Objective Church Environment Audits and Attendee Perceptions of Healthy Eating and Physical Activity Supports within the Church Setting.

Marilyn E Wende,Sara Wilcox,John A Bernhart,Andrew T Kaczynski,Caroline G Dunn

doi:10.3390/ijerph17103598

Abstract

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.

Highlights

Physical activity (PA) and healthy eating (HE) are important for maintaining energy balance and reducing risk for obesity [1,2]
We explored four related research questions: (1) Is the church physical environment positively associated with attendees’ perceptions of the PA and HE supports within the church environment? (2) Is the church physical environment positively associated with attendees’ self-efficacy for PA and HE? (3) Is the church physical environment positively associated with attendees’ self-reported PA participation and fruit and vegetable intake? and (4) Does weekly church attendance modify the relationship between church environments and perceptions of church environment supports, self-efficacy, and behaviors related to PA and HE?
The cross-sectional study design limits conclusions about any causal or temporal relationships; it would be valuable to understand how changes in the church environment impact church member behaviors over time. This innovative study adds to research on the importance of working with faith-based organizations to promote health and, the impact of church environments on church attendee perceptions

Summary

Introduction

Physical activity (PA) and healthy eating (HE) are important for maintaining energy balance and reducing risk for obesity [1,2]. PA and HE can reduce risk for numerous chronic diseases [3,4]. Despite knowing these benefits, a large proportion of United States (U.S.). Residents do not meet PA guidelines or consume enough fruits and vegetables [6]. Interventions involving faith-based organizations offer opportunities to increase levels of PA and HE since they facilitate reach within underrepresented groups. In the U.S, approximately 75% of individuals report religious affiliation and 36% report weekly church attendance [7]. Affiliation is highest among older adults, African Americans, and Southeastern residents [7]

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Discussion

Conclusion