Who's addressing the cardiovascular needs of uninsured women? The WISEWOMAN projects

Abstract

RATIONALE: Uninsured women are an especially vulnerable population with a host of cardiovascular disease (CVD) risk factors. WISEWOMAN was developed to address the screening and intervention needs of this special population. OBJECTIVES: To assess the effect of enhanced interventions on CVD risk factors. METHODS: Women receiving free mammography and Pap smear screening in three states were enrolled in a supplemental CVD risk factor screening and intervention program involving either a minimum (MI) or enhanced intervention (EI). The EI featured a variety of skill-building exercises and activities to improve diet and increase physical activity. Blood pressure, body mass index, total cholesterol, HDL cholesterol, smoking, diet and physical activity were assessed at baseline, 6 months, and 12 months. We used mixed model regression with adjustment for age, race, and education to compare intervention groups at baseline and 12 month follow-up. RESULTS: Blood pressure, total cholesterol, and HDL cholesterol profiles improved in both the MI and EI groups. Body weight was maintained and smoking declined in both groups. Whereas the EI group was significantly more likely to increase their daily intake of fruit and vegetables compared to the MI group (P=0.001), no such differences were found for the other measurements. CONCLUSIONS: Lifestyle behaviors and physiologic measures were improved in both groups. Further research is needed to help uninsured women achieve maximum behavioral and physiologic change.