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

Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Health Education Research (Impact Factor: 1.66). 08/2009; 24(4):622-33. DOI: 10.1093/her/cyn063
Source: PubMed


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.

Download full-text


Available from: Nell Brownstein, Jul 31, 2014
23 Reads
  • Source
    Journal of Nutrition Education and Behavior 07/2009; 41(4). DOI:10.1016/j.jneb.2009.03.110 · 1.77 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Examine the effectiveness of a community-based, multimedia intervention on medication adherence among hypertensive adults. Randomized controlled trial. Rural south Alabama. Low-income adults (N  =  434) receiving medication at no charge from a public health department or a Federally Qualified Health Center. Both interventions were home-based and delivered via computer by a community health advisor. The adherence promotion (AP) intervention focused on theoretical variables related to adherence (e.g., barriers, decisional balance, and role models). The cancer control condition received general cancer information. Adherence was assessed by pill count. Other adherence-related variables, including barriers, self-efficacy, depression, and sociodemographic variables, were collected via a telephone survey. Chi-square analysis tested the hypothesis that a greater proportion of participants in the AP intervention are ≥80% adherent compared to the control group. General linear modeling examined adherence as a continuous variable. Participants receiving the intervention did not differ from individuals in the control group (51% vs. 49% adherent, respectively; p  =  .67). Clinic type predicted adherence (p < .0001), as did forgetting to take medications (p  =  .01) and difficulty getting to the clinic to obtain medications (p < .001). Multilevel interventions that focus on individual behavior and community-level targets (e.g., how health care is accessed and delivered) may be needed to improve medication adherence among low-income rural residents.
    American journal of health promotion: AJHP 07/2011; 25(6):372-8. DOI:10.4278/ajhp.090123-QUAN-26 · 2.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Recipe For Health educational initiative was designed to increase knowledge of diabetes prevention and management for African Americans (AAs) in rural Alabama. By providing culturally competent information, training, and skill-building activities to lay leaders in faith-based settings who teach church members, Recipe For Health can create a ripple effect of diabetes knowledge that could lower disease complications in the AA population.
    Journal of Christian nursing: a quarterly publication of Nurses Christian Fellowship 01/2012; 29(1):49-53. DOI:10.1097/CNJ.0b013e31823a8a77
Show more