Table 2.

Qualitative Interviews to Gauge Cultural Fit of Healthy Hearts for an Abundant Life

Domain	Themes	Representative Quotes
Social support and comradery	The group setting improved accountability and motivation for participants	What I liked the most was meeting other women of color and doing this experience together. I got to make some friendships and share issues in life as women of color (Program Participant Group 4 Participant 2) I think accountability and just being able to meet with people who had the same goal of living an abundant healthy life with no judgment, but encouragement was big. The information and everything were good, and exercise was good, and cooking was good but the really the best part was having a group of women who were looking to do the same thing without judgment. (Program Participant Group 3 Participant 2) I mean we would text each other you know to see if people were coming. If the person wouldn't come, we would text them and make sure they were okay, or I mean we had a thread together on the phone, so we were really close. (Program Participant Group 4 Participant 2)
Racism and stress	Racism class fitted with the overall program and participants' lived experiences	The class on racism was absolutely relevant. Unfortunately, it is a part of their reality. It affects a lot of stuff because with more stress, you do more emotional eating and don't care as much about being healthy and physically active. Not having this class would be a disservice to the program. (Program Leader 1)
Community	Examples of linking the class material to the community	We had to go into our community and look at different marketing materials and how it targets people of color and what does that mean for us and what we can do to help other people understand how [we] were being targeted, you know? (Program Participant Group 4 Participant 2) You know, there are liquor stores and fast food restaurants on every corner in the hood, but in the suburbs, you don't see that. And it made me aware of that and I'm a teacher, and you know I hear my students say 3 nights a week that they're at McDonalds I'm like “Dude, what”? But, that's what's there, and that's what convenient for those families. So it made me really aware of and sensitive to the fact that that's what there. (Program Participant Group 1 Participant 3)
Emotional wellness and spirituality	The role of faith in living a healthy life was paramount	God and prayer is an important role in helping us to sort of achieve some of the goals that we were trying to accomplish so um, I think it was definitely a good fit. You know, like we prayed, so it was definitely a good fit with my own personal beliefs. (Program Participant Group 2 Participant 1) I'm a woman of faith and having my faith in God and going to church and being involved in church is very important to my heart health and my health period. You know being with my family keeps me healthy, being with friends keeps me healthy setting limits is keeping me healthy and that is an Abundant Life. (Program Participant Group 3 Participant 2)
Relationships and family role	Participants discussed the struggles of balancing work and family	We are so busy, but we need to take time for ourselves for self-care. We do so much for our families, but you know we can't be as effective if we're not healthy. So, I guess continue to drill that we need to take care of ourselves and be as healthy as possible (Program Participant Group 2 Participant 3).
Cultural resonance	Having a women of color as a program leader and using spices from the recipe book enabled behavioral changes	Just having someone, a nutritionist, that deals with women of color, you know older women of color, not even of color, just women period. When I get in class, I'm really taking time to do this, I really want to hear about women, I don't want to hear about anything else, I want to hear nutrition, women, exercise. (Program Participant Group 1 Participant 5) you know, culturally we operate this way, but then individually within that culture we operate differently as well. I know people think that people are monolithic we aren't- we aren't all the same. (Program Participant Group 3 Participant 2) I believe it fits my lifestyle because I'm trying to trying to be healthy and eat better and exercise and go to the gym and keep my calorie count, you know, at a healthy place, and my blood pressure, and I've been really, really consistent, I've actually been able to come off of blood pressure medicine since I started. (Program Participant Group 2 Participant 3) I love the recipe thing. It uses spices. I think that's a real cultural thing because I think in this area of Massachusetts food does not have a lot of seasoning in it. But what I liked about this one is it used a lot of different spices and seasoning and put combinations of food, like fruit with greens. (Program Participant Group 4 Participant 1)
Challenges with ASA24 dietary recalls	Using the ASA24 dietary recalls was time consuming and frustrating	I can't keep up with it. As much as I wish I could have, I missed some days and it took a lot to log in what you ate because we had to go back and measure sizes and that was a lot of work. I was pretty frustrated trying to figure out how to put all the information in. I think they would need to walk people through how to do that at the first training. (Program Participant Group 1 Participant 1)

n=12: Themes and representative quotes.