The Heart Healthy Lenoir Project is a five-year, NIH-funded project to reduce heart disease risk among residents of Lenoir County, North Carolina. Of all North Carolina counties, Lenoir County has one of the highest heart disease and stroke death rates. Heart Healthy Lenoir is a collaborative project among researchers from East Carolina University and the University of North Carolina at Chapel Hill. One component of the Heart Healthy Lenoir Project is to learn more about community-level supports for and barriers to healthy lifestyles among Lenoir County residents.
Health promotion researchers are increasingly noting the potential impact that the environment has on population health. For example, individuals’ accessibility to health-promoting environments and resources, such as farmers’ markets and pedestrian-friendly neighborhoods, is increasingly touted as a major determinant of healthy behaviors and subsequent health status. Therefore, the Heart Healthy Lenoir Project used systematic windshield tours to better understand the community-level supports for and barriers to healthy behaviors in Lenoir County. Windshield tours involve driving through an area, taking detailed and systematic notes on physical and social attributes that are observed. Windshield tours are similar to “ground-truthing,” a process by which data gathered from secondary sources are corroborated against the same data gathered onsite. Windshield tours are also qualitative data collection tools, as several researchers have used such tours to document general social attributes of an area.
During the months of August through October 2010, we conducted six windshield tours in Lenoir County, with a focus on understanding community context and enumerating county physical activity and nutrition resources. During each tour, a knowledgeable community member accompanied researchers to provide context to the community and venue characteristics. These community informants gave the researchers an important insiders’ perspective, including information on past and present community transitions, cultural and social issues, and important characteristics of venues which enhanced community understanding and can guide future policy considerations.
Once community resources were accurately enumerated, they were listed in a community resource guide that will be used in a lifestyle intervention program for residents (the lifestyle program is scheduled to begin in Fall of 2011). During interviews with community members, the community resource guide was found to be very useful as many interview participants did not know about many of the health-promoting resources in Lenoir County. This highlights the importance of raising awareness of health-promoting community resources. The community members also offered important suggestions on how the guide could be modified to improve its impact on behavior change, such as adding information about the family-friendliness of the resources and including larger images and font. The hope is that the comprehensive community resource guide will serve as an information source for residents to explore health-promoting resources. This will help us to be more effective as partners with the Lenoir County community, to promote heart-healthy lifestyles and ultimately fight the burden of heart disease.
Written by Stephanie Jilcott, PhD & Jared McGuirt, MPH at the Department of Public Health, Brody School of Medicine, East Carolina University