1. Kennedy, Maureen Shawn MA, RN


A tailored health promotion can be effective.


Article Content

Increased morbidity and mortality rates have a well documented link to unhealthful diet and low levels of physical activity. These factors are especially salient in midlife and older rural women, who have demonstrated some of the poorest lifestyle behaviors and health outcomes. A group of researchers hypothesized that improvements to the health-related behaviors and outcomes in this population can be achieved by using a public health intervention that targets physical activity and eating behaviors simultaneously. In a "randomized-by-site, community-based [horizontal ellipsis] clinical trial," 225 women (mean age = 58 years, 94% white, 74% attended some college or were college graduates, 47% employed full-time) were recruited in two rural areas. Participants were randomized to one of two groups: generic newsletters (n = 110) or computer-tailored "health promotion model" (HPM) newsletters (n = 115). At six and 12 months behavioral markers and biomarkers of physical activity and eating were recorded. Overall, there were improvements in several behavior-change and health-outcome measures in both groups at both six and 12 months. However, comparisons in physical activity, healthful eating, and biomarkers revealed significant improvements in specific areas in the HPM group, compared with the generic group. For example, at 12 months the HPM group achieved greater lower body strength as measured through timed standing. The HPM group also sustained an increased intake of fruits and vegetables at 12 months, whereas the generic-information group had returned to baseline levels. Finally, the percentages of body fat differed significantly between groups, with the HPM group trending consistently downward and the generic-information group trending upward. These findings provide additional support for the practice of encouraging improvements in health behaviors in rural women by providing them with health information. Moreover, the results indicate that providing health and lifestyle information that is tailored to a specific population's needs may result in significant added health benefits.


Walker SN, et al. Nurs Res 2009;58(2):74-85.