Publications (7)16.25 Total impact
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Article: Lifestyle intervention and cardiovascular risk reduction in the Illinois WISEWOMAN Program.
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ABSTRACT: The Illinois WISEWOMAN Program (IWP) was designed to address the disproportionate risk of cardiovascular disease (CVD) among disadvantaged, low-income women. In total, 1021 women aged 40 to 64 years were recruited from the Illinois Breast and Cervical Cancer Program. The women were randomized to either a minimum intervention (MI) or an enhanced intervention (EI) group. Both groups received CVD risk factor screening and educational materials, and the EI group received a 12-week lifestyle change intervention. Demographic and clinical data were collected in addition to data on CVD risk, which was measured in terms of nutritional and physical activity behavior, using culturally adapted versions of three valid and reliable questionnaires. IWP data were analyzed for demographic characteristics and clinical and behavioral outcomes at baseline, post-intervention, and follow-up at 1 and 2 years from baseline. This article reports the change in these outcomes up to the 1-year follow-up. Participants in the EI group showed significant improvement on some of the dietary and physical activity outcomes both at post-intervention and 1-year follow-up. Compared with the MI group, the EI group showed more improvement in dietary fat- and fiber-related behaviors and increased physical activity levels. There were improvements in all of the cardiovascular outcomes at post-intervention in both the EI and MI groups; however, these changes were not statistically significant. As an integrated physical activity and nutrition intervention, the IWP has shown its strength in addressing some of the lifestyle behaviors for CVD prevention in this at-risk target population.Journal of Women s Health 12/2011; 21(3):294-301. · 1.57 Impact Factor -
Article: A web-based intervention to support increased physical activity among at-risk adults.
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ABSTRACT: Physical inactivity is an important contributor to the development of numerous chronic conditions and alone is an independent risk factor for diabetes, cardiovascular disease, and depression and yet, most Americans consistently fail to achieve the recommended amount of physical activity. As part of Project HealthDesign, we designed and prototyped a personal health record application (PHA) that delivers and supports a highly individualized, behaviorally based lifestyle physical activity intervention for sedentary adults. Through a user centered design approach, we engaged consumers, health care providers, and personal trainers for multiple facilitated group discussions and structured interviews to determine their needs and wants related to an activity PHA. The PHA was developed to include elements of evidence-based approaches which help participants adopt cognitive and behavioral skills such as goal-setting, self-monitoring, accepting social support, cognitive restructuring, contingency management, decisional balance, and relapse prevention. This PHA demonstrated the potential for research-based behavioral interventions to be delivered via a web portal. This finding is important for both consumers and their providers who have the desire to implement physical activity recommendations, but lack the tools to facilitate or undertake such interventions.Journal of Biomedical Informatics 10/2010; 43(5 Suppl):S41-5. · 1.79 Impact Factor -
Article: A lifestyle approach to reducing cardiovascular risk factors in underserved women: design and methods of the Illinois WISEWOMAN Program.
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ABSTRACT: Few lifestyle intervention programs address the needs of financially disadvantaged, low literacy populations. The overall goal of the Illinois WISEWOMAN Program (IWP) was to design such a program and test its effectiveness in reducing cardiovascular disease (CVD) risk, specifically physical activity and nutrition factors. The purpose of this paper is to describe the IWP study design and methods, development of the evidence-based curriculum appropriate for a low socioeconomic status (SES) population, and baseline characteristics of IWP participants. The Cooper Institute, in collaboration with the Illinois Department of Public Health and the University of Illinois at Chicago, adapted evidence-based interventions for financially disadvantaged, low literacy populations. The study used a randomized, two-group, experimental design. In total, 1021 women were recruited from the Illinois Breast and Cervical Cancer Program, which serves uninsured and underinsured women, aged 40-64, at or below 200% of poverty. The women were randomized to either a minimum intervention (MI) or an enhanced intervention (EI) group. Both groups received CVD risk factor screening and educational materials. Additionally, the EI group received a 12-week lifestyle intervention. Baseline comparisons show equivalent groups. IWP participants had a higher prevalence of obesity and smoking than similar national samples. IWP addressed many of the cultural and implementation barriers in programs that seek to improve the health of financially disadvantaged, low literacy populations. Because of the high burden of disease, the unique study population, and the sound design, we anticipate that our future results will contribute to the translation literature, which has largely ignored significant health disparities.Journal of Women s Health 04/2009; 18(3):409-19. · 1.57 Impact Factor -
Article: Results from the Active for Life process evaluation: program delivery fidelity and adaptations.
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ABSTRACT: Active for Life((R)) (AFL) was a large (n = 8159) translational initiative to increase physical activity (PA) in midlife and older adults. Translational research calls for a shift in emphasis from just understanding what works (efficacy) to also understanding how it works in more 'real world' settings. This article describes the process evaluation design and findings, discuss how these findings were used to better understand the translational process and provide a set of process evaluation recommendations with community-based translational research. AFL community organizations across the United States implemented one of two evidence-based PA programs (Active Living Every Day-The Cooper Institute; Human Kinetics Inc. or Active Choices-Stanford University). Both programs were based on the transtheoretical model and social cognitive theory. Overall, the process evaluation revealed high-dose delivery and implementation fidelity by quite varied community organizations serving diverse adult populations. Findings reveal most variation occurred for program elements requiring more participant engagement. Additionally, the results show how a collaborative process allowed the organizations to 'fit' the programs to their specific participant base while maintaining fidelity to essential program elements.Health Education Research 04/2009; 25(2):325-42. · 1.66 Impact Factor -
Article: Active for life: final results from the translation of two physical activity programs.
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ABSTRACT: Most evidence-based programs are never translated into community settings and thus never make a public health impact. Active for Life (AFL) was a 4-year translational initiative using a pre-post, quasi-experimental design. Data were collected from 2003 to 2007. Analyses were conducted in 2005 and 2008. Nine lead organizations at 12 sites participated. Active Choices participants (n=2503) averaged 65.8 years (80% women, 41% non-Hispanic white). Active Living Every Day (ALED) participants (n=3388) averaged 70.6 years (83% women, 64% non-Hispanic white). In AFL, Active Choices was a 6-month telephone-based and ALED a 20-week group-based lifestyle behavior change program designed to increase physical activity, and both were grounded in social cognitive theory and the transtheoretical model. The interventions were evaluated in Years 1, 3, and 4. An adapted shortened ALED program was evaluated in Year 4. Moderate- to vigorous-intensity physical activity, assessed with the CHAMPS self-reported measure. Posttest survey response rates were 61% for Active Choices and 70% for ALED. Significant increases in moderate- to vigorous-intensity physical activity, total physical activity, and satisfaction with body appearance and function, and decreases in BMI were seen for both programs. Depressive symptoms and perceived stress, both low at pretest, also decreased over time in ALED. Results were generally consistent across years and sites. Active Choices and ALED were successfully translated across a range of real-world settings. Study samples were substantially larger, more ethnically and economically diverse, and more representative of older adult's health conditions than in efficacy studies, yet the magnitude of effect sizes were comparable.American Journal of Preventive Medicine 11/2008; 35(4):340-51. · 4.04 Impact Factor -
Article: Results of the first year of active for life: translation of 2 evidence-based physical activity programs for older adults into community settings.
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ABSTRACT: Translating efficacious interventions into practice within community settings is a major public health challenge. We evaluated the effects of 2 evidence-based physical activity interventions on self-reported physical activity and related outcomes in midlife and older adults. Four community-based organizations implemented Active Choices, a 6-month, telephone-based program, and 5 implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active. Participants completed pretest and posttest surveys. Participants (n=838) were aged an average of 68.4 +/-9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys. Intent-to-treat analyses found statistically significant increases in moderate-to-vigorous physical activity and total physical activity, decreases in depressive symptoms and stress, increases in satisfaction with body appearance and function, and decreases in body mass index. The first year of Active for Life demonstrated that Active Choices and Active Living Every Day, 2 evidence-based physical activity programs, can be successfully translated into community settings with diverse populations. Further, the magnitudes of change in outcomes were similar to those reported in the efficacy trials.American Journal of Public Health 08/2006; 96(7):1201-9. · 3.93 Impact Factor -
Article: Pilot test of a behavioral skill building intervention to improve overall diet quality.
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ABSTRACT: To determine the effect of a cognitive and behavioral skills building intervention delivered via a small group or correspondence on improvement in total diet quality. Randomized, controlled trial comparing 2 intervention groups with a usual care (UC) group. Generally healthy men (n = 35) and women (n = 63); mean age = 49.6 years (range = 29 to 71 years). 20-session behavioral and cognitive skills curriculum to train participants to improve personal dietary habits that were inconsistent with public health guidelines. One group (weekly meeting [WM]) met in small groups with 2 cofacilitators. A correspondent (CR) group received the curriculum via mail and an interactive study Web site. The UC group received a copy of a consumer nutrition book. Modified Healthy Eating Index (MHEI) score derived from 9 components of the US Department of Agriculture's Healthy Eating Index. The WM group significantly improved their MHEI score compared with the CR (P =.04) and UC (P =.002) groups. The CR group's improvement in MHEI score was not significantly different from that of the UC group (P =.19). A behaviorally focused intervention can improve overall diet quality, especially if delivered through small-group meetings.Journal of Nutrition Education and Behavior 36(1):20-4. · 1.69 Impact Factor
