Abstract
Objective
To evaluate the implementation of a community-based cardiovascular disease prevention
program for rural women: Strong Hearts, Healthy Communities (SHHC).
Design
Mixed-methods process evaluation.
Setting/Participants
A total of 101 women from 8 rural towns were enrolled in the SHHC program; 93 were
enrolled as controls. Eligible participants were aged ≥40 years, sedentary, and overweight
or obese. Local health educators (n = 15) served as program leaders within each town.
Outcome Measures
Reach, fidelity, dose delivered, dose received, and program satisfaction were assessed
using after-class surveys, participant satisfaction surveys, interviews with program
leaders, and participant focus groups.
Analysis
Descriptive statistics, chi-square tests of independence, and thematic analysis were
employed.
Results
Intervention sites reported high levels of fidelity (82%) and dose delivered (84%).
Overall reach was 2.6% and program classes were rated as effective (3.9/5). Participants
were satisfied with their experience and reported benefits such as camaraderie and
awareness of healthy eating and exercise strategies. Common recommendations included
increasing class time and enhancing group discussion.
Conclusions and Implications
Implementation was good in terms of fidelity, dose delivered, and satisfaction, although
low reach. Findings from this research have informed a second round of implementation
and evaluation of the SHHC program in rural communities.
Key Words
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Footnotes
Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.
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© 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
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