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Cardiovascular Health Interventions in Women

Cardiovascular Health Interventions in Women - JOURNAL O F...

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JOURNAL OF WOMEN’S HEALTH & GENDER-BASED MEDICINE Volume 10, Number 2, 2001 Mary Ann Liebert, Inc. Cardiovascular Health Interventions in Women: What Works? DEBRA A. KRUMMEL, Ph.D., R.D., 1 DYANN MATSON KOFFMAN, Dr.P.H., 2 YVONNE BRONNER, Sc.D., R.D., 3 JIM DAVIS, Ph.D., 4 KURT GREENLUND, Ph.D., 2 IRENE TESSARO, Dr.P.H., R.N., 1 DONA UPSON, M.D., 5 and JOELLEN WILBUR, Ph.D., R.N. 6 ABSTRACT Women’s Cardiovascular Health Network members representing 10 Prevention Research Cen- ters completed a literature review of approximately 65 population-based studies focused on improving women’s cardiovascular health through behavior change for tobacco use, physical inactivity, or diet. A framework was developed for conducting the search. Databases (Med- line, Psychlit, Smoking and Health, Cumulative Index to Nursing and Allied Health Litera- ture) of studies published from 1980 to 1998 were searched. The review was presented at a meeting of experts held in Atlanta, Georgia. Output from the meeting included identification of what has worked to improve cardiovascular health in women and recommendations for future behavioral research. Additional information is available at www.hsc.wvu.edu/ womens-cvh. Cardiovascular health interventions geared toward women are scant. Based on the available studies, program components that emerged as effective included personalized advice on diet and physical activity behaviors and tobacco cessation, multiple staff contacts with skill building, daily self-monitoring, and combinations of strategies. Recommendations for community-based tobacco, physical activity, and diet interventions are discussed. A few overarching recommendations were to (1) conduct qualitative research to determine the kinds of interventions women want, (2) examine relapse prevention, motivation, and maintenance of behavior change, (3) tailor programs to the stage of the life cycle, a woman’s readiness to change, and subgroups, that is, minority, low socioeconomic, and obese women, and (4) eval- uate policy and environmental interventions. The effects of cardiovascular interventions in women have been inappropriately understudied in women. Our review found that few stud- ies on cardiovascular risk factor modification have actually targeted women. Hence, adoption and maintenance of behavior change in women are elusive. Intervention research to improve women’s cardiovascular health is sorely needed. 117 1 West Virginia University School of Medicine, Morgantown, West Virginia. 2 Centers for Disease Control and Prevention, Atlanta, Georgia. 3 Johns Hopkins University, Baltimore, Maryland. Present address : Morgan State University, Baltimore, Maryland. 4 Saint Louis University, St. Louis, Missouri. 5 University of New Mexico, Albuquerque, New Mexico. 6 University of Illinois–Chicago, Chicago, Illinois.
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