Community Health Advisors’ Participation in a Dissemination and Implementation Study of an Evidence-Based Physical Activity and Healthy Eating Program in a Faith-Based Setting

Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees’ perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was used to analyze associations between the church environment and outcomes. Physical elements of churches were positively related to attendees’ perceptions of church environment supports for PA (B = 0.03, 95% CI = 0.01, 0.05) and HE (B = 0.05, 95% CI = 0.01, 0.09) and there was a significant interaction between perceptions of HE supports and HE church environment. Self-efficacy and behaviors for PA and HE did not show an association with the church environment. Future research should establish a temporal relationship between the church environment and these important constructs for improving health. Future faith-based interventions should apply infrastructure changes to the church environment to influence important mediating constructs to health behavior.

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Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

10.21203/rs.3.rs-16135/v2 ◽

2020 ◽

Author(s):

Jessica Haughton ◽

Michelle L. Takemoto ◽

Jennifer Schneider ◽

Steven P. Hooker ◽

Borsika Rabin ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Scale Up ◽

Implementation Strategies ◽

Barriers And Facilitators ◽

Physical Activity Program ◽

Evidence Based ◽

Church Staff ◽

Faith Based ◽

Activity Program

Abstract Background: Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.Methods: We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results: Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support.Conclusions: While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

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Engaging stakeholders to identify implementation strategies for a faith-based physical activity program

10.21203/rs.2.23928/v1 ◽

2020 ◽

Author(s):

Jessica Haughton ◽

Michelle L. Takemoto ◽

Jennifer Schneider ◽

Steven P. Hooker ◽

Borsika Rabin ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Scale Up ◽

Implementation Strategies ◽

Health Behavior Change ◽

Barriers And Facilitators ◽

Physical Activity Program ◽

Evidence Based ◽

Faith Based ◽

Activity Program

Abstract Background Stakeholder engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community stakeholders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action ( Fe en Acción ) is an evidence-based promotora -led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women. Methods We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of a Faith in Action and to identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results Stakeholders described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of PA; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support. Conclusions While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

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Engaging stakeholders to identify implementation strategies for a faith-based physical activity program

10.21203/rs.3.rs-16135/v1 ◽

2020 ◽

Author(s):

Jessica Haughton ◽

Michelle L. Takemoto ◽

Jennifer Schneider ◽

Steven P. Hooker ◽

Borsika Rabin ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Scale Up ◽

Implementation Strategies ◽

Health Behavior Change ◽

Barriers And Facilitators ◽

Physical Activity Program ◽

Evidence Based ◽

Faith Based ◽

Activity Program

Abstract Background: Stakeholder engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community stakeholders increases the likelihood of successful implementation, scale up, and sustainment of evidence-based interventions. Faith in Action ( Fe en Acción ) is an evidence-based promotora -led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.Methods: We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of a Faith in Action and to identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach.Results: Stakeholders described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of PA; influence on churchgoers’ behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: 1) health behavior change training for pastors and staff; 2) tailored messaging; 3) developing community collaborations; and 4) gaining denominational support.Conclusions: While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

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Healthy Eating and Physical Activity Interventions in Faith-Based Settings: A Systematic Review Using the Reach, Effectiveness/Efficacy, Adoption, Implementation, Maintenance Framework

American Journal of Preventive Medicine ◽

10.1016/j.amepre.2020.05.014 ◽

2021 ◽

Vol 60 (1) ◽

pp. 127-135

Author(s):

Caroline G. Dunn ◽

Sara Wilcox ◽

Ruth P. Saunders ◽

Andrew T. Kaczynski ◽

Christine E. Blake ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Healthy Eating ◽

Faith Based ◽

Physical Activity Interventions

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Promoting Policy and Environmental Change in Faith-Based Organizations: Description and Findings From a Mini-Grants Program

American Journal of Health Promotion ◽

10.4278/ajhp.150212-quan-724 ◽

2016 ◽

Vol 31 (3) ◽

pp. 192-199 ◽

Cited By ~ 8

Author(s):

Kimberly R. Jacob Arriola ◽

April Hermstad ◽

Shauna St.Clair Flemming ◽

Sally Honeycutt ◽

Michelle L. Carvalho ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Environmental Change ◽

Healthy Eating ◽

Healthy Foods ◽

Rural South ◽

P Values ◽

South Georgia ◽

Faith Based ◽

Faith Based Organizations

Purpose. The Emory Prevention Research Center’s Cancer Prevention and Control Research Network mini-grant program funded faith-based organizations to implement policy and environmental change to promote healthy eating and physical activity in rural South Georgia. This study describes the existing health promotion environment and its relationship to church member behavior. Design. Cross-sectional. Setting. Data were obtained from parishioners of six churches in predominantly rural South Georgia. Subjects. Participants were 319 church members with average age of 48 years, of whom 80% were female and 84% were black/African-American. Measures. Questionnaires assessed perceptions of the existing church health promotion environment relative to nutrition and physical activity, eating behavior and intention to use physical activity facilities at church, and eating and physical activity behaviors outside of church. Analysis. Multiple regression and ordinal logistic regression using generalized estimating equations were used to account for clustered data. Results. Results indicate that delivering messages via sermons and church bulletins, having healthy eating programs, and serving healthy foods are associated with participants’ self-reported consumption of healthy foods at church (all p values ≤ .001). Serving more healthy food and less unhealthy food was associated with healthier eating in general but not to physical activity in general (p values ≤ .001). Conclusion. The church environment may play an important role in supporting healthy eating in this setting and more generally.

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Social Environmental Correlates of Health Behaviors in a Faith-Based Policy and Environmental Change Intervention

Health Education & Behavior ◽

10.1177/1090198118757826 ◽

2018 ◽

Vol 45 (5) ◽

pp. 672-681 ◽

Cited By ~ 1

Author(s):

April Hermstad ◽

Sally Honeycutt ◽

Shauna StClair Flemming ◽

Michelle L. Carvalho ◽

Tarccara Hodge ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Health Behaviors ◽

Environmental Change ◽

Social Norms ◽

Healthy Eating ◽

Environmental Changes ◽

Faith Based ◽

Social Environmental

Diet and physical activity are behavioral risk factors for many chronic diseases, which are among the most common health conditions in the United States. Yet most Americans fall short of meeting established dietary and physical activity guidelines. Faith-based organizations as settings for health promotion interventions can affect members at multiple levels of the social ecological model. The present study investigated whether change in the church social environment was associated with healthier behavior at church and in general at 1-year follow-up. Six churches received mini-grants and technical assistance for 1 year to support policy and environmental changes for healthy eating (HE) and physical activity (PA). Socioenvironmental (social support and social norms) and behavioral (HE and PA at church and in general) outcomes were derived from baseline and 1-year follow-up church member surveys ( n = 258). Three of six churches demonstrated significant improvements in all three socioenvironmental aspects of HE. Two of five churches exhibited significant socioenvironmental improvements for PA at follow-up. Church social environmental changes were related to health behaviors at church and in general ( p < .05). Change in social support for HE, social support for PA, and social norms for PA were each associated with three church-based and general behavioral outcomes. Social norms for healthy eating were related to two general behavior outcomes and social norms for unhealthy eating to one general behavioral outcome. Study findings demonstrate that socioenvironmental characteristics are essential to multilevel interventions and merit consideration in designing policy and environmental change interventions.

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