Heart-to-Heart - Promoting walking in rural women through motivational interviewing and group support

Background: Walking can significantly increase cardiorespiratory fitness and thereby reduce the incidence of heart disease in women. However, there is a paucity of research aimed at increasing walking in rural women, a high-risk group for heart disease and one for which exercise strategies may pose particular challenges. Purpose: This study tested Heart-to-Heart (HTH), a 12-week walking program, designed to increase fitness through walking in rural women. Heart-to-Heart integrated individual-oriented strategies, including motivational interviewing, and group-based strategies, including team building. Methods: Forty-six rural women were randomized to either HTH or a comparison group. The primary outcome of cardiorespiratory fitness and secondary outcomes of self-efficacy and social support were measured preintervention and postintervention. Group differences were analyzed with repeated-measures analysis of variance. Results: Women in HTH had a greater improvement in cardiorespiratory fitness (P=.057) and in social support (P=.004) compared with women in the comparison group. Neither group of women experienced a change in exercise self-efficacy (P=.814). Conclusions: HTH was effective in improving cardiorespiratory fitness in a sample of rural women. Further research is needed to refine HTH and determine the optimal approach in rural women to increase their walking.