Lifestyle intervention, behavioral changes, and improvement in cardiovascular risk profiles in the California WISEWOMAN project.
BACKGROUND
The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program in California (Heart of the Family) implements lifestyle interventions to improve health behaviors while reducing cardiovascular disease (CVD) risk factors among low income, uninsured, or underinsured Hispanic women aged 40-64 who participate in the Cancer Detection Programs: Every Woman Counts (CDP: EWC). This study reports the first-year results of the California WISEWOMAN program.


METHODS
Heart of the Family is a within-site randomized controlled study with an enhanced intervention group (EIG) and a usual care group (UCG). The study was conducted between January 2006 and June 2007 at four community health centers in Los Angeles and San Diego counties. Lifestyle counseling focusing on health behaviors was provided by bilingual, bicultural (Spanish and English) community health workers. The study examines two outcome measures: changes in health behaviors; and changes in the CVD risk profile, as measured by the 10-year probability of having a coronary heart disease (CHD) event.


RESULTS
Women in the EIG group (n = 433), compared to those in the UCG group (n = 436), experienced more improvements in health behaviors, both eating habits and physical activity. The improvement in the 10-year CHD risk was greater for EIG than UCG women. Multiple regression results indicate that this improvement was significantly greater when the women's CHD risk levels were in the upper quartile at baseline.


CONCLUSIONS
Compared with UCG women, women in the EIG were more likely to improve their health behaviors. The CVD risk profile, as measured by the 10-year CHD risk, improved in women with the highest baseline risk.
Hayashi
Toshi
T
Institute for Health and Aging, University of California, San Francisco, San Francisco, California, USA. toshi.hayashi@cdph.ca.gov
Farrell
Maureen A
MA
Chaput
Lily A
LA
Rocha
David A
DA
Hernandez
Marianne
M
D000328:Adult; D002140:California; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006630:Hispanic or Latino; D006801:Humans; D008019:Life Style; D017057:Medically Uninsured; D008875:Middle Aged; D012307:Risk Factors; D016387:Women's Health