Feasibility and acceptability of an adapted community-based cardiovascular disease prevention program: a pilot study of the StrongPeople strong hearts intervention for women living in urban settings

Introduction Black/African American and Hispanic/Latina women living in urban areas are at increased risk of cardiovascular diseases (CVD). Adapting evidence-based interventions (EBIs) to different contexts offers a resource-efficient alternative to developing new interventions. StrongPeople Strong Hearts (SPSH; formerly Strong Hearts, Healthy Communities) is an EBI that significantly improved CVD-related health outcomes and behaviors among rural women. SPSH was adapted for a racially diverse urban female population. Our study examined the feasibility and acceptability of the adapted program to improve behavior and health outcomes. Methods We conducted a single-group pre-post pilot study with Black/African American and Hispanic/Latinx women living in an urban area, with a BMI ≥ 25, and engaging in ≤ 150 min of moderate physical activity per week. The 12-week intervention focused on improving diet, physical activity, and CVD prevention skills. We assessed feasibility outcomes (recruitment, attendance, fidelity) and evaluated acceptability through surveys and thematic analysis of interviews. Results We enrolled 51 participants; 72.5% ( n = 37) completed the study Attendance varied across participants, with higher participation observed among completers (median 66.67%) compared to the overall sample (median 54.2%). Participants reported high overall satisfaction (4.89 on a 5-point Likert scale). In interviews, participants (1) reported increased knowledge and skills and improvements in healthy behaviors; (2) praised SPSH implementation including enthusiastic instructors, group support, and structured content, and offered suggestions for enhancing the participant toolkit; (3) appreciated the digital health tools and suggested ways to enhance their use; and (4) expressed desire for more flexible class schedule, extended program duration, and additional content. Conclusion Results suggest that the adapted SPSH program is feasible and acceptable among racially diverse women, while additional program refinements (i.e., hybrid program delivery and flexible scheduling) may further enhance program feasibility and acceptability. The desire for digital tools and personalization should be considered in behavior change intervention development.