Healthy Eating and Harambee: Designing a Culturally Centered Biomedically Oriented Community Health Promotion Curriculum

The objective of the Healthy Eating and Harambee project was to develop a theoretically-centered and biomedical nutrition-focused curriculum to shift stage of change for African American women of childbearing age toward a more healthful dietary pattern focused on health promotion and prevention of cardiovascular disease (CVD) and hypertension. The word “Harambee” originated in Kenya and conveys “pulling together” to build community. This culturally embedded concept served as a driving focus of the peer-educator based delivery of the curriculum. The health promotion curriculum was designed to be interactive, to be completed during weekly 60-90 minute lessons over 13 weeks, and guided by the 3 domains of the PEN-3 theoretical framework, which incorporates culture into health interventions: (1) cultural identity, (2) relationships and expectations, and (3) cultural empowerment. The experiential learning activities were created using the U.S Dietary Guidelines and Dietary Approaches to Stop Hypertension (DASH). Building on the Transtheoretical model, a staging algorithm (fruits, vegetables, fat, and sodium) was customized for classifying participants by Stage of Change. Correlation analysis matrices were created to assess association between the number of weeks the participants interacted with the program and change in Stage for the dietary and biomedical variables (egs., monitoring blood pressure, and exercise). Participant testimonial logs were designed for tracking meal preparation, monitoring dietary behaviors through food records, and tracking biomedical behaviors. Translation of emerging biomedical findings and combining novel and traditional methods of nutrition dissemination are integral to effectively reach this minority population at high risk for CVD and hypertension.