Improving Health Behaviors in an African American Community: The Charlotte Racial and Ethnic Approaches to Community Health Project

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Abstract
Objectives. We examined the effect on 3 behavioral risk factors for heart disease and diabetes (low fruit and vegetable consumption, low physical activity, and cigarette smoking) of an intervention in an African American community in North Carolina. Methods. A community coalition, a lay health advisor program, and policy and community environment change strategies were implemented in a community of 20000 African Americans in 2001 to 2005. Health behavior questions from the Behavioral Risk Factor Surveillance System survey were administered to a cross-section of the community annually. The results were compared with African Americans’ responses from a statewide survey. Results. All 3 health behaviors improved in the study population. Improvements were statistically significant for physical activity (P= .02) and smoking (P= .03) among women and for physical activity among middle-aged adults (P=.01). Lower baseline physical activity rates improved to levels comparable to those of African Americans statewide (2001, P<.001; 2005, P=.38), and comparable fruit and vegetable consumption rates became significantly higher (2001, P=.68; 2005, P<.001). Conclusions. Our findings support the emerging role of policy and community environment change strategies and community participation as promising practices to improve health behaviors in African American communities and to reduce health disparities.