Adaptation of an evidence-based intervention for Appalachian women: New STEPS (Strength through education, physical fitness and support) for breast health

Appalachia is characterized by a high prevalence of individual-level risks for breast cancer, including physical inactivity and postmenopausal obesity. The availability of local, evidence-based programs to improve physical fitness is limited. We adapted an evidence-based intervention, StrongWomen, to improve physical fitness and increase breast cancer knowledge among women 40 years and older in Appalachian Pennsylvania. Utilizing a multi-site, community-based design, we tested the adapted 12-week, supervised program - New STEPS (Strength Through Education, Physical fitness and Support) - among 139 women. The completion rate was 67.6 %. Pre/post scores improved for each of six fitness assessments (P < 0.01). We found differences in overall fitness by study site (P < 0.001), but no differences by age (P = 0.13) or by previous breast cancer diagnosis (P = 0.73). New STEPS is an adapted, evidence-based program that can improve physical fitness and breast cancer awareness among women in Appalachian Pennsylvania. New STEPS may help fill a void in local fitness programs for Appalachian women at risk for breast cancer or breast cancer recurrence.