Stroke Belt initiative: the Tennessee experience

African Americans have a higher rate of stroke than other U.S. population groups. As part of the 11-state "Stroke Belt" region, Tennessee has the fifth highest death rate from stroke in the country. In 1993, a two-year community-based project was initiated to reduce the incidence of stroke and its associated risk factors among African Americans. Three counties, Shelby (Memphis), Davidson (Nashville), and Hamilton (Chattanooga), were selected as project sites because of their large African American populations. Specific objectives of the project were to promote risk factor awareness in African Americans, assist African American churches and community groups in developing and implementing intervention programs, and build the capacity for intervention programs within African American communities by collaborating with a variety of community organizations. This article describes the program's approach, which included using both adults and youth as mentors. In addition, it presents major accomplishments and lessons learned in project implementation.