(provided by the investigator): Cardiovascular disease (CVD) is the leading cause of death for women in the United States and disproportionately affects underserved populations. The Strong Women - Healthy Hearts Program has the potential for positive impact on this public health issue. The 12-week intervention has demonstrated effectiveness in increasing physical activity, improving diet quality, and decreasing body weight in a controlled, randomized trial in two states. This application seeks to evaluate the dissemination of the Strong Woman - Healthy Hearts Program through two approaches in partnership with the Cooperative State Research, Education, and Extension Service (CSREES), our partner in the effectiveness trial. The proposed dissemination plan leverages a successful, five-year collaboration between Tufts University and CSREES, which has an extensive network of 2,900 county and regional offices nationwide. First, we will work with the Pennsylvania State Cooperative Extension to conduct an in-depth evaluation in Pennsylvania according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework using quantitative and qualitative methods. Second, in partnership with the National Extension Association of Family and Consumer Sciences, we will evaluate the first wave of national dissemination with a larger number of CSREES educators to quantitatively assess the RE-AIM components. The central objective of this application is to rigorously evaluate dissemination of the Strong Women - Healthy Hearts Program using the RE-AIM framework in order to achieve maximal public health impact. The results will help to reach Healthy People 2010 Goal 1, Objectives 12, 19, and 22. This study is also designed to provide data on best practices for reaching priority subpopulations, especially low-income and rural women. In this way it will contribute to Healthy People 2010 Goal 2, the reduction of health disparities.

Public Health Relevance

Midlife and older women are at elevated risk of heart disease due to their higher rates of overweight and obesity, sedentary behaviors, and poor nutrition. Our community-based physical activity and nutrition intervention has been developed with national partners and has the potential to be widely disseminated. If successful, the program has the ability to reduce the risk of heart disease in women, thus reducing burgeoning health care costs.

National Institute of Health (NIH)
National Center for Chronic Disease Prev and Health Promo (NCCDPHP)
Research Demonstration and Dissemination Projects (R18)
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Special Emphasis Panel (ZCD1-CJM (11))
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Tufts University
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Folta, Sara C; Lichtenstein, Alice H; Seguin, Rebecca A et al. (2015) The StrongWomen-Healthy Hearts program in Pennsylvania: RE-AIM analysis. Transl Behav Med 5:94-102
Folta, Sara C; Seguin, Rebecca A; Chui, Kenneth K H et al. (2015) National Dissemination of StrongWomen-Healthy Hearts: A Community-Based Program to Reduce Risk of Cardiovascular Disease Among Midlife and Older Women. Am J Public Health 105:2578-85