Feasibility and acceptability of a community-led health promotion program to reduce cardiovascular disease risk in adults in rural Illinois

Background: Adults in rural, southernmost Illinois have an elevated risk of cardiovascular disease (CVD) compared with Illinois overall. Prevention interventions may target modifiable behaviors like diet and physical activity; however, rural communities often have limited resources to promote sustained behavior change.

Methods: We partnered with nine churches and the local health department to implement Heart Smart Maintenance, a monthly booster program designed to sustain improved health behaviors after completion of a 12-week, evidence- and theory-based CVD risk reduction intervention. With participants’ input, community-based coordinators guided the 24-month booster program to ensure activities were tailored to local needs and resources. We analyzed coordinator and participant feedback to understand session content, successes and challenges, and assess feasibility and acceptability.

Results: From June 2012 to December 2014, coordinators implemented 122 maintenance sessions, serving 151 participants, with 1100 points of contact. Mean session attendance was 9.0 ± 3.9. Programming focused on both CVD risk and other health topics of interest to participants. Implementation challenges involved tailoring activities to different age groups and maintaining attendance. Successes included the creation of health-related church policies and high levels of satisfaction. Most participants agreed that they were able to apply information to make healthy lifestyle choices (95.9%) and they would recommend the program (94.6%).

Conclusion: Integration of community-based coordinators into health promotion programs is a feasible and acceptable model, especially in rural communities with limited health promotion resources. By tailoring programming to community needs and resources, this model has potential to facilitate maintenance of improved health behaviors.