Background: Cardiovascular disease is the leading cause of death in women in the United States. Rural women have an increased risk of cardiovascular disease due to both behavioral and environmental factors. Models of prevention that are tailored to community needs and build on existing resources are essential for effective outreach to rural women. The Southern Seven Women's Initiative for Cardiovascular Health (SSWICH) was such a model. Purpose: This research describes the development and implementation of SSWICH, and examines the success of the initiative in reaching a population of rural women in southernmost Illinois. Methods: SSWICH used a collaborative, multi-strategy approach to reduce cardiovascular disease risk in rural women through community-based health promotion, peer education and a mass media campaign. Evaluation data from each strategy were used to examine the success of SSWICH in reaching the women in southernmost Illinois. Results: SSWICH community-based health promotion programs reached over 600 adult women. The mass media campaign reached an estimated 60% of adult women. Discussion: Rural communities present unique challenges for conducting health promotion programs. Successful ways of expanding program reach include collaborating with community partners, being flexible and responsive to program challenges and opportunities, and utilizing mass media. Translation to Public Health Practice: SSWICH offers an example of a multi-strategy approach to deliver health promotion messages to rural women. (Contains 3 tables.)