Rural populations derive greater benefits from prevention programs than urban populations
Urban participants were more likely to look to external factors for influence over their outcomes.
American College of Cardiology 59th Annual Scientific Sessions
ATLANTA – Rural populations were more likely to feel empowered to control their health outcomes, lose weight and be active than their urban counterparts, findings from a new study indicated.
Researchers enrolled 400 participants in a one-year CV risk-reduction program. Asymptomatic participants from both disadvantaged inner-city neighborhoods and from rural neighborhoods were included in the study, in which researchers evaluated participants with Framingham risk scores to assess their 10-year risk for developing CVD. Participants with a risk score of 10% or greater (n=388) were given pedometers, BP monitors and counseling on heart disease risk reduction. Participants were followed for one year and received a counseling session every three months.
The researchers reported that both rural and urban participants achieved a mean reduction in their risk for heart disease of 2.5% over the one-year study period. Of those, 30% of participants achieved more than 5% reduction in their risk score. Rural participants, however, showed significantly decreased weight loss (–2.0% ± 9.2% vs. –0.4% ± 9.8%), deceased BMI (–0.3 ± 1.6 vs. 0.0 ± 1.8) and improved six-minute walking distance (50.8 ± 236.1 feet vs. 6.9 ± 246.0 feet) at study conclusion vs. their urban counterparts. According to the researchers, rural participants were also more likely to believe they had greater control over their health outcomes, resulting in more exercise activity and more significant weight loss. Urban participants, conversely, tended to believe that outcomes were more greatly affected by external forces, and consequently were less successful at instituting lifestyle changes and modifying certain CV risk factors than rural participants.
“It is very important to implement these risk-reduction programs, particularly in underserved communities who may not have as much access to health care as well-served communities,” Mohamed Alkouli, MD, future chief medical resident at Temple University Hospital in Philadelphia, said in a press conference at the American College of Cardiology 59th Annual Scientific Sessions in Atlanta. “We really have a better understanding now of what motivates people to participate in managing their own health and managing CV risk reduction programs. If we are able to turn people from being externally-focused to internally-focused, we may be to significantly begin reducing the risk for CVD.”
Regarding the findings that rural participants appeared to derive a more significant benefit from the risk reduction programs than their urban counterparts, the researchers also took into consideration participant education levels and socioeconomic status, which tended to be higher among rural residents. Rural residents, the researchers also acknowledged, had greater access to open and green spaces that were conducive to exercise activities. – by Eric Raible
For more information:
- Alkouli A. Behavioral comparison between rural and urban populations in cardiovascular disease risk reduction. Presented at: American College of Cardiology 59th Annual Scientific Sessions; March 13-16, 2010; Atlanta.
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