Cardiovascular disease risk factor intervention in low-income women: The North Carolina WISEWOMAN project

Objectives. The North Carolina WISEWOMAN project was initiated to evaluate the feasibility of expanding an existing cancer screening program to includ e a cardiovascular disease (CVD) screening and intervention program among l ow-income women. Methods. Seventeen North Carolina county health departments were designated as minimum intervention (MI), and 14 as enhanced intervention (EI). The EI included three specially constructed counseling sessions spanning 6 months using a structured assessment and intervention program tailored to lower i ncome women. Results. Of the 2,148 women screened, 40% had elevated total cholesterol (g reater than or equal to 240 mg/dL), 39% had low high-density lipoprotein ch olesterol (HDL-C) levels (<45 mg/ dL), and 63% were hypertensive (systolic blood pressure 140 and/or diastolic blood pressure greater than or equal to 90 mm Hg or on hypertensive medication). The majority of women (86%) had a t least one of these three risk factors. Seventy-six percent were either ov erweight or obese. After 6 months of follow-up in the EI health departments , changes in total cholesterol levels, HDL-C levels, diastolic blood pressu re, and BMI were observed (-5.8 mg/ dL, -0.9 mg/dL, -1.7 mm Hg, and -0.3 kg /m(2), respectively), but were not significantly different from MI health d epartments. A dietary score that summarized fat and cholesterol intake impr oved by 2.1 units in the EI group, compared with essentially no change in t he MI group. Conclusions. Expanding existing cancer screening programs to include CVD in tervention was feasible and may be an effective means for promoting healthf ul dietary practices among low-income women. (C) 2000 American Health Found ation and Academic Press.