title: The StrongWomen-Healthy Hearts program: reducing cardiovascular disease risk factors in rural sedentary, overweight, and obese midlife and older women.
abstract: OBJECTIVE
  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.
authors.affiliation: John Hancock Center for Physical Activity and Nutrition,Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA. sara.folta@tufts.edu
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Seguin
authors.forename: Jeanne P
authors.initials: JP
authors.lastname: Goldberg
authors.forename: Julia F
authors.initials: JF
authors.lastname: Kuder
authors.forename: Miriam E
authors.initials: ME
authors.lastname: Nelson
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001131:Arkansas; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004038:Diet, Reducing; D002149:Energy Intake; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007615:Kansas; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000517:prevention & control; D050177:Overweight / Q000150:complications / Q000517:prevention & control; D012044:Regression Analysis; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population; D016896:Treatment Outcome