Abstract
BackgroundCommunity 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.MethodsWe 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.ResultsPastors 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.ConclusionsWhile 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.
Highlights
Despite the well-established evidence for physical activity (PA) in the prevention and control of cancer and other chronic diseases, approximately 80% of US adults and adolescents are insufficiently active [1,2,3,4]
We suggest that faith-based health promotion programs include training and education on health behavior for pastors and influential church staff be included in the intervention, even if the pastors and church staff are not the primary program implementers
This study with Faith-based organization (FBO) leaders about a faith-based PA promotion program yielded important information about barriers and facilitators to implementation and helped identify implementation strategies to employ in future work that supports scale-up and sustained implementation
Summary
Despite the well-established evidence for physical activity (PA) in the prevention and control of cancer and other chronic diseases, approximately 80% of US adults and adolescents are insufficiently active [1,2,3,4]. Dissemination and implementation of evidence-based PA programs are needed to help mitigate health disparities among Latinas and other at risk groups [7]. Faith-based organizations (FBOs) provide a unique setting to implement evidence-based interventions (EBIs) and are increasingly recognized as important partners in Latino-focused health promotion efforts, including PA [8,9,10,11,12]. Studies have documented the effectiveness of health promotion programs in FBOs; significant gaps exist in translating EBIs into faith-based settings to have broader reach [15, 16]. 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
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