lunes, 12 de mayo de 2014

Preventing Chronic Disease | The Effect of the Missouri WISEWOMAN Program on Control of Hypertension, Hypercholesterolemia, and Elevated Blood Glucose Among Low-Income Women - CDC

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Preventing Chronic Disease | The Effect of the Missouri WISEWOMAN Program on Control of Hypertension, Hypercholesterolemia, and Elevated Blood Glucose Among Low-Income Women - CDC



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The Effect of the Missouri WISEWOMAN Program on Control of Hypertension, Hypercholesterolemia, and Elevated Blood Glucose Among Low-Income Women

Sherri G. Homan, RN, FNP, PhD; David G. McBride, PhD; Shumei Yun, MD, PhD

Suggested citation for this article: Homan SG, McBride DG, Yun S. The Effect of the Missouri WISEWOMAN Program on Control of Hypertension, Hypercholesterolemia, and Elevated Blood Glucose Among Low-Income Women. Prev Chronic Dis 2014;11:130338. DOI: http://dx.doi.org/10.5888/pcd11.130338External Web Site Icon.
PEER REVIEWED

Abstract

Introduction
The Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) public health program is designed to reduce the risk of heart disease and stroke among low-income, underinsured or uninsured women through clinical screenings, risk factor assessment, and lifestyle interventions. We assessed the effect of the Missouri WISEWOMAN program on the control of high blood pressure, total cholesterol, and blood glucose levels.
Methods
We calculated the proportion of participants (N = 1,130) with abnormal blood pressure, total cholesterol, or blood glucose levels at an initial screening visit who gained control at a follow-up visit 11 to 18 months later during a 7-year period from June 30, 2005, to June 29, 2012. We used logistic regression to identify sociodemographic characteristics and other factors associated with achieving control.
Results
Many WISEWOMAN participants gained control of their blood pressure (41.2%), total cholesterol (24.7%), or blood glucose levels (50.0%). After controlling for sociodemographic factors, smoking status, weight status, medication use, and number of lifestyle interventions, nondiabetic women with stage II hypertension (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] = 0.21–0.60) and diabetic women with stage I (AOR = 0.54, 95% CI = 0.32–0.92) and stage II (AOR = 0.23, 95% CI = 0.07–0.77) hypertension were less likely to achieve control of their blood pressure than nondiabetic women with stage I hypertension. Women aged 45 to 64, women with less than a high school education, women who were obese in the initial visit, women who gained 7% or more of their weight, and women who did not participate in any lifestyle intervention sessions were significantly less likely to achieve total cholesterol control than their counterparts.




Conclusion
The Missouri WISEWOMAN program helps many participants achieve control of blood pressure, total cholesterol, and blood glucose levels; the lifestyle intervention is likely to help participants control total cholesterol. More efforts are needed for women with diabetes and stage II hypertension to achieve blood pressure control.

Author Information

Corresponding Author: Shumei Yun, MD, PhD, Missouri Department of Health and Senior Services, Division of Community and Public Health, 920 Wildwood Dr, Jefferson City, MO, 65102-0570. Telephone: 573-522-2809. E-mail: Shumei.Yun@health.mo.gov.
Author Affiliations: Sherri G. Homan, David G. McBride, Missouri Department of Health and Senior Services, Jefferson City, Missouri.

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