Table 5.

Recommendations based on Conclusions from Formative Research on Carriacou, Grenada

Program Conclusions	Recommendations
Self--perception of health	Survey: Incorporate items into the survey about stress, and barriers to exercise; local foods and the manners of preparation/use; awareness of risk factors for disease
	Program: Address issues of uncertainty about health and role of heredity; role of education and screening;
Connection between prevention activities, risk, and heredity in cardiovascular disease development	Survey: Build risk profile into survey, help individuals establish their risk; provide counseling as first step to help individuals to identify how to reduce risk
	Program: differentiate between harm reduction and risk reduction; address both programmatically. Clearly identify the role and value of prevention. Help individuals identify facets of their own risk profile, beyond just heredity. Promote individual empowerment (personal responsibility) through proficiency in using their risk profile to reduce their risk.
Functional limitations	Survey: Assess work and physical activity
	Program: Design prevention programs in the context of maintenance of function, rather than the promotion of health.
Health improvement activities	Survey: use of natural/bush medicines; barriers to implementation of healthy lifestyle habits;
	Program: Build existing practices into a coherent set of risk- based lifestyle changes, use risk profile to provide individualized priorities. Make use of their acceptance of natural (not prescription/medication) approaches to treating conditions. Link with faith-based organizations.
Physical activity is implicitly valued, not practiced	Survey: Assess level and types of physical activity
	Program: Design skills building programs for time and stress management to create opportunities for exercise. When fashioning exercise promotion programs, build on existing sources of physical activity, such as gardening, job-related exercise
Institutionalization of dietary changes post Hurricane Ivan	Survey: Identify dietary patterns particularly fish, vegetables, fruits and use of fat
	Program: Work to better understand what is available and affordable on Carriacou. Redefine “what is a balanced diet”, based on what is currently available and affordable. Build on pre-Ivan dietary patterns.