Using Community Based Participatory Research to Strengthen the Health of Rural, Low-Income Families

The Patient Protection and Affordable Care Act of 2010 emphasized prevention. Rural families, however, experience limited availability and access to preventive health services. Health disparities are particularly challenging for economically vulnerable rural families who also tend to be less-than-fully health literate and experience poorer health than their urban counterparts. One tactic to reduce disparities is to involve the targeted population and promote a health-conducive environment where information is sensitive to both health literacy and culture. We chose to work with rural, low-income mothers for two years to determine the elements of health messages and channels of communication that resonated with them because mothers are key family health decision-makers. Empowerment theory was used to engage mothers in: identifying components of core health messages; creation of messages, testing of message delivery and responding to messages; reviewing results; and making recommendations. We conducted focus groups in 6 states and interviews in 8 which produced preferences for content, style and channel. Another round of interviews, using preferred channels, tested the resulting physical health, dental health, food security and health insurance messages. Underway are interviews with professionals who serve this population to ascertain their perspectives regarding mothers' preferences. We will also conduct focus groups with a sample of mothers and stakeholders to review findings and generate recommendations for future health messages for rural, low-income mothers. We believe that this community-based participatory research study will increase the likelihood that the research-based messages will be effectively communicated, leading to positive health outcomes.