Community-Based Cardiovascular Health Promotion Intervention for Women in East Jerusalem

Background: Cardiovascular mortality is 60% higher in Arab women compared to Jewish women, and occurs at an earlier age. The prevalence of obesity, diabetes and sedentary lifestyle may account for some of these health disparities.

Objectives: To create and pilot an effective culturally-sensitive cardiovascular health promotion program for Arab women in East Jerusalem.

Methods: We adapted the CDC diabetes prevention program to the specific cultural, language, gender, and religious sensitivities of the study population. Height, weight, blood pressure, lipids, HbA1c and steps were assessed pre and post intervention. Questionnaires were administered pre and post intervention that assessed diet, physical activity and health self-efficacy.

Results: 85 women participated in the program, which consisted of 22 sessions of 4 hours, and 96% of them completed the program. Mean age of participants was 48.5 (19-69), and 43% had not completed high school. Statistically significant changes include: Average daily steps increased from 4590 to 5800, average BMI decreased 31.3 to 30.4, and the percentage of women with BMI>30 was reduced by 6%. Mean systolic blood pressure decreased from 132mmHg to 122mmHg. In participants with diabetes and pre-diabetes, the average HbA1c decreased from 7.0 to 6.5. Women reported increased weekly physical activity, increased consumption of fruit, vegetables, and legumes, and a decrease in their consumption of candy, snacks and soft drinks.

Conclusions: A culturally-tailored, group-based lifestyle intervention in the community setting led to weight loss, increased physical activity, improved nutrition behaviors and reduced blood pressure in participants.

This intervention may be adapted and replicated in Israel and other Arabic speaking countries.