Cardiovascular health interventions in women: What works?

Women's Cardiovascular Health Network members representing 10 Prevention Re search Centers completed a literature review of approximately 65 population -based studies focused on improving women's cardiovascular health through b ehavior change for tobacco use, physical inactivity, or diet. A framework w as developed for conducting the search. Databases (Medline, Psychlit, Smoki ng and Health, Cumulative Index to Nursing and Allied Health Literature) of studies published from 1980 to 1998 were searched. The review was presente d at a meeting of experts held in Atlanta, Georgia. Output from the meeting included identification of what has worked to improve cardiovascular healt h in women and recommendations for future behavioral research. Additional i nformation is available at www.hsc.wvu.edul womens-cvh. Cardiovascular heal th interventions geared toward women are scant. Based on the available stud ies, program components that emerged as effective included personalized adv ice on diet and physical activity behaviors and tobacco cessation, multiple staff contacts with skill building, daily self-monitoring, and combination s of strategies. Recommendations for community-based tobacco, physical acti vity, and diet interventions are discussed. A few overarching recommendatio ns were to (1) conduct qualitative research to determine the kinds of inter ventions women want, (2) examine relapse prevention, motivation, and mainte nance of behavior change, (3) tailor programs to the stage of the life cycl e, a woman's readiness to change, and subgroups, that is, minority, low soc ioeconomic, and obese women, and (4) evaluate policy and environmental inte rventions. The effects of cardiovascular interventions in women have been i nappropriately understudied in women. Our review found that few studies on cardiovascular risk factor modification have actually targeted women. Hence , adoption and maintenance of behavior change in women are elusive. Interve ntion research to improve women's cardiovascular health is sorely needed.