Reducing Blood Pressure in Prehypertensive Older Rural Women Also Known as Wellness for Women: DASHing Toward Health
Condition: Pre-Hypertension
MeSH terms: Prehypertension
Study type: Interventional

Summary: 
      The purpose of this study is to evaluate the effectiveness of a theory-based intervention
      tailored to constructs in the Health Promotion Model and delivered by two distance modes to
      achieve improvement in healthy eating and physical activity for the control of blood pressure
      (BP) among an underserved and vulnerable population of prehypertensive rural women aged 50 to
      69.
    

Detailed description: 
      Hypertension (HTN), a major health problem in the US, is the most prevalent modifiable risk
      factor for cardio-vascular disease (CVD), the leading killer of women. The incidence of HTN
      in women increases markedly after menopause, equaling or exceeding that in men. The
      prehypertension category of blood pressure (BP) -- systolic BP of 120-139 mm Hg or diastolic
      BP of 80-89 mm Hg -- designates individuals at high risk of developing HTN. Prehypertensive
      women are not candidates for drug therapy, but for lifestyle modifications to prevent
      progression to HTN and CVD. Recommended lifestyle modifications include adoption of the
      Dietary Approaches to Stop Hypertension (DASH) diet that is high in fruits, vegetables and
      low fat dairy products; dietary sodium reduction; regular endurance physical activity
      supplemented by resistance exercise; and weight reduction by those who are overweight or
      obese. A few studies of face-to-face individual and/or group interventions have demonstrated
      that these lifestyle modifications could lower BP over 6 months in pre-hypertensive
      individuals. There remains a need to develop distance delivery methods to target rural women
      with similar behavioral interventions to lower BP. This competitive renewal application will
      build upon our current work in which we demonstrated that computer-generated print (mailed)
      newsletters tailored to constructs in the Health Promotion Model (HPM) resulted in
      significant and clinically important changes in behavioral and biomarkers of healthy eating
      and physical activity in a general population of rural midlife/older women. The proposed
      randomized controlled trial will evaluate Internet versus mailed print delivery methods for
      delivering theory-based tailored newsletters to encourage lifestyle change for BP reduction.
      A sample of 275 prehypertensive rural women aged 50-69 will be randomly assigned 2:2:1 to
      receive a) tailored messages delivered via the Internet and brief telephone counseling, b)
      tailored print newsletters delivered via mail and brief telephone counseling, or c) initial
      standard advice only. Results of this study may lead to expanded access to lifestyle guidance
      via the Internet by other populations.
    

Intervention name(s): Tailored Internet Newsletters; Tailored print newsletters delivered via mail
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Tailored newsletters delivered via the Internet with content for improving eating and activity to reduce blood pressure; Tailored Newsletters with content to improve eating and activity to reduce blood pressure
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment