Date of Conferral

1-1-2009

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

James Rohrer

Abstract

WISEWOMAN (WW) is a comprehensive program for medically underserved women in South Dakota (SD), aged 30 to 64, which aims to reduce morbidity and mortality from chronic diseases. Screening services include blood total cholesterol, blood pressure and blood glucose, and body mass index (BMI). Lifestyle intervention (LSI) sessions are also offered to address physical activity and nutrition. The purpose of this retrospective longitudinal study was to quantitatively examine whether the combination of LSI's and clinical screenings or clinical screenings alone lead to improvements in blood pressure, blood glucose, total cholesterol, and/or BMI at rescreening 10 to14 months from initial screening. Guided by the social ecological model, it was hypothesized that SD-WW participants attending the screening sessions as well as the intervention sessions would have greater reductions in blood pressure, total cholesterol, and blood glucose than participants who only received screenings. Participants included 653 low-income women aged 30 to 64 enrolled in the screening alone (N=423) and SD-WW program (N=230) from 2000-2005, who completed both the screening and rescreening 10 to14 months later. Secondary data analysis using forced-entry multiple regression of the traditional measures employed in the screening alone control condition yielded significant predictive models for change scores in blood pressure, BMI, blood glucose, and cholesterol among all participants. Neither dummy variable regression nor ANOVA results indicated any significant impact of the SD-WW intervention on these same health outcome changes. Findings contribute to positive social change by demonstrating that screening alone is effective in predicting health outcomes, thus allowing more disadvantaged women to be served by public agencies that may face reduced funding for their array of programs.

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