A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women

Abstract

The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the community's physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention.

A Tailored Nutrition Intervention to Reduce Cardiovascular Disease Risk in Low-Income African American Women

“…29 however they did not have the practical knowledge to do so. 32 Using SCT constructs (knowledge, environment, and self-efficacy), a series of CVD risk reduction classes were designed and implemented to address physical activity, nutrition, and tobacco use.…”

“…Additionally, these activities continued to receive financial support from the Alabama Department of Public Health and Alabama Cooperative Extension Service when the intervention period was completed. 32 The Uniontown Project illustrates that community efforts to improve cardiovascular health among low-income populations may be well-received. However, in order to measure how effective a SCT based intervention is, researchers must assess individual health outcomes such as nutritional intake, physical activity, and weight status.…”

“…Disease prevention programs that target at-risk populations are effective for reducing the yearly costs of preventable chronic diseases by promoting physical activity and improving nutrition. 32 Cardiovascular disease is highly prevalent among African Americans; however there are few interventions that work consistently to improve cardiovascular health among this population. 33 Among non-Hispanic blacks aged 20 years and older, 44.6% of women and 49.0% of men have some form of cardiovascular disease.…”

Perceptions of Community Resources and Insights for Program Development from Southern, Rural Hypertensive Women

“…However, although physical activity and dietary interventions are effective, long-term change in personal health behavior is difficult to maintain [7]. In addition to identifying interventions that stimulate long-term change, these strategies must address the unique needs of rural populations.Recent studies have focused on rural populations [11][12][13], yet few studies focused solely on African Americans residing in rural locations [14][15][16], and even fewer focused on African Americans in rural areas of the Southern United States [10,14,17,18]. Given the higher rate of HTN and CVD, additional efforts are needed to address the incidence and prevalence of these diseases among African Americans in rural locations, especially in the south.…”

Community Organizing Goes to College: A Practice-Based Model to Implement Environmental Strategies to Reduce High-Risk Drinking on College Campuses

“…For example, numerous public health initiatives, including a number of community trials, have used community organizing to restrict youth access to alcohol and tobacco (Blaine et al, 1997; Wagenaar et al, 2000; Toomey & Fabian, 2006), promote positive youth development (Cheadle et al, 2001; Kegler & Wyatt, 2003), reduce cardiovascular disease risk (Cornell et al, 2008), and change sex and drug behaviors to prevent the spread of HIV/AIDS (Rietmeijer et al, 1996; Silvestre et al, 2006). …”