The University of Nebraska Medical Center College of Nursing has received
a four-year, $1.6 million grant from the National Institute of Nursing
Research, National Institutes of Health, to evaluate the effectiveness
of a program to encourage women living in rural areas to adopt health-related
behaviors of physical activity and healthy eating. Lack of physical activity
and poor diet together increase individuals risk for many chronic diseases
and account for at least 300,000 deaths annually in the United States,
according to the U.S. Department of Health and Human Services.
Two groups of 110 randomly-selected women, ages 50 to 69, will be recruited
for the study from the Scottsbluff, Gering and Norfolk areas. The grant
focuses on women in rural areas where there is less access to exercise
facilities and other health promotion activities, as well as distance and
transportation barriers.
The study is designed so women can work toward their lifestyle change
goals at home rather than in organized groups.
The study is unique, say researchers, in that it targets behavior changes
simultaneously in physical activity and healthy eating in this population,
and follows participants over two years. Researchers say positive changes
in diet and exercise can significantly change midlife and older rural womens
risk for disability and premature death.
Womens health risks increase at menopause, but chronic diseases and
their associated disability do not have to be an inevitable consequence
of aging, said Susan Noble Walker, Ed.D., principal investigator for the
grant. Research shows lifestyle choices have more influence than genetics
in determining how well one ages. There is an increasing density of this
population of women in rural areas. Helping them to stay healthy is a high
priority in Nebraska.
Dr. Walker, professor and chair of the Department of Gerontological,
Psychosocial and Community Health Nursing at UNMC, has more than 20 years
of experience working in the area of health-promoting lifestyle behavior.
She said the study is well-suited for those women at menopause and beyond
who may be more interested in improving their health to maintain an independent
lifestyle as they age.
The research is designed to evaluate an innovative approach to achievement
of the nations Healthy People 2010 objectives, which are built on the
best scientific knowledge in the public health arena. HP 2010 reflects
consensus that midlife and older women should reduce consumption of dietary
fat, increase consumption of fruits, vegetables and grain products and
engage regularly in moderate intensity physical activity. It also calls
for activities that enhance muscular strength, endurance and flexibility
in order to reduce the risk for chronic diseases.
Disability in older women is costly and may be preventable by the adoption
of health-promoting lifestyle behaviors, said Carol Pullen, Ed.D., co-principal
investigator for the study and UNMC College of Nursing assistant dean for
rural nursing education. Rural older women are particularly vulnerable
to disability associated with chronic illness as compared with their urban
counterparts. They are poorer in health, have a greater incidence of chronic
disease and suffer more limitations in daily activities.
The interdisciplinary team of investigators also includes Patricia Hageman,
Ph.D., director of physical therapy education in the UNMC School of Allied
Health Professions, Linda Boeckner, Ph.D., University of Nebraska-Lincoln
(UNL) Department of Nutritional Science and Dietetics and Jan Atwood, Ph.D.,
UNMC College of Nursing.
Study participants will be selected randomly through the UNL Bureau
of Sociological Research. They will receive initial and periodic assessments
of dietary and activity patterns via the Internet, and physical function
and blood cholesterol testing by registered nurses at the local cooperative
extension offices. They also will be assisted in setting goals for eating
and activity change, as well as guidance about behavior change through
periodic newsletters.
Marcia Gilliam, 53, of Omaha, was involved in a three-month preliminary
study directed by Dr. Hageman that evaluated short-term compliance to a
similar exercise program this summer. She found the program motivated her
to exercise, which gave her increased energy and strength as well as decreasing
her body fat.
“The study freed me up to take care of myself,” Gilliam said. “There’s
always something else you have to take care of like laundry and other responsibilities.
It helped me form the habit, so I think I’m able to keep it going now.
I told them (the researchers) I’d like to have them follow me for two more
years. I needed the motivation.”