They say " Two heads are better than one"
and North Carolina seems to have proved that adage true. According to a new
study, a largely African-American area of Charlotte, North Carolina owes its
success in a program, which helped reduce risky health behaviours, to community
involvement. The report is carried in the September issue of the American
Journal of Public Health.
The four-year project — intended to reduce
diabetes and heart disease risk factors — led to significant declines in
physical inactivity and smoking as well as to an increase in fruit and
"We reached out to find people who were
already natural leaders through various community organizations," said lead
study author Marcus Plescia, M.D. He is Chief of the Chronic Disease and Injury
Section, of the North Carolina Division of Public Health.
Members of the Charlotte community were
involved in every step of the project, from designing and implementing
interventions to evaluating and refining them. Local resources went to good
use; for instance:
- A neighbourhood association organized a farmer's market and
members of a grassroots community group encouraged a local YMCA to expand
its physical activity programs.
- Lay health advisors and coalition members took part in state
and local advocacy efforts to raise the state tax on tobacco products and
ban smoking in restaurants and bars.
- A local public relations firm helped to publicize the health
risks and associated behaviours.
To gauge how well the project worked, the
researchers looked at responses from a widely used survey on behavioural risk
factors to compare area and statewide results for the study period.
For the Charlotte participants, physical
inactivity among women dropped from 33 percent to 26.1 percent. The number of
people consuming five servings of fruits and vegetables daily grew from 26.0
percent to 27.4 and the number of women who smoked dropped from 26.8 percent to
20.9. Among men, vegetable and fruit consumption rose from 17.9 percent to 21.9
The Charlotte Reach Project offers lessons
that can apply to other parts of the country, said registered dietitian Suzanne
Pelican, a food and nutrition expert at the University of Wyoming-based WIN
Wyoming project, which attempts to overcome health disparities faced by
low-income rural communities.
"A person's choices are greatly influenced
by the options they have where they live work and play, by their families and
the communities they live in," Pelican said. "Charlotte is a community like no
other, but if policy makers, educators, researchers and community leaders look
at such projects, we can find ways to enhance similar projects in other