affiliation: College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, USA. swalker@unmc.edu
authors.forename: Susan Noble
authors.initials: SN
authors.lastname: Walker
authors.forename: Carol H
authors.initials: CH
authors.lastname: Pullen
authors.forename: Linda
authors.initials: L
authors.lastname: Boeckner
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Hageman
authors.forename: Melody
authors.initials: M
authors.lastname: Hertzog
authors.forename: Maureen K
authors.initials: MK
authors.lastname: Oberdorfer
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Rutledge
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015444:Exercise / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D020380:Needs Assessment; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010347:Patient Care Planning / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration; D010506:Periodicals as Topic; D012423:Rural Health; D013813:Therapy, Computer-Assisted; D016387:Women's Health