Abstract Body (Do not enter title and authors here): Background: Cardiovascular disease is a major chronic disease that contributes toward high rates of death and disability in the United States, especially in southern rural areas with limited access to health resources. Worse outcomes among rural populations have been associated with increased prevalence of modifiable disease risk factors, which are influenced by determinants including norms, attitudes, and social support. The purpose of this study was to evaluate the impact of a web-based lifestyle medicine program on the dietary and social support health behavior determinants of rural adults.

Methods: A randomized controlled pilot study was conducted to test the lifestyle medicine intervention among rural adults. The sample included participants (n = 80) at risk for or currently diagnosed with a chronic disease who were randomized to either an intervention (n = 40) and waitlisted control (n = 40) group. Participants in the intervention group received a lifestyle medicine program via an online format. A series of repeated-measures general linear models (GLMs) were conducted to evaluate the effects of the intervention over time across outcome variables.

Results: The results indicated no significant between-group differences regarding socio-demographic characteristics, except for race. More people self-identified as White in the waitlisted control group compared with the intervention group. The analysis also showed significant intervention effects (Time X Group) for dietary produce attitudes (F(3, 65) = 7.89, p < .001) and norms (F(3, 65) = 4.96, p = .004), and marginal for intentions (F(3, 65) = 2.72, p = .052). The perceived behavior control determinant showed an upward trend for the intervention group but did not reach significance. A significant intervention effect was noted for emotional support (F(3, 64) = 4.02, p = .011).

Conclusion: Health determinants are often difficult to modify, but participation in the web-based lifestyle medicine intervention improved determinants of produce consumption and support. Online interventions can make an impact on cardiovascular health by promoting modifications in psychosocial determinants that influence health behaviors and extending program reach in rural areas.