Native Proverbs 31 Health Project: Lessons learned in community research

Introduction: American Indians have higher rates of cardiovascular disease (CVD) compared to whites largely due to high prevalence of hypertension, diabetes, obesity and tobacco use. Culturally appropriate interventions are helpful in establishing health behavior change to reduce CVD risk. The Christian church is an important institution for many Lumbee Indians in southeastern North Carolina and can be a partner in delivering health education. The Native Proverbs 31 Project is a collaboration between Wake Forest School of Medicine and the Lumbee tribe to develop and test a church-based program to prevent CVD among Lumbee women. Methods: Classes in 4 Lumbee churches are led by community lay health advisors. The program has been adapted for Lumbee women to address CVD with topics including nutrition, physical activity, depression, and tobacco cessation. Topics are coupled with health-related messages from Biblical Proverbs 31 passages, which describe the virtuous, Godly woman. Surveys collected at the beginning and end of the program measure programmatic impacts and BMI. Results: Focus groups conducted among female church members provided guidance for intervention development. Women discussed difficulties of raising healthy families and keeping themselves fit. They provided guidance about what might cause the intervention to succeed or fail in their individual churches. Measures on depression and tobacco use were difficult to collect because they are stigmatizing. Conclusions: Community partners, like churches, are treasured resources in developing and executing health education and disease prevention programs in Christian populations. Through these partnerships, interventions can be tailored to suit the needs of targeted groups.