Rural appalachian perspectives on heart health: Social ecological contexts

Gia Mudd-Martin, Martha J. Biddle, Misook L. Chung, Terry A. Lennie, Alison L. Bailey, Baretta R. Casey, M. J. Novak, Debra K. Moser

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objective: To explore factors associated with cardiovascular disease (CVD) risk in Central Appalachia Kentucky to guide development of a culturally appropriate risk reduction intervention. Methods: Based on community-based participatory research principles, 7 focus groups were conducted with 88 healthcare employees and residents from 6 Appalachian counties. Sessions were audio-recorded and transcribed. Thematic analysis was used to identify themes and sub-themes. Results: Participants most frequently attributed CVD risk to behaviors including unhealthy diets, physical inactivity, and smoking, and to inadequate preventive care. Intrapersonal, interpersonal, sociocultural, environmental, organizational, and policy level influences on risk were identified. Conclusion: Comprehensive intervention guided by a social ecological framework is needed to address CVD risk reduction in Appalachian Kentucky communities.

Original languageEnglish
Pages (from-to)134-143
Number of pages10
JournalAmerican Journal of Health Behavior
Issue number1
StatePublished - Jan 2014


  • Appalachia
  • Cardiovascular disease
  • Focus groups
  • Health behaviors

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health


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