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A Cholesterol Intervention Program for Public Health Nurses in the Rural Southeast: Description of the Intervention, Study Design, and Baseline Results

Authors

  • Thomas C Keyserling M.D., M.P.H.,

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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  • Alice S Ammerman Dr.P.H., R.D.,

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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  • Jan R Atwood Ph.D, R.N.,

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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  • James D Hosking Ph.D.,

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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  • Cristina Krasny B.A.,

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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  • Hany Zayed M.Sc.,

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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  • Betty H Worthy R.N., M.P.H.

    1. Thomas C. Keyserling is an Assistant Professor, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, North Carolina. Alice S. Ammerman is an Assistant Professor, Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, North Carolina. Jan R. Atwood was a Professor, Curriculum in Public Health Nursing, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is a Professor, Colleges of Nursing and Medicine, University of Nebraska Medical Center, and Associate Director, Cancer Prevention Center and Control, University of Nebraska Medical Center/Eppley Cancer Center, Omaha, Nebraska. James D. Hosking is a Research Associate Professor, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina. Cristina Krasny was a Research Assistant, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is with the Division of Community Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina. Hany Zayed was a Graduate Research Assistant and Ph.D. Candidate, Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, he is a biostatistician at Family Health International, Research Triangle Park, North Carolina. Betty H. Worthy was a Research Associate, Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, North Carolina, during the project. Currently, she is an Administrator of Personal Health Services, Gaston County Health Department, Gastonia, North Carolina.
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Thomas C. Keyserling, CB# 8140, 1700 Airport Road, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599. E-mail: tkeyserling@med.unc.edu

Abstract

Residents of the rural South are at high risk for heart disease and are frequently identified as having high blood cholesterol, but sources for nutrition counseling in rural areas are often limited. To increase the availability of high quality nutrition counseling, the Food for Heart Program was developed for public health nurses and is designed to circumvent many of the obstacles common to dietary counseling. We conducted a randomized trial to assess the effectiveness of this program to lower blood cholesterol. In this report, we describe the study design, intervention program, and baseline characteristics of participants. Nurses at 17 health departments screened 781 subjects to enroll 468 with high blood cholesterol: three-quarters of the subjects were female, the mean age was 55, and 80% were white. Participants were at high risk for heart disease: 60% had two or more risk factors for coronary disease, the majority were overweight with a mean BMI of 29, and the mean cholesterol was 257 mg/dL. Reported baseline dietary intake included relatively modest consumption of high fat meats and snack foods, excessive consumption of sweets, modest intake of complex carbohydrates, and inadequate consumption of fruits and vegetables.

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