Tackling the Higher Rate of Stroke Among Low-Income Women
Presence Mercy Medical Center Studies Feasibility of “Be Wise” Lifestyle Intervention
Aurora, IL – Stroke is the third leading cause of death for women, this according to the American Heart Association. However, studies have shown that women – and especially low-income women – underestimate their personal risk for stroke. A newly published study by Helen Agomo, DNP, APRN, ACNS-BC, the Clinical Nurse Specialist and Stroke Program Coordinator at Presence Mercy Medical Center in Aurora, found a low cost lifestyle intervention program that will raise awareness and potentially make a difference can be implemented at community health centers..
Agomo and co-authors of the small study Pam Andresen, PhD , RN, and Deepa Deshmukh, MPH, RD LD, CDE BC-ADM, evaluated the “Be Wise” life-style intervention. The case study “Be wise: Implementing a Lifestyle Intervention to Reduce Stroke Risk in Low-income Midlife Women “ is published in the February 2015 issue of the Journal of Neuroscience Nursing.
Women typically participate in “Be Wise” through the CDC’s Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program. To study the feasibility, costs, and potential barriers to the program, Agomo partnered with VNA Healthcare, a federally funded community health center in Aurora to offer “Be Wise” to 20 low-income, primarily Hispanic women, who were at risk for stroke.
“The three month intervention focused on small, manageable changes to improve diet and physical-activity,” said Agomo. Participants learned about food labels, motivations for overeating, the importance of social support and incorporating exercise into everyday life.
Nutritious foods were prepared for each session by a registered dietitian with consideration for ethic dietary preferences. One of the groups’ favorite dishes was an avocado ice cream.
“We purchased ingredients from the stores were our participants shopped, but also introduced them to healthier stores that carry a better selection,” said Deshmukh. “The participants were intimidated by health foods and some were surprised to learn that many of these health stores participate in the Supplemental Nutrition Assistance Program.”
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Questionnaires were completed by participants at the first, fourth, and 3-month follow-up sessions. Statistically significant increases were noted in the hours-per-week spent on overall physical activity, F(2, 34) = 31.53, p < .0005, and moderate-intensity physical activities, F(2, 34) = 24.18, p < .0005.
Interestingly, Agomo found you don’t need an expensive gym membership to make a difference. Participants were provided with simple exercise items: an exercise ball, exercise mat, a pedometer and a resistance band.
“These small incentives motivated the women to be more active, and in turn they motivated their family members to become more active and supportive of the women,” said Agomo.
Statistically, the post-intervention found no improvement in dietary indicators. However, because the screening tool focused on the frequency of eating fats and fruits/vegetables , the authors note it did not capture some of the positive behavior changes including reducing portion sizes and replacing high-sugar fruit juices with whole fruits.
“People were very enthusiastic and made long lasting changes,” said Deshmukh. “It’s been nearly a year since the intervention and when I encounter participants as patients in the clinic I see they have been able to maintain many of the lifestyle changes.”
Agomo adds that future interventions, especially in relation to nutrition, should include the whole family, as having the support of the family was very important.
Overall, the study authors declare the program a success due to the high participation rate of 90% and low cost. Excluding the facilitator’s salaries, the total cost of the program was $965.
“The ‘Be Wise’ program can be successfully incorporated into an outpatient department, especially if the primary care providers are involved throughout the planning process,” said Agomo. “Because these providers will continue to care for women who completed ‘Be Wise’, the program messages can be reinforced ensuring these small changes transform into big results.”
For more information about Presence Mercy Medical Center’s Stroke Program, please visit www.provena.org/mercy.
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About Presence Mercy Medical Center
With family-friendly, patient-centered features like new private rooms and a state-of-the-art outpatient surgery center, Presence Mercy Medical Center is positively impacting the health of Fox River Valley communities. Offering 293 licensed beds and more than 450 physicians, Presence Mercy provides advanced services in cardiology, cancer care, behavioral health, GI, diabetes care, orthopedics, and maternal/child health.
About Presence Health
Presence Health is the largest Catholic health system based in Illinois, created in November 2011 through the merger of Provena Health and Resurrection Health Care. With more than 150 sites of care, including 12 hospitals, Presence Health has more than 20,000 employees, 4,000 medical professionals and a revenue base of $2.5 billion.