Koffman D M, Bazzarre T, Mosca L, Redberg R, Schmid T, Wattigney W A
Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-47, Atlanta, GA 30341-3717, USA.
Arch Intern Med. 2001 Oct 8;161(18):2193-9. doi: 10.1001/archinte.161.18.2193.
Rates of physical inactivity and poor nutrition, which are 2 of the most important modifiable risk factors for cardiovascular disease in women, are substantial. Even so, studies of interventions designed to improve lifestyle behaviors in women have been limited and often confined to particular geographical areas.
To evaluate the effect of Choose to Move on increasing women's physical activity, improving their knowledge of heart disease and stroke, and improving their nutrition.
A prospective, nonrandomized, 12-week educational intervention designed by the American Heart Association for women across the United States. Participants received a welcome kit and manual with weekly information about how to manage cardiovascular disease risk factors and how to build a support system for lifestyle change. Women (N = 23 171) aged 25 years or older were recruited by direct mail, the media, health care providers, and other means. Follow-up evaluations were returned from 6389 women at 2 weeks, 5338 at 4 weeks, 4209 at 8 weeks, 3916 at 10 weeks, and 3775 at 12 weeks. Participants self-reported their physical activity, diet, and knowledge about heart disease, stroke, and related symptoms.
Ninety percent of the participants were white and 56% were aged between 35 and 54 years. Among the participants who completed the week 12 follow-up evaluation, the percentage who reported being active (at least moderate exercise > or =5 times per week or >2(1/2) hours per week for the past 1 to 6 months) increased from 32% at baseline to 67% at the program's end (P =.001). Participants currently limiting excess calories or fat increased from 72% to 91% at week 10 follow-up evaluation (P =.001). The proportion correctly identifying heart disease as the leading cause of death increased from 84% to 91% at week 10 follow-up evaluation (P<.001).
Women who completed the Choose to Move program evaluation reported that they significantly increased their levels of physical activity, reduced their consumption of high-fat foods, and increased their knowledge and awareness of cardiovascular disease risk and its symptoms. This program provides an important model for public health, voluntary, and other health organizations of population-based, targeted low-cost self-help programs that support the Healthy People 2010 objectives for physical activity, nutrition, and cardiovascular health.
缺乏身体活动和营养不良是女性心血管疾病最重要的两个可改变风险因素，其发生率很高。即便如此，旨在改善女性生活方式行为的干预研究一直有限，且往往局限于特定地理区域。
评估“选择行动”项目在增加女性身体活动、提高她们对心脏病和中风的认识以及改善她们营养状况方面的效果。
这是一项由美国心脏协会为美国各地女性设计的前瞻性、非随机、为期12周的教育干预项目。参与者收到一个欢迎礼包和手册，其中每周提供有关如何管理心血管疾病风险因素以及如何建立生活方式改变支持系统的信息。通过直邮、媒体、医疗保健提供者及其他方式招募年龄在25岁及以上的女性（N = 23171）。在2周时收到6389名女性的随访评估回复，4周时收到5338名，8周时收到4209名，10周时收到3916名，12周时收到3775名。参与者自行报告她们的身体活动、饮食以及对心脏病、中风和相关症状的了解情况。
90%的参与者为白人，56%的参与者年龄在35至54岁之间。在完成第12周随访评估的参与者中，报告有身体活动（过去1至6个月内至少进行中等强度运动每周≥5次或每周＞2.5小时）的比例从基线时的32%增至项目结束时的67%（P = 0.001）。在第10周随访评估时，目前限制热量或脂肪摄入过多的参与者比例从72%增至91%（P = 0.001）。在第10周随访评估时，正确将心脏病识别为主要死因的比例从84%增至91%（P＜0.001）。
完成“选择行动”项目评估的女性报告称，她们显著增加了身体活动水平，减少了高脂肪食物的摄入，并提高了对心血管疾病风险及其症状的认识。该项目为公共卫生、志愿及其他健康组织提供了一个重要模式，即基于人群、有针对性的低成本自助项目，以支持《2010年美国人健康目标》中关于身体活动、营养和心血管健康的目标。
