Understanding Community Members in Order to Change Health Behaviors

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Plescia M, Groblewski M: A community-oriented primary care demonstration project: Refining interventions for cardiovascular disease and diabetes. Ann Fam Med 2:103-109, 2004.

What is the problem and what is known about it so far?

A North Carolina coalition includes health professionals and members of a mostly African American community. The coalition named heart disease and diabetes as health priorities.

Researchers wanted to find out how to change health behaviors in this community.

Who was studied?

A total of 386 African American adults in a North Carolina community.

How was the study done?

Researchers surveyed community members at random. They were trained on how to administer a questionnaire. They went door-to-door and surveyed household members.

Questionnaires included items on exercise, eating, and smoking. Participants were asked about their health. They were asked if they had diabetes, high blood pressure, or high cholesterol (level of fat in the blood).

Researchers also asked participants about their motivations. Some people believed their own actions affect their health, while others believed their health is the result of fate or chance.

What did the researchers find?

Male participants were more likely to believe that their own actions affected their health.

Participants aged 65 or older were more likely to believe that others' influence affected their health.

People who had heart blood vessel problems, high blood pressure, or diabetes believed that powerful people had an influence on their health. Examples of powerful others included physicians, ministers, nurses, spouses, parents, and children of elderly parents. Ministers, and the church, were considered especially important.

Researchers found low levels of physical activity. People were not eating enough healthy food, especially fresh fruit or vegetables.

Coalition members described some of the problems people were having with diet and exercise. Many neighborhoods did not have sidewalks or good street lighting. Crime was a problem in some neighborhoods. There were few public places appropriate for exercise and few local places to buy healthy, fresh foods.

After the survey, a community farmers' market was started. Local restaurants and school cafeterias began work on healthy menu labeling. A local YMCA branch agreed to provide community fitness programs. Ministers and churches will be involved in health education programs.

What were the limitations of the study?

All information was reported by participants. Some participants may have given inaccurate answers.

Older adults and women were more likely to be at home when the surveyors came over. Therefore, they may have been over-sampled.

Since the study included only African Americans, the results may not apply to other groups of people

What are the implications of the study?

It's important to understand what motivates people to change health behaviors. It's also important to include community members in planning public health projects.