ArticleAmerican journal of health promotion : AJHP2022
A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study.
Article in American journal of health promotion : AJHP, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Lay advisor interventions for hypertension outcomes: A Systematic Review, Meta-analysis and a RE-AIM evaluation.Frontiers in medicine · 2024Pooled it
- The role of community health workers in a collaborative care management intervention for cancer pain management: a feasibility study for a randomized controlled trial.Annals of palliative medicine · 2025Trial
- Scaling up the Med-South Lifestyle Program in public health settings to reduce chronic disease risk: a hybrid implementation-effectiveness study.Frontiers in public health · 2025Trial
- Exploring the Facilitators and Barriers to Physical Activity among Adults Experiencing Food Insecurity During the Healthy Food First Trial: A Qualitative Study.Current developments in nutrition · 2026Article
- A Multisite, Randomized Trial Testing a Community-Digital Health Intervention among Black and Latino Adults with Cardiometabolic Conditions: The Roots of Wellness (Raíces del Bienestar) Protocol.medRxiv : the preprint server for health sciences · 2026Article
- Implementing intervention mapping to tailor the evidence-based PREDIMED intervention for medically underserved prostate cancer patients.Translational behavioral medicine · 2026Article
- Adaptation of Navigate-Kidney: A Community Health Worker Intervention for People With Kidney Disease.Kidney international reports · 2026Article
- Homelessness, Race/Ethnicity, and Cardiovascular Disease: a State‑of‑the‑Evidence Summary and Structured Review of Race/Ethnicity Reporting.Current cardiovascular risk reports · 2023Article
- Tailoring implementation strategies for scale-up: Preparing to take the Med-South Lifestyle program to scale statewide.Frontiers in health services · 2022Article
- Implementing Self-Measured Blood Pressure Monitoring With Clinical Support: A Qualitative Study of Federally Qualified Health Centers.Journal of public health management and practice : JPHMPArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
purposeTo evaluate the implementation and effectiveness of the Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program, an adapted evidence-based cardiovascular disease risk reduction intervention delivered by Community Health Workers (CHW) to rural adults.
designHybrid implementation-effectiveness study with a pre-post design.
settingNorth Carolina Federally Qualified Health Center and local health department in a rural, medically underserved area. SAMPLE: Participants (n = 255) included 87% Non-Hispanic Black with a mean age of 57 years; 84% had diagnosed hypertension, 55% had diabetes, and 65% had hypercholesterolemia.
interventionA CHW-delivered, low-intensity, 4-month behavioral lifestyle intervention promoting a southern-style Mediterranean dietary pattern and physical activity. MEASURES: We measured number and representativeness of participants reached and retained, intervention delivery fidelity, weight, blood pressure, and self-reported dietary and physical activity behaviors. ANALYSIS: Pre-post changes at 4 months were analyzed using paired t-tests.
resultsStudy participants completed 90% of planned intervention contacts; 87% were retained. Intervention delivery fidelity measures showed participants receiving a mean of 3.5 counseling visits, 2.7 booster calls, and on average completing 1.7 modules, setting 1.8 goals, and receiving 1.3 referrals per visit. There were significant mean reductions in systolic (-2.5 mmHg, P < .05) and diastolic blood pressure (-2.1 mmHg, P < .01); the proportion of participants with systolic blood pressure <130 increased by 7 % points (P = .05), and diastolic pressure <80 by 9 percentage points (P < .01). Dietary behaviors improved significantly with average weekly servings of nuts increased by .5 serving (P < .0001), and fruits and vegetables by .8 daily serving (P < .0001). Physical activity also increased on average by 45 min./week (P < .001). Weight did not change significantly.
conclusionsThe CHANGE program showed both implementation and program effectiveness and adds to the evidence supporting CHW-delivered lifestyle interventions to reduce CVD risk among rural, Non-Hispanic Black, and medically underserved populations.
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