Fidelity and Acceptability of an Adapted Cardiovascular Disease Prevention Intervention: StrongPeople Strong Hearts

Objective To evaluate fidelity and acceptability of the adapted StrongPeople Strong Hearts (SPSH; formerly Strong Hearts Healthy Communities) intervention – originally designed and implemented with rural, older women – for diverse urban women. Use of Theory We used the Intervention Mapping (IM) Adapt stepwise framework to guide the adaptation of the behavioral theory, cultural and implementation fit of the SPSH program. Target Audience Black and Latina adult women living in an urban city. Program Description SPSH is an evidence-based, multilevel, community-based intervention that has demonstrated effectiveness in improving cardiovascular disease (CVD)-related health behaviors and outcomes in at-risk women. The program emphasizes behavior modification through experiential learning and focuses on improving dietary intake, increasing physical activity, and imparting other CVD prevention skills, including stress management. Evaluation Methods Program fidelity surveys were completed by implementers after each class, and acceptability was assessed using a post-intervention participant satisfaction survey and interviews. Results The adapted 12-week program (2 classes/week) was delivered to 2 cohorts (n=51) with attendance (median 68.9%), mirroring the original SPSH (67%). High fidelity was observed (82.6% of activities completed, 93.75% of classes delivered), demonstrating similar fidelity and slightly improved dosage delivery compared to the original SPSH (82% and 84%, respectively). Unforeseen circumstances (power outage, weather) impacted 3 classes, but the content was consolidated to maintain dosage. The average class length was 70.9 minutes, including 15 minutes of aerobic activity, 19.5 minutes of strength training, and 36.4 minutes on nutrition and CVD-related topics. The average duration to prepare for each class was 38.3 minutes. Participant satisfaction was high (98.4% rated "5" on a 5-point scale), and they described the program as enjoyable, with noticeable health improvements like increased energy, increased body strength and endurance and healthier eating habits. Conclusions The results suggest that SPSH can be adapted and delivered with fidelity and high acceptability, expanding its reach to diverse urban populations. Funding None