Organizational readiness for wellness promotion \u2013 a survey of 100 African American church leaders in South Los Angeles

Annette E Maxwell,Juana Gatson,Aziza Lucas-Wright,L Cindy Chang,Rhonda Santifer,Catherine M Crespi

doi:10.1186/s12889-019-6895-x

Abstract

BackgroundChurches are an important asset and a trusted resource in the African American community. We needed a better understanding of their readiness to engage in health promotion before launching a large-scale health promotion effort in partnership with South Los Angeles churches.MethodsIn 2017, we conducted surveys with leaders of 100 churches. Surveys were conducted face-to-face (32%) or by telephone (68%) with senior pastors (one per church) and lasted on average 48 min. We compared small (less than 50 active members), medium (50–99 active members) and large churches (at least 100 active members), and assessed which church characteristics were associated with the implementation of wellness activities.ResultsMedium and large churches conducted significantly more wellness activities than small churches and were more likely to have wellness champions and health policies. Regardless of church size, insufficient budget was the most commonly cited barrier to implement wellness activities (85%). A substantial proportion of churches was not sure how to implement wellness activities (61%) and lacked volunteers (58%). Forty-five percent of the variation in the number of wellness activities in the last 12 months was explained by church characteristics, such as size of congregation, number of paid staff, leadership engagement, having a wellness ministry and barriers.ConclusionsMany churches in South Los Angeles are actively engaged in health promotion activities, despite a general lack of resources. We recommend a comprehensive assessment of church characteristics in intervention studies to enable the use of strategies (e.g., stratification by size) that reduce imbalances that could mask or magnify study outcomes. Our data provide empirical support for the inner settings construct of the Consolidated Framework for Implementation Research in the context of health promotion in African American churches.

Highlights

Churches are an important asset and a trusted resource in the African American community
This study provides local data on the readiness/capacity of African American churches in South Los Angeles to engage in health promotion activities
Church characteristics associated with implementation of wellness activities Overall, we found statistically significant differences between small, medium and large churches with respect to number of wellness activities conducted and with respect to resources

Summary

Introduction

Churches are an important asset and a trusted resource in the African American community. South Los Angeles, a region containing 28 neighborhoods, has the highest rate of obesity in the Los Angeles area and high mortality due to diabetes, coronary heart disease, stroke and lung, breast, cervical and colorectal cancer. These health disparities exist in a setting of high rates of poverty and limited access to care. Church-based health promotion programs are effective, feasible and acceptable in many minority populations including African Americans and in populations that have limited access to health promotion programs [4,5,6,7,8,9]

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Discussion

Conclusion