Pamela Stewart Fahs

Promoting Heart Health in Rural Women

PURPOSEnTo compare 2 strategies, stage-matched nursing and community intervention (SMN+CI) and community intervention (CI) alone in changing cardiovascular risk factors in up to 3 behavioral areas: diet, physical activity, and/or smoking among rural women.nnnMETHODSnA 14-month, multisite randomized controlled trial of 117 rural women was conducted. Transtheoretical model was used in identification of stage of change and development of the SMN+CI nursing interventions. A social-ecological model was used to address issues of rurality in the development of interventions.nnnFINDINGSnThe SMNu2009+u2009CI group was superior on 4 outcomes. There were significant increases in 2 measures of dietary intake; improvement in dietary stage of change for fruits and vegetables; and reduced diastolic blood pressure (DBP) in the SMNu2009+u2009CI group. After log transformation DBP significance was lost. The CI group had a significant reduction in change in total cholesterol; however, significance was lost after control for the initiation of lipid lowering medications. There was a significant reduction in Framingham risk scores pre- to postintervention, regardless of group.nnnCONCLUSIONSnThere continues to be a need to improve cardiovascular risk factors in rural women. There should be an exploration of whether intensified dose and fidelity of the intervention strategies of diet and physical activity are effective in improving anthropometric and laboratory values. Further investigation is warranted into factors influencing the pre- to postreduction in Framingham risk scores.

C-Reactive Protein (hsCRP), Diet, and Physical Activity in Rural Women

Purpose: The purpose of this study was to evaluate the effect of dietary fruit and vegetable intake and physical activity (PA) levels on inflammatory marker high sensitivity C-reactive protein (hsCRP) among rural women 35-65 years of age. Sample: Rural, non-smoking women (N = 99) in two states. Method: Cohort analysis from a primary study with randomized-controlled trial (RCT). Results: The dependent variable was calculated as: (a) the log-transformed (log) hsCRP difference , post minus pre values and (b) post log hsCRP. There was no difference between the intervention groups on log difference hsCRP (t (97) = -.88, p = .38); however, those women in the experimental group had half the level of log hsCRP. There was a significant difference in log hsCRP difference by activity level (F (2, 90) = 3.67, p = .03) indicating higher activity reduced hsCRP. Those women with a moderate activity level in the experimental group had the lowest hsCRP levels. The log hsCRP difference was not significantly different when evaluated for those who increased or did not increase their fruit and vegetable intake (p = .35). When analyzed by body mass level there was a significant difference in log hsCRP difference (F = 2.96, 7, 47, p = .001). A multiple regression with three variables accounted for 12% of the variance in log hsCRP. C onclusion: Cardiovascular health of rural women is an area of great concern but limited research. The results of this study indicate increased levels of PA and fruit and vegetable intake by rural women are associated with decreased levels of hsCRP and thus with improved cardiovascular health. This study can contribute to the body of knowledge concerning the role of diet and physical activity on cardiovascular health in rural female populations. Key Words: Rural, C-reactive protein, Diet, Physical Activity, Female Cardiovascular Disease, CVD

RNO-DSON Call for Abstracts for Rural Conference Oct 2011

Announce the Bi-Annual International Rural Nursing & Rural Health ConferenceOctober 13, 14, & 15, 2011Including a special Graduate Student Research Session on October 15, 2011 in Binghamton, NYThe DSON, Binghamton University and the RNO are seeking abstracts of research, projects, practicexa0and conceptual or theoretical papers that focus on Rural Nursing or Health/Health Care of Rural andxa0Underserved Populations.xa0This is a broad xa0multidisciplinary conference with a special invitation for xa0interdisciplinary researchxa0teams focused on rural or underserved populations.xa0Review for podium presentations will require xa0completed xa0work by abstract deadline. xa0Symposiumxa0presentations may included completed work (desired) or in progress (if slots available). Posterxa0presentations and/or symposia may include work in progress with the planned completion date prior toxa0the October 2011 conference.