Catalysts for Health Behavior Change in Midlife and Older Rural Adults: A Qualitative Study

Abstract

Positive health behaviors, such as a heart healthy diet, physical activity, and tobacco cessation, can help reduce cardiovascular disease risk at any age. However, many people do not adopt these behaviors. This qualitative study's purpose was to identify and understand specific catalysts for health behavior change among midlife and older residents of rural communities, a group inadequately represented in research and at elevated risk for chronic disease.Seventeen focus groups were held with 126 sedentary, overweight/obese adults aged 40‐91 years (64±12 years; 57% female) residing in government designated “medically underserved” rural Montana towns (average population <3,000). Groups were stratified by age (40‐64 and 蠅65) and gender. The topic guide had questions about barriers and facilitators to healthy eating, active living, and smoking cessation. Transcripts were reviewed and common themes were identified related to behavior change.Participants were generally aware of heart healthy behaviors and some reported recently making a major change. Catalysts for change included a serious household medical event (e.g. heart attack), shift in family structure (e.g. death of a partner), policy change (e.g. indoor smoking ban), or desire to reduce aging associated functional decline. For women, in particular, the opportunity to take part in health programs (e.g. classes) was a catalyst. These findings provide important insight about what motivates rural residents to change behavior and may inform interventions relevant for this population.Funded by NHLBI, R01 HL120702‐01.