Self-Regulation Intervention by Telephone to Reduce Weight and Blood Pressure in Overweight Women with Elevated Blood Pressure

Abstract

Excess weight and increases in blood pressure are two biological risk factors that can be modified with changes in lifestyle behaviors. Lifestyle modification involving nutrition and activity level remain the cornerstone of prevention and treatment for individuals who are overweight and hypertensive. Self-regulation intervention delivered by telephone is designed to assist individuals in adopting lifestyle modifications to lose weight and reduce blood pressure. The purpose of this randomized clinical study was to test the effectiveness o f a telephone-delivered self-regulation intervention in reducing weight and systolic blood pressure in overweight women with elevated blood pressure. Secondary aims were to test the effectiveness of self-regulation intervention on weight self-efficacy, exercise selfefficacy and health status. Sixty-two overweight women with elevated blood pressure were randomly assigned to either five weeks of telephone-delivered self-regulation intervention (n=31) or usual care control group (n=31). Repeated measurements for outcome variables occurred at Baseline, 6-weeks and 10-weeks. Two-way ANOVA with one repeated factor demonstrated a significant interaction for weight x group (F= 8.79, df = 1/60 p = .004), with individuals in the self-regulation intervention group having a significantly greater weight loss as compared to individuals in the usual care group. Examining weight self-efficacy x group differences there was a significant difference in weight self-efficacy (F= 12.39, df = 1/60 p = .001) with individuals in the self-regulation intervention having a greater increase as compared to individuals in the usual care control group. There was a significant main effect for systolic blood pressure (F = 9.00, df 2/120, p < 01) and health status (F= .4.94, d f = 1/60, p = .03). There was no significant interaction for systolic blood pressure x group, exercise self-efficacy x group, or health status x group. These results support the use of telephone-delivered self-regulation intervention in the primary care setting as a more effective means than usual care to assist overweight women with elevated blood pressure in losing weight and increasing weight self-efficacy. Self-regulation was shown to be effective in lowering blood pressure and improving health status but it did not prove to be more effective than usual care.