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In a sample of 360 participants recruited by two Federally Qualified Health Centers and two local health departments in Hertford, Edgecombe, and Nash Counties in North Carolina and using community health workers as health counselors, the following statistically significant findings were achieved:


photo of fruits and vegetables
photo of running shoes
photo of blood pressure monitor

Dietary Intake

  • Daily fruit and vegetable intake increased by nearly 1 serving.
  • Sugar-sweetened beverages were lowered by 0.4 servings daily.
  • Weekly intake of nuts increased by 0.4 units.


Physical Activity

  • Moderate-intensity physical activity increased by an average of 43 minutes per week.


Blood Pressure

  • There were more participants with controlled blood pressure at the end of the program.
  • Average decrease in systolic blood pressure was 4 mm Hg.
  • Average decrease in diastolic blood pressure was 2.2 mm Hg.


Publications and Active Projects

The above results are a combination from two published studies:

  • Samuel-Hodge CD, Gizlice Z, Allgood SD, Bunton AJ, Erskine A, Leeman J, Cykert S. A hybrid implementation-effectiveness study of a CHW-delivered cardiovascular disease risk reduction intervention among rural minority high-risk adults: the CHANGE Study. Am J Health Promot. 2022.
  • Samuel-Hodge CD, Gizlice Z, Allgood SD, Bunton AJ, Erskine A, Leeman J, Cykert S. Strengthening community-clinical linkages to reduce cardiovascular disease risk in rural NC: Feasibility phase of the CHANGE Study. BMC Public Health. 2020;20:264.

Additional publications supporting the Med-South Lifestyle Program’s evidence base that were developed by researchers at the UNC Center for Health Promotion and Disease Prevention are included below:

  • Embree GGR, Samuel-Hodge CD, Johnston LF, Garcia BA, Gizlice Z, Evenson KR, DeWalt DA, Ammerman AS, Keyserling TC. Successful long-term weight loss among participants with diabetes receiving an intervention promoting an adapted Mediterranean-style dietary pattern: the Heart Healthy Lenoir Project. BMJ Open Diabetes Research and Care 2017; 5:e000339.
  • Keyserling TC, Samuel-Hodge CD, Pitts SJ, Garcia BA, Johnston LF, Gizlice Z, Miller CL, Braxton DF, Evenson KR, Smith JC, Davis GB, Quenum EL, Elliott NTM, Gross MD, Donahue KE, Halladay JR, Ammerman AS. A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project. BMC Public Health. 2016; 16:732.
  • Keyserling TC, Ammerman AS, Samuel-Hodge CD, Ingram AF, Skelly AH, Elasy TA, Johnston LF, Cole AS, Henriquez-Rolddn CF. A diabetes management program for African American women with type 2 diabetes. The Diabetes Educator. 2016; 26(5):796-805.
  • Keyserling TC, Sheridan SL, Draeger LB, Finkelstein EA, Gizlice Z, Kruger E, Johnston LF, Sloane PD, Samuel-Hodge C, Evenson KR, Gross MD, Donahue KE, Pignone MP, Vu MB, Steinbacher EA, Weiner BJ, Bangdiwala SI, Ammerman AS. A comparison of live counseling with a web-based lifestyle and medication intervention to reduce coronary heart disease risk: a randomized clinical trial. JAMA Intern Med. 2014 Jul; 174(7):1144-57. https://doi:10.1001/jamainternmed.2014.1984
  • Sheridan SL, Draeger LB, Pignone MP, Sloane PD, Samuel-Hodge C, Finkelstein EA, Gizlice Z, Vu MB, Gitterman DP, Bangdiwala SI, Donahue, KE, Evenson K, Ammerman AS, Keyserling TS. Designing and implementing a comparative effectiveness study of two strategies for delivering high quality CHD prevention: methods and participant characteristics for the Heart to Health study. Contemp Clin Trials 2013;36(2):394-405. https://doi: 10.1016/j.cct.2013.07.013.
  • Samuel-Hodge CD, Johnston LF, Gizlice Z, Garcia BA, Lindsley SC, Gold AD, Braxton DF, Keyserling TC. A pilot study comparing two weight loss maintenance interventions among low-income, mid-life women. BMC Public Health. 2013; 13:653.
  • Keyserling TC, Samuel Hodge CD, Jilcott SB, Johnston LF, Garcia BA, Gizlice Z, Gross MD, Savinon CE, Bangdiwala SI, Will JC, Farris RP, Trost S, Ammerman AS. Randomized trial of a clinic-based, community supported, lifestyle intervention to improve physical activity and diet: The North Carolina enhanced WISEWOMAN project. Prev Med  2008; 46(6):499-510.
  • Jilcott SB, Keyserling TC, Samuel-Hodge CD, Rosamond W, Garcia B, Will JC, Farris RS, Ammerman AS. Linking clinical care to community resources for cardiovascular disease prevention: the North Carolina Enhanced WISEWOMAN project. Journal of Women’s Health 2006; 15(5):569-583.
  • Jilcott SB, Macon ML, Rosamond WD, Garcia BA, Jenkins LK, Cannon PM, Townsend CR, Tawney KW, Keyserling TC, Will JC, Ammerman AS. Implementing the WISEWOMAN program in local health departments: staff attitudes, beliefs, and perceived barriers. Journal of Women’s Health 2004; 13(5):598-606.
  • Rosamond WD, Ammerman AS, Holliday JL, Tawney KW, Hunt KJ, Keyserling TC, Will JC, Mokdad AH. Cardiovascular disease risk factor intervention in low-income women: the North Carolina WISEWOMAN project. Prev Med 2000; 31(4):370-9.
  • Keyserling TC, Ammerman AS, Davis CE, Mok MC, Garrett J, Simpson R, Jr. A randomized controlled trial of a physician-directed treatment program for low-income patients with high blood cholesterol: the Southeast Cholesterol Project. Archives of Family Medicine 1997; 6(2):135-145.
  • Ammerman AS, DeVellis BM, Haines PS, Keyserling TC, Carey TS, DeVellis RF, Simpson, Jr RJ. Nutrition educator for cardiovascular disease prevention among low income populations – description and pilot evaluation of a physician-based model. Patient Educ Couns 1992: 19(1): 5-18.