Promoting Heart Health in Rural Women



This article is corrected by:

  1. Errata: Promoting Heart Health in Rural Women Volume 30, Issue 1, 120, Article first published online: 2 January 2014

  • Funding: This study was funded by the National Institutes of Health, National Institute of Nursing Research, and National Heart Blood and Lung Institute Academic Research Enhancement Award (AREA) 1R15NR009218-01A. The authors have no conflict of interest to report.

  • Acknowledgments: The authors would thank the rural women who participated in this study. In addition we would like to acknowledge the assistance of community liaisons Phyllis Highland, MA, Unionville, VA; Mary Hamil Parker, PhD, Alexandria, VA; Vera Buel, BS, Delaware County Public Health Nursing Service; & Dottie Kruppo, Delaware Valley Hospital, Walton, NY. We would like to acknowledge the following RNs for their interventions and assistance in data collection: Mary X. Britten, EdD;1 Maureen Daws, PhDC;1 Alison Dura, MS;1 Theresa N. Grabo, PhD (retired);1 Yvonne Johnston, MPH;1 Irma H. Mahone, PhD;3 Donna Morgan, PhD;1 Mary Ann Nemcek PhD (retired);1 Judy Quaranta, MS;1 Elizabeth Reese, MS (retired);1 Fran Srnka-Debnar, MS;1 and former DSON graduate students Mary Ann Barron, MS, and Elizabeth Austin, PhD. We would like to acknowledge the contribution of the following people for their input into the original concept and design of this study: Geri Britton, PhD;1 Theresa N. Grabo, PhD (retired);1 Gale Spencer, PhD;1 and Elizabeth Merwin, PhD.3 A special acknowledgement goes to the over 50 undergraduate nursing students from the Decker School of Nursing, who assisted with the screenings and data collection in this R15 study. We would like to acknowledge Sedar Atav, PhD;1 and Stephen Samuels, PhD (retired);1 for their assistance with statistical analysis. In addition, we would like to thank Malgosia Krasuska, PhD;1 Lindsay Lake Morgan, PhD (retired);1 Mary Ann Swain, PhD;1 and Steve Wiitala, PhD, for their assistance in manuscript preparation.

For further information, contact: Pamela Stewart Fahs, RN, DSN; Professor and Decker Chair in Rural Nursing; Decker School of Nursing; Binghamton University; Box 6000; Binghamton, NY 13902-6000; e-mail:



To compare 2 strategies, stage-matched nursing and community intervention (SMN+CI) and community intervention (CI) alone in changing cardiovascular risk factors in up to 3 behavioral areas: diet, physical activity, and/or smoking among rural women.


A 14-month, multisite randomized controlled trial of 117 rural women was conducted. Transtheoretical model was used in identification of stage of change and development of the SMN+CI nursing interventions. A social-ecological model was used to address issues of rurality in the development of interventions.


The SMN + CI group was superior on 4 outcomes. There were significant increases in 2 measures of dietary intake; improvement in dietary stage of change for fruits and vegetables; and reduced diastolic blood pressure (DBP) in the SMN + CI group. After log transformation DBP significance was lost. The CI group had a significant reduction in change in total cholesterol; however, significance was lost after control for the initiation of lipid lowering medications. There was a significant reduction in Framingham risk scores pre- to postintervention, regardless of group.


There continues to be a need to improve cardiovascular risk factors in rural women. There should be an exploration of whether intensified dose and fidelity of the intervention strategies of diet and physical activity are effective in improving anthropometric and laboratory values. Further investigation is warranted into factors influencing the pre- to postreduction in Framingham risk scores.