Focus groups on cardiovascular health in rural women: implications for practice.

OBJECTIVE: To determine rural women's perceptions about cardiovascular disease (CVD) prevention and behavior change for cardiovascular health.
DESIGN: A trained moderator and nutritionist (observer) led the groups. The discussion guide was developed from the Health Belief Model and Social Cognitive Theory. The data were analyzed inductively looking at patterns and themes that emerged from the data and deductively looking at relationships from the theoretical models.
SUBJECTS: Thirty-four white women participated in six groups: three younger (20-40 years; n = 18) and three older (40-55 years; n = 16) groups. Women with no more than 13 years of education were recruited by social service providers, Extension agents, and church groups.
RESULTS: Rural women were unaware of their personal CVD risks. Common themes included the overriding influence of family preferences and cultural food patterns on women's food choices and the lack of support for adoption of a heart-healthy diet. Self-efficacy for dietary change spanned the continuum from no confidence (younger women) to complete empowerment (older women).
CONCLUSIONS: Efforts need to be directed toward providing education and skill building for CVD prevention based on a better understanding of women's cultural beliefs and life situations. All women believed that dietary choices were important for cardiovascular health; however, they lacked the skills for food selection and preparation. Family preference and support are key to the adoption and maintenance of a heart-healthy eating plan. For interventions, women preferred active learning (hands-on experiences) coupled with group classes for learning and support. Rural women lacked these resources or access to a nutritionist.