Journal of Community Health

, Volume 39, Issue 4, pp 737–746 | Cite as

Lifestyle Intervention and Cardiovascular Disease Risk Reduction in Low-Income Hispanic Immigrant Women Participating in the Illinois WISEWOMAN Program

  • Manorama M. Khare
  • John F. Cursio
  • Cara A. Locklin
  • Nancy J. Bates
  • Ryan K. Loo
Original Paper


Cardiovascular disease (CVD) is the leading cause of death for Hispanic women in the United States. In 2001, the Illinois Department of Public Health received funding from the Centers for Disease Control and Prevention to implement the enhanced WISEWOMAN program (IWP) to address the disproportionate CVD risk among uninsured and underinsured women enrolled in the Illinois Breast and Cervical Cancer Early Detection Program. This paper presents the results of the Spanish-language arm of the IWP. Spanish speaking IWP participants were recruited from two sites, and randomized into either the minimum intervention (MI) or the enhanced intervention (EI) group. Both groups received CVD risk factor screening and educational handouts. The EI group also received an integrated 12-week nutrition and physical activity lifestyle change intervention. Of the 180 Spanish-speaking immigrants in this sample, 90 (50 %) received the EI and 90 (50 %) received the MI. At baseline there were no significant differences between group demographics or clinical values. At post-intervention, the EI group showed improvements in fat intake, fiber intake, moderate intensity physical activity, and total physical activity. At 1 year only the change in fiber intake remained. A significant improvement was also seen in body mass index (BMI) at the 1-year follow-up. The IWP Spanish-language arm was moderately successful in addressing risk factors for CVD in this population. The behavior changes that sustained up to a year were an increase in fiber intake and a decrease in BMI.


Cardiovascular health Physical activity Nutrition Hispanic 


  1. 1.
    Go, A. S., Mozaffarian, D., Roger, V. L., et al. (2013). Heart disease and stroke statistics—2013 update: A report from the American Heart Association. Circulation, 127, e6–e245. doi:10.1161/CIR.0b013e31828124ad.PubMedCrossRefGoogle Scholar
  2. 2.
    Daviglus, M. L., Talavera, G. A., Avilés-Santa, M. L., et al. (2012). Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. The Journal of the American Medical Association, 308(17), 1775–1784. doi:10.1001/jama.2012.14517.CrossRefGoogle Scholar
  3. 3.
  4. 4.
    Forman, D., & Bulwer, B. E. (2006). Cardiovascular disease: Optimal approaches to risk factor modification of diet and lifestyle. Current Treatment Options in Cardiovascular Medicine, 8, 47–57.PubMedCrossRefGoogle Scholar
  5. 5.
    Winkelby, M. A., Kraemer, H. C., Ahn, D. K., & Varady, A. N. (1998). Ethnic and socioeconomic differences in cardiovascular disease risk factors: Findings for women from the Third National Health and Nutrition Examination Survey, 1988–1994. The Journal of the American Medical Association, 4, 356–362.CrossRefGoogle Scholar
  6. 6.
    Greaney, M. L., Lees, F. D., Lynch, B., Sebelia, L., & Green, G. W. (2012). Using focus groups to identify factors affecting healthful weight maintenance in Latino immigrants. Journal of Nutrition Education and Behavior, 44, 448–453.PubMedCrossRefGoogle Scholar
  7. 7.
    D’Alonzo, K. T. (2012). The influence of marianismo beliefs on physical activity of immigrant Latinas. Journal of Transcultural Nursing, 23(2), 124–133.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Lindsay, A. C., Sussner, K. M., Greaney, M. L., & Peterson, K. E. (2009). Influence of social context on eating, physical activity, and sedentary behaviors of Latina mothers and their preschool-age children. Health Education and Behavior, 36, 81–96.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Quiñones, A.R., O’Neil, M., Saha, S., Freeman, M., Henry, S., & Kansagara, D. (2011). Interventions to Reduce Racial and Ethnic Disparities. VA-ESP Project #05-225.Google Scholar
  10. 10.
    National Heart, Lung, and Blood Instituted. (2001, October). National Heart, Lung, and Blood Institute Task Force Report on Research in Prevention of Cardiovascular Disease. Retrieved from
  11. 11.
    Khare, M. M., Carpenter, R. A., Huber, R., Bates, N. J., Cursio, J. F., Balmer, P. W., et al. (2012). Lifestyle intervention and cardiovascular risk reduction in the Illinois WISEWOMAN program. Journal of Womens Health, 21(3), 294–301.CrossRefGoogle Scholar
  12. 12.
    Illinois Department of Public Health. Illinois WISEWOMAN Program. Retrieved from
  13. 13.
    Khare, M. M., Huber, R., Carpenter, R. A., et al. (2009). A lifestyle approach to reducing cardiovascular risk factors in underserved women: Design, and methods of the Illinois WISEWOMAN Program. Journal of Womens Health, 18, 409–419.CrossRefGoogle Scholar
  14. 14.
    Centers for Disease Control and Prevention. (2013, December 17). WISEWOMAN. Retrieved from
  15. 15.
    Dunn, A. L., Garcia, M. E., Marcus, B. H., Kampert, J. B., Kohl, H. W., I. I. I., & Blair, S. N. (1998). Six-month physical activity and fitness changes in Project Active, a randomized trial. Medicine and Science in Sports Exercise, 30, 1076–1083.CrossRefGoogle Scholar
  16. 16.
    Carpenter, R. A., Finley, C., & Barlow, C. E. (2004). Pilot test of a behavioral skill building intervention to improve overall diet quality. Journal of Nutrition Education and Behavior, 36, 20–24.PubMedCrossRefGoogle Scholar
  17. 17.
    Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  18. 18.
    Prochaska, J. O., & Velicer, W. F. (1997). Transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38–48.PubMedCrossRefGoogle Scholar
  19. 19.
    Knowles, M. S. (1973). The adult learner: A neglected species. Houston: Gulf Publishing Company.Google Scholar
  20. 20.
    Shannon, J., Kristal, A. R., Curry, S. J., & Beresford, S. A. (1997). Application of a behavioral approach to measuring dietary change: The fat- and fiber-related behavior questionnaire. Cancer Epidemiology, Biomarkers and Prevention, 6, 355–361.PubMedGoogle Scholar
  21. 21.
    National Cancer Institute. (2013, October 18). Fruit and vegetable screeners in the Eating at America’s Table Study (EATS): overview. Retrieved from
  22. 22.
    Bates, N.J. (2001). An evaluation of a stage of change nutrition intervention in families with young children. (Doctoral dissertation). University of Illinois at Chicago School of Public Health, Chicago, IL.Google Scholar
  23. 23.
    Stewart, A. L., Mills, K. M., King, A. C., Haskell, W. L., Gillis, D., & Ritter, P. L. (2001). CHAMPS physical activity questionnaire for older adults: Outcomes for interventions. Medicine and Science in Sports and Exercise, 33, 1126–1141.PubMedCrossRefGoogle Scholar
  24. 24.
    Marin, G., Sabogal, F., Marin, B. V., Otero-Sabogal, R., & Perez-Stable, E. J. (1987). Development of a short acculturation scale for Hispanics. Hispanic Journal of Behavioral Sciences, 9(2), 183–205.CrossRefGoogle Scholar
  25. 25.
    Cohen, J. (1988). Statistical power and analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
  26. 26.
    IBM Corp. (2012). IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Google Scholar
  27. 27.
    Hayashi, T., Farrell, M. A., Chaput, L. A., Rocha, D. A., & Hernandez, M. (2010). Lifestyle intervention, behavioral changes, and improvement in cardiovascular risk profiles in the California WISEWOMAN Project. Journal of Womens Health, 19(6), 1129–1138.CrossRefGoogle Scholar
  28. 28.
    Staten, L. K., Gregory-Mercado, K. Y., Ranger-Moore, J., et al. (2004). Provider counseling, health education, and community health workers: The Arizona WISEWOMAN project. Journal of Womens Health, 13(5), 547–556.CrossRefGoogle Scholar
  29. 29.
    Coleman, K. J., Farrell, M. A., Rocha, D. A., et al. (2012). Readiness to be physically active and self-reported physical activity in low-income Latinas, California WISEWOMAN, 2006–2007. Preventing Chronic Disease, 9, 110190. doi:10.5888/pcd9.110190.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Manorama M. Khare
    • 1
  • John F. Cursio
    • 2
  • Cara A. Locklin
    • 3
  • Nancy J. Bates
    • 4
  • Ryan K. Loo
    • 5
  1. 1.Division of Health Policy and Social Science Research, Department of Family and Community MedicineUniversity of Illinois College of Medicine at RockfordRockfordUSA
  2. 2.Center for QualityUniversity of Chicago HospitalChicagoUSA
  3. 3.Center for Research on Women and GenderUniversity of Illinois at ChicagoChicagoUSA
  4. 4.Center for Clinical and Translational ScienceUniversity of Illinois at ChicagoChicagoUSA
  5. 5.Spectrum Health Policy Research, LLCLawrencevilleUSA

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