The purpose of this study is to evaluate the effectiveness of an intervention framed within the Health Promotion Model (Pender, 1996) in changing the health-related behaviors of insufficient physical activity and poor diet among an underserved and vulnerable population of rural women aged 50 to 69. Women's health risks increase at menopause, but chronic diseases and their associated disability and economic costs are not an inevitable consequence of aging. It has been demonstrated that lifestyle choices play a greater role than genetics in determining how well one ages. The Healthy People 2010 objectives reflect consensus that midlife and older women should reduce consumption of dietary fat, increase consumption of fruits, vegetables, and grain products, and engage regularly in moderate intensity physical activity and in activities that enhance muscular strength, muscular endurance and flexibility to reduce risk for many chronic diseases. A randomized by group controlled trial will evaluate prospectively whether 110 women who receive a theory-based intervention tailored to constructs in the HPM will be more successful than 110 who receive a standard intervention in initiating and maintaining long-term change in physical activity and healthy eating behaviors. The theory-based intervention will include individualized plans of action and newsletters with content tailored to HPM constructs; the standard intervention will include customary instructional materials arranged in non-tailored newsletter format. The project's aims are to: 1) compare the effectiveness of an HPM-tailored and a standard (non-tailored) intervention in facilitating initiation (3, 6 mo.) and maintenance (9, 12, 18, 24 mo.) of change in physical activity and healthy eating (as measures by behavioral and biomarkers); 2) compare the effectiveness of an HPM-tailored and a standard intervention in facilitating change in behavior-specific influences from the HPM (perceived benefits, perceived barriers, perceived self-efficacy and interpersonal influences) at 6 &12 months during the intervention and at 18 &24 months following the intervention.; and 3) determine the extent to which HPM variables: individual characteristics and experiences (prior related behavior, age, health/functional status and readiness for behavior change) and behavior-specific influences (perceived benefits, barriers, self-efficacy and interpersonal influences) explain and predict the initiation and maintenance of physical activity and healthy eating. Innovative features of the study are: a) targeting of under-served rural women, b) creative approaches to reach these women c) simultaneous focus on two behaviors, d) multiple points of intervention over 1 year to allow time for incorporation of behavior change into lifestyle, e) evaluation of maintenance of behavior change over 2 years, and f) technologically advanced use of the Intranet to obtain assessment data and computer algorithms to generate tailored newsletters.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR004861-04
Application #
6759232
Study Section
Nursing Research Study Section (NURS)
Program Officer
Bryan, Yvonne E
Project Start
2001-09-15
Project End
2006-06-30
Budget Start
2004-07-01
Budget End
2006-06-30
Support Year
4
Fiscal Year
2004
Total Cost
$419,311
Indirect Cost
Name
University of Nebraska Medical Center
Department
Type
Schools of Nursing
DUNS #
168559177
City
Omaha
State
NE
Country
United States
Zip Code
68198
Boeckner, L S; Young, T D; Pullen, C H et al. (2015) Dietary mineral intakes of rural midlife to older adult women with prehypertension in Midwestern United States. J Nutr Health Aging 19:13-9
Hageman, Patricia A; Pullen, Carol H; Hertzog, Melody et al. (2014) Effectiveness of tailored lifestyle interventions, using web-based and print-mail, for reducing blood pressure among rural women with prehypertension: main results of the Wellness for Women: DASHing towards Health clinical trial. Int J Behav Nutr Phys Act 11:148
Hageman, Patricia A; Pullen, Carol H; Dizona, Paul et al. (2013) Obesity and Physical Function in Rural Women who enroll in a Lifestyle Modification Intervention for Reducing Blood Pressure. Cardiopulm Phys Ther J 24:4-11
Hageman, Patricia A; Pullen, Carol H; Hertzog, Melody et al. (2012) Associations of cardiorespiratory fitness and fatness with metabolic syndrome in rural women with prehypertension. J Obes 2012:618728
Yates, Bernice C; Pullen, Carol H; Santo, Jonathan Bruce et al. (2012) The influence of cognitive-perceptual variables on patterns of change over time in rural midlife and older women's healthy eating. Soc Sci Med 75:659-67
Walker, Susan Noble; Pullen, Carol H; Hageman, Patricia A et al. (2010) Maintenance of activity and eating change after a clinical trial of tailored newsletters with older rural women. Nurs Res 59:311-21
Walker, Susan Noble; Pullen, Carol H; Boeckner, Linda et al. (2009) Clinical trial of tailored activity and eating newsletters with older rural women. Nurs Res 58:74-85
Boeckner, Linda S; Pullen, Carol H; Walker, Susan Noble et al. (2007) Eating behaviors and health history of rural midlife to older women in the midwestern United States. J Am Diet Assoc 107:306-10
Walker, Susan Noble; Pullen, Carol H; Hertzog, Melody et al. (2006) Determinants of older rural women's activity and eating. West J Nurs Res 28:449-68; discussion 469-74
Hageman, Patricia A; Walker, Susan Noble; Pullen, Carol H et al. (2005) Physical activity and fitness among midlife and older rural women. J Aging Phys Act 13:327-42

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