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Health Education Research Advance Access published online on December 1, 2008
Health Education Research, doi:10.1093/her/cyn063
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

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

C. E. Cornell1,*, M. A. Littleton2, P. G. Greene1, L. Pulley1, J. N. Brownstein3, B. K. Sanderson4, V. G. Stalker5, D. Matson-Koffman3, B. Struempler6 and J. M. Raczynski1

1 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
2 Department of Public Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
3 Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA
4 Division of Cardiovascular Medicine, Department of Medicine
5 Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35205, USA
6 Department of Nutrition and Food Science, Auburn University, Auburn, AL 36849, USA

Correspondence to: * Correspondence to: C. E. Cornell. E-mail: ccornell{at}uams.edu

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.

Received on March 20, 2008; accepted on September 29, 2008


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