Outcomes of national community organization cardiovascular prevention programs for high-risk women

Amparo C Villablanca, Shavon Arline, Jacqui Lewis, Sekar Raju, Susan Sanders, Shannon Carrow

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The purpose of this study was to reduce cardiovascular disease (CVD) risk in women by implementing a cardiovascular prevention health promotion program in faith- and community-based sites. The primary outcomes were reducing obesity and increasing physical activity. A longitudinal cohort of high-risk (age∈>∈40, ethnic minority) women (n∈=∈1,052) was enrolled at 32 sites across the USA. The pre- or post-educational intervention consisted of eight biweekly counseling sessions conducted over 4 months each addressing one of six of the major CVD risk factors (smoking, diabetes, hypertension, cholesterol, obesity, and physical inactivity) as well as signs and symptoms of a heart attack and stroke; plus 4-6 maintenance sessions over three additional months. A multifaceted approach delivered by lay and medically trained personnel involving medical screenings, health behavior counseling, risk behavior modification, and stage of change were determined at baseline and end of counseling or maintenance. Following list-wise deletion, data were analyzed on 423 women who completed all follow-up time-points. Overall, significant improvement was attained in most of 28 secondary outcomes but not in the primary outcomes. Knowledge and awareness of heart disease as the leading killer or women, all of the signs and symptoms of a heart attack, calling 911, and CVD risk factors increased significantly (p∈<∈0.05) by 8.8%, 13.6%, 5.8%, and 10%, respectively. There was a 10% (p∈<∈0.05) increase in participants attaining control for hypertension (blood pressure∈<∈ 140/90) coupled with a significant reduction in mean blood pressure in the entire cohort. Knowledge of effective CVD risk modification strategies for all CVD risk factors increased significantly (p∈<∈0.05), except for obesity. In addition, there were significant (p∈<∈0.05) increases in forward movement in stage of change for each CVD risk factor (range +10% to +39%). Thus, a heart disease prevention intervention built around a model of community engagement, advocacy, self-efficacy, resource knowledge, and health promotion in faith- and community-based organizations is successful at improving cardiovascular knowledge and awareness outcomes in high-risk women. Limitations of our study include the high dropout rate, significant time demands on site coordinators, limited resources for program implementation, lack of morbidity and mortality endpoints, and failure to attain the primary outcomes of weight loss and physical activity. Future studies should not only assess the effect of community education interventions on lifestyle change and knowledge and awareness of participants but should also address program duration, cost, and resources required to attain improved outcomes.

Original languageEnglish (US)
Pages (from-to)306-320
Number of pages15
JournalJournal of Cardiovascular Translational Research
Volume2
Issue number3
DOIs
StatePublished - Sep 2009

Fingerprint

Cardiovascular Diseases
Organizations
Counseling
Obesity
Health Promotion
Signs and Symptoms
Heart Diseases
Myocardial Infarction
Maintenance
Exercise
Blood Pressure
Hypertension
Behavior Therapy
Health Behavior
Self Efficacy
Risk-Taking
Life Style
Weight Loss
Smoking
Stroke

Keywords

  • Community-Based
  • Education and Awareness
  • Faith-Based Organization
  • Heart Disease
  • Minority
  • Prevention
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Genetics
  • Genetics(clinical)
  • Molecular Medicine
  • Pharmaceutical Science

Cite this

Outcomes of national community organization cardiovascular prevention programs for high-risk women. / Villablanca, Amparo C; Arline, Shavon; Lewis, Jacqui; Raju, Sekar; Sanders, Susan; Carrow, Shannon.

In: Journal of Cardiovascular Translational Research, Vol. 2, No. 3, 09.2009, p. 306-320.

Research output: Contribution to journalArticle

Villablanca, Amparo C ; Arline, Shavon ; Lewis, Jacqui ; Raju, Sekar ; Sanders, Susan ; Carrow, Shannon. / Outcomes of national community organization cardiovascular prevention programs for high-risk women. In: Journal of Cardiovascular Translational Research. 2009 ; Vol. 2, No. 3. pp. 306-320.
@article{b12b8feb3c184100a13801b5cf07fe64,
title = "Outcomes of national community organization cardiovascular prevention programs for high-risk women",
abstract = "The purpose of this study was to reduce cardiovascular disease (CVD) risk in women by implementing a cardiovascular prevention health promotion program in faith- and community-based sites. The primary outcomes were reducing obesity and increasing physical activity. A longitudinal cohort of high-risk (age∈>∈40, ethnic minority) women (n∈=∈1,052) was enrolled at 32 sites across the USA. The pre- or post-educational intervention consisted of eight biweekly counseling sessions conducted over 4 months each addressing one of six of the major CVD risk factors (smoking, diabetes, hypertension, cholesterol, obesity, and physical inactivity) as well as signs and symptoms of a heart attack and stroke; plus 4-6 maintenance sessions over three additional months. A multifaceted approach delivered by lay and medically trained personnel involving medical screenings, health behavior counseling, risk behavior modification, and stage of change were determined at baseline and end of counseling or maintenance. Following list-wise deletion, data were analyzed on 423 women who completed all follow-up time-points. Overall, significant improvement was attained in most of 28 secondary outcomes but not in the primary outcomes. Knowledge and awareness of heart disease as the leading killer or women, all of the signs and symptoms of a heart attack, calling 911, and CVD risk factors increased significantly (p∈<∈0.05) by 8.8{\%}, 13.6{\%}, 5.8{\%}, and 10{\%}, respectively. There was a 10{\%} (p∈<∈0.05) increase in participants attaining control for hypertension (blood pressure∈<∈ 140/90) coupled with a significant reduction in mean blood pressure in the entire cohort. Knowledge of effective CVD risk modification strategies for all CVD risk factors increased significantly (p∈<∈0.05), except for obesity. In addition, there were significant (p∈<∈0.05) increases in forward movement in stage of change for each CVD risk factor (range +10{\%} to +39{\%}). Thus, a heart disease prevention intervention built around a model of community engagement, advocacy, self-efficacy, resource knowledge, and health promotion in faith- and community-based organizations is successful at improving cardiovascular knowledge and awareness outcomes in high-risk women. Limitations of our study include the high dropout rate, significant time demands on site coordinators, limited resources for program implementation, lack of morbidity and mortality endpoints, and failure to attain the primary outcomes of weight loss and physical activity. Future studies should not only assess the effect of community education interventions on lifestyle change and knowledge and awareness of participants but should also address program duration, cost, and resources required to attain improved outcomes.",
keywords = "Community-Based, Education and Awareness, Faith-Based Organization, Heart Disease, Minority, Prevention, Women",
author = "Villablanca, {Amparo C} and Shavon Arline and Jacqui Lewis and Sekar Raju and Susan Sanders and Shannon Carrow",
year = "2009",
month = "9",
doi = "10.1007/s12265-009-9118-5",
language = "English (US)",
volume = "2",
pages = "306--320",
journal = "Journal of Cardiovascular Translational Research",
issn = "1937-5387",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Outcomes of national community organization cardiovascular prevention programs for high-risk women

AU - Villablanca, Amparo C

AU - Arline, Shavon

AU - Lewis, Jacqui

AU - Raju, Sekar

AU - Sanders, Susan

AU - Carrow, Shannon

PY - 2009/9

Y1 - 2009/9

N2 - The purpose of this study was to reduce cardiovascular disease (CVD) risk in women by implementing a cardiovascular prevention health promotion program in faith- and community-based sites. The primary outcomes were reducing obesity and increasing physical activity. A longitudinal cohort of high-risk (age∈>∈40, ethnic minority) women (n∈=∈1,052) was enrolled at 32 sites across the USA. The pre- or post-educational intervention consisted of eight biweekly counseling sessions conducted over 4 months each addressing one of six of the major CVD risk factors (smoking, diabetes, hypertension, cholesterol, obesity, and physical inactivity) as well as signs and symptoms of a heart attack and stroke; plus 4-6 maintenance sessions over three additional months. A multifaceted approach delivered by lay and medically trained personnel involving medical screenings, health behavior counseling, risk behavior modification, and stage of change were determined at baseline and end of counseling or maintenance. Following list-wise deletion, data were analyzed on 423 women who completed all follow-up time-points. Overall, significant improvement was attained in most of 28 secondary outcomes but not in the primary outcomes. Knowledge and awareness of heart disease as the leading killer or women, all of the signs and symptoms of a heart attack, calling 911, and CVD risk factors increased significantly (p∈<∈0.05) by 8.8%, 13.6%, 5.8%, and 10%, respectively. There was a 10% (p∈<∈0.05) increase in participants attaining control for hypertension (blood pressure∈<∈ 140/90) coupled with a significant reduction in mean blood pressure in the entire cohort. Knowledge of effective CVD risk modification strategies for all CVD risk factors increased significantly (p∈<∈0.05), except for obesity. In addition, there were significant (p∈<∈0.05) increases in forward movement in stage of change for each CVD risk factor (range +10% to +39%). Thus, a heart disease prevention intervention built around a model of community engagement, advocacy, self-efficacy, resource knowledge, and health promotion in faith- and community-based organizations is successful at improving cardiovascular knowledge and awareness outcomes in high-risk women. Limitations of our study include the high dropout rate, significant time demands on site coordinators, limited resources for program implementation, lack of morbidity and mortality endpoints, and failure to attain the primary outcomes of weight loss and physical activity. Future studies should not only assess the effect of community education interventions on lifestyle change and knowledge and awareness of participants but should also address program duration, cost, and resources required to attain improved outcomes.

AB - The purpose of this study was to reduce cardiovascular disease (CVD) risk in women by implementing a cardiovascular prevention health promotion program in faith- and community-based sites. The primary outcomes were reducing obesity and increasing physical activity. A longitudinal cohort of high-risk (age∈>∈40, ethnic minority) women (n∈=∈1,052) was enrolled at 32 sites across the USA. The pre- or post-educational intervention consisted of eight biweekly counseling sessions conducted over 4 months each addressing one of six of the major CVD risk factors (smoking, diabetes, hypertension, cholesterol, obesity, and physical inactivity) as well as signs and symptoms of a heart attack and stroke; plus 4-6 maintenance sessions over three additional months. A multifaceted approach delivered by lay and medically trained personnel involving medical screenings, health behavior counseling, risk behavior modification, and stage of change were determined at baseline and end of counseling or maintenance. Following list-wise deletion, data were analyzed on 423 women who completed all follow-up time-points. Overall, significant improvement was attained in most of 28 secondary outcomes but not in the primary outcomes. Knowledge and awareness of heart disease as the leading killer or women, all of the signs and symptoms of a heart attack, calling 911, and CVD risk factors increased significantly (p∈<∈0.05) by 8.8%, 13.6%, 5.8%, and 10%, respectively. There was a 10% (p∈<∈0.05) increase in participants attaining control for hypertension (blood pressure∈<∈ 140/90) coupled with a significant reduction in mean blood pressure in the entire cohort. Knowledge of effective CVD risk modification strategies for all CVD risk factors increased significantly (p∈<∈0.05), except for obesity. In addition, there were significant (p∈<∈0.05) increases in forward movement in stage of change for each CVD risk factor (range +10% to +39%). Thus, a heart disease prevention intervention built around a model of community engagement, advocacy, self-efficacy, resource knowledge, and health promotion in faith- and community-based organizations is successful at improving cardiovascular knowledge and awareness outcomes in high-risk women. Limitations of our study include the high dropout rate, significant time demands on site coordinators, limited resources for program implementation, lack of morbidity and mortality endpoints, and failure to attain the primary outcomes of weight loss and physical activity. Future studies should not only assess the effect of community education interventions on lifestyle change and knowledge and awareness of participants but should also address program duration, cost, and resources required to attain improved outcomes.

KW - Community-Based

KW - Education and Awareness

KW - Faith-Based Organization

KW - Heart Disease

KW - Minority

KW - Prevention

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=68749109276&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68749109276&partnerID=8YFLogxK

U2 - 10.1007/s12265-009-9118-5

DO - 10.1007/s12265-009-9118-5

M3 - Article

C2 - 19654887

AN - SCOPUS:68749109276

VL - 2

SP - 306

EP - 320

JO - Journal of Cardiovascular Translational Research

JF - Journal of Cardiovascular Translational Research

SN - 1937-5387

IS - 3

ER -