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CHW Health Disparities Initiative

University of Alabama at Birmingham (UAB)


Birmingham, AL

Intended Population:

African Americans

Key Partners:

Congregations for Public Health, Inc., Mt. Pilgrim District, National Baptist Convention USA

CVD Burden:

Cardiovascular disease (CVD) is the leading cause of death and disability in Alabama, accounting for more than a third of all deaths. Heart disease, the most common form of CVD, is the single leading cause of death in Alabama, accounting for more than a quarter of all deaths in 2006. Strokes are the third leading cause, following cancer. In 2006, strokes accounted for more than 2,740 deaths (5.83 percent) in the state. Men are about 50 percent more likely to die from stroke than women are, and African Americans have significantly higher age-adjusted stroke mortality rates than whites. Most Alabama deaths from heart disease occurred in people over the age of 75; however, nearly one in four deaths from CVD occurred in those under the age of 65. As with heart disease, strokes can be prevented by modifying risk factors. Jefferson County and the state of Alabama continue to have a high prevalence of modifiable risk factors for heart disease and stroke, compared with the nation.1


UAB led a faith-based partnership to adapt the NHLBI’s materials and provide heart health education in faith-based settings. A three-phase plan allowed for iterative learning and modification of the With Every Heartbeat Is Life curriculum through assessment and documentation. This process led to an NHLBI curriculum that has been modified for faith-based settings with existing health ministries. The first phase featured a pilot with existing community health worker (CHW) Master Trainers to give them experience with teaching the curriculum in select communities served by the Congregations for Public Health, Inc. The second phase was an expansion of the program to the Mt. Pilgrim District Nurses Guild (a volunteer group of church members in the Baptist network) to train African American communities throughout Jefferson County. The third phase was the development of a plan to expand the program to the national network of NBCUSA through its National Baptist Congress of Christian Education.

Each phase offered opportunities for problem solving and mentoring across different congregations and communities. The Master Trainers communicated about lessons learned, particularly program successes and problem solving. They also trained and coached the trainees of the Mt. Pilgrim District and the broader NBCUSA convention in the program’s best practices. CHWs had access to formal (e.g., person-to-person meetings, conference calls, webinars) and informal (e.g., blogs, social networking) opportunities to support and share information in order to build a cohesive network of heart health educators. A total of 11 CHWs were trained, reaching 124 community members.


UAB measured changes in knowledge, attitudes, and behaviors among CHWs and community participants. In addition to using the NHLBI evaluation forms from the curriculum, UAB evaluated the partnerships that were strengthened by or newly formed through participation in the project. This evaluation was accomplished using a social network analysis conducted via survey or interview to determine how and when new partners became involved, their roles in the project and/or their organization, and how communication (e.g., frequency, quality) has improved over the course of the project.

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1 Alabama Department of Public Health. (2010). The risk of heart disease and stroke in Alabama: burden document.external disclaimerFinding the path to cardiovascular health, 2010. Montgomery, AL: Alabama Department of Public Health.

Last Updated: June 2014