Strong Hearts for New York: A Rural Heart Disease Prevention Study

There are notable cardiovascular disease (CVD) disparities among people living in rural
settings, particularly medically underserved rural areas. Complex factors such as
socioeconomic disadvantage, social and cultural dynamics, geographic distances/barriers, and
limited access to healthcare, healthy foods, and/or physical activity opportunities
contribute to the issue. The objective of Strong Hearts, Healthy Communities (SHHC) is to
reduce rural CVD disparities through civic engagement and implementation of a community-based
intervention in 11 underserved New York communities. SHHC builds upon a long-standing
collaboration with National Institute of Food and Agriculture cooperative extension
educators, who will implement the project. There is limited knowledge about how programs and
services can move beyond commonly used individual-level approaches—which have limitations in
terms of cost, impact, reach, and sustainability—to effectively reduce rural CVD health
disparities using an integrated, multi-level, community-engaged approach. The objective of
Strong Hearts, Healthy Communities (SHHC) is to address this gap in knowledge and practice by
working with residents, practitioners, health educators, local leadership, and other
stakeholders in 11 medically underserved rural communities in New York to test a
comprehensive program designed to: a) improve diet and physical activity behaviors, b)
promote local built environment resources, and c) shift social norms about active living and
healthy eating through civic engagement, capacity building, and community based programming.

RANDOMIZED INTERVENTION AND DELAYED INTERVENTION: In the current phase of the project, the
efficacy of the SHHC program curriculum will be evaluated in a 24-week delayed intervention
trial. The investigators will compare changes in CVD-related anthropometric, physiologic,
behavioral, and psychosocial parameters between subjects in 5 intervention and 6 delayed
communities in New York State. In addition, changes in behavior, attitudes, and knowledge
among SHHC intervention subjects' "social network" will be evaluated.

Inclusion Criteria:

- Body Mass Index (BMI) greater than or equal to 25

- If BMI is less than 30, not currently physically active

- Blood pressure is less than 160/100 mm Hg

- Heart rate is between 60-100 bpm

- English-speaking

- Able and willing to obtain physician's approval to participate in intervention
starting either in March 2017 or September 2017

- Willing to participate in assessment activities

- Willing to make a firm commitment to participate in intervention starting either in
Spring or Fall 2017

Exclusion Criteria:

- BMI less than 25

- If BMI is less than 30, currently physically active

- Untreated hypertension

- Heart rate lower than 60 or higher than 100 bpm

- Non-English speaking

- Not able or willing to obtain physician's approval to participate

- Not interested or willing to participate in assessment activities

- Not able or willing to make a firm commitment to participate in intervention starting
either in Spring or Fall 2017