Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities

Abstract

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.

A community-based, culturally relevant intervention to promote healthy eating and physical activity among middle-aged African American women in rural Alabama: Findings from a group randomized controlled trial

“…The “New Leaf… Choices for Healthy Living” program is a structured nutrition and physical activity assessment and a counseling program that emphasizes practical strategies for change. It was originally developed for low-income adults with limited literacy skills residing in the south-eastern United States and is based on a combination of behavior change theories, including social cognitive theory, the transtheoretical model, and basic behavior modification principles (Melvin et al, 2013; Keyserling et al, 1997, 1999, 2000, 2002; Bandura, 1986; Eraker et al, 1984; Prochaska and Di Clemente, 1983; Rosamond et al, 2000; Ammerman et al, 2003; Cheng et al, 2004; Samuel-Hodge et al, 2006). For the current study, sessions were adapted to address healthy eating choices, promote physical activity, and provide practical applications of the newly acquired knowledge and skills in order to encourage behavior modification (Table 1).…”

Prevalence of risk factors and programs for prevention of cardiovascular disease among the rural population

“…В то же время распространенность ССЗ и смертность в разных сельских районах США значительно варьирует и различия в ожидаемой продолжительности жизни среди сельских жителей южных штатов или Аппа-лачи и северных штатов составляют до 15 лет. Согласно данным нескольких исследований, проведенных в США и представленных в обзоре [4], на различия в частоте ФР ССЗ, показателях сердечно-сосудистой заболеваемости и смертности оказывают влияние раса, этническая принад-лежность, пол, доступность первичной и специализиро-ванной медицинской помощи, экологические факторы, финансовые ограничения местных органов власти, а так-же такие факторы, как неравенство доходов и бедность. Жители тех сельских районов, в которых регистрировался значительный уровень неравенства в доходах между са-мыми богатыми и бедными, имели худшие показатели здоровья и смертности, чем жители сельских районов с меньшим уровнем неравенства в доходах.…”

“…Melvin и соавт. [4] обращают внимание на тот факт, что в настоящее время нет единого подхода к определе-нию термина «сельская местность, сельское население».…”

Puentes hacia una mejor vida (Bridges to a Better Life): Outcome of a Diabetes Control Peer Support Intervention

“…Patients were excluded if their last HbA 1c was less than 7 or if they did not live in 1 of the 3 cities where the participating clinics were located, to minimize travel costs to the peer leaders. 5 A random sample of 1,202 patients taken relatively evenly from the 3 clinics received a study invitation letter from CDSDP and, in 96% of cases, a follow-up telephone call from an English/Spanish bilingual, HIPAA-certified research assistant. A further method of recruiting these sampled patients involved a HIPAA-certified research assistant approaching the randomly sampled patient in the clinic waiting room.…”

“…1 Rates are higher among Mexican-Americans (13.9%), among those who live near the US-Mexico border (14.7% on the US side, for instance) 2 and among residents of rural areas. 3 Health care use remains low in rural border communities, 4,5 and health care is underused for managing diabetes. 6,7 Research is needed on how to promote glycemic control in rural border communities.…”