OBJECTIVES: African-Americans consume a diet high in fat, salt and sugar; such dietary habits increase the risks of cancer and other chronic diseases. The objective of this study was to engage rural communities in a nutrition and physical activity behavior modification program to promote cancer awareness and risk reduction. METHODS: Focus group discussions were conducted to generate information for the development of a nutrition and physical activity program. African Americans (N=62) from two rural counties (Bullock and Macon) in Alabama participated in a year-long intervention program in 2012 and 2013. Weight loss and blood pressure were evaluated to measure the impact of the intervention. RESULTS: Themes emerged for the focus group discussions were: nutrition, health, family, environment, and resource access. In Macon County participants lost weight irrespective of the exercise regimen, with those involved in floor exercise losing the most weight (-22.4 lbs, or-11.18 % change), while in Bullock county walking was most effective in weight loss (6.1 lbs or -3.40 % change) p<0.05. Systolic and diastolic pressure decreased from 5.3 to 10.5 mm Hg; -2.0 to -6.4 mmHg, respectively, for Bullock county, except for the walking group,). In Macon County, both systolic and diastolic pressure % change ranged from -8.94 to 12.66 and -5.34 to 12.66 mmHg respectively, irrespective of physical activity respectively. CONCLUSION: In this study, changes in weight lost and blood pressure were observed among individuals engaged in a nutrition education and physical activity program.