African American Faith-based Organizations Research Articles

Collaboration With African American Faith-Based Organizations to Promote Physical Activity: Lessons Learned From a Process Evaluation of a Shared-Use Agreements Program.

Chronic diseases are disproportionately high among African Americans, often caused by social determinants of health (e.g., access to physical activity opportunities), as stated by the Centers for Disease Control and Prevention. Several studies have examined practices and policies of shared-use in school-based and other settings. There is still a gap in the literature regarding how faith-based shared-use programs, practices, and policies are implemented in a virtual or hybrid setting. This evaluation reviewed program activities and partnerships and assessed program needs for quality improvement. Focus groups (n = 2) were conducted with program participants and site coordinators from five faith-based shared-use sites. A 12-question discussion guide was developed based on topics of interest predetermined by the project team to understand participant perceptions about participation, satisfaction, and recommendations. Focus group audio recordings were transcribed verbatim and reviewed using thematic analysis. The evaluators reviewed transcripts separately to confirm final coding and ensured intercoder reliability. The analysis yielded six themes and eight subthemes. Findings indicated that the program was rewarding and achievable, with suggestions for improvement. Social support was developed as a result of the program, health improvements were observed by participants, and networked partnerships were formed to promote health and wellness. The virtual platform presented limited access; therefore, adopting a hybrid approach could offer greater flexibility and reach broader audiences. It may be helpful for public health agencies to partner with faith-based organizations to jointly open their facilities. Agencies, like local health departments, may consider establishing agreements to expand shared-use to local faith-based settings.

Sermons to Address Obesity in Partnership With African American and Latino Churches

Sermons to Address Obesity in Partnership With African American and Latino Churches

Abstract A024: Planning for scale-up of an evidence-based intervention in community settings: Project HEAL insights from the SPRINT Initiative

Abstract Project HEAL (Health through Early Awareness and Learning) is an evidence-based intervention rooted in health behavior change theory and aiming to increase cancer awareness and early detection through African American faith-based organizations. This study explored the potential for broader scale-up and dissemination of Project HEAL through the team's participation in a training program called Speeding Research-tested INTerventions (SPRINT). The SPRINT training was framed using tools from the Business Model Canvas and the Value Proposition Canvas to guide trainees in designing (1) compelling value propositions, (2) a minimal viable product, and (3) questions to gain critical insight from various stakeholders during a process called Customer Discovery. We report on our experiences in the SPRINT training and insights on intervention scale-up that we gained from the training, including key findings from 41 discovery interviews conducted with various stakeholders of the church ecosystem. We learned several valuable lessons from the discovery interviews, including the realization that scale-up will likely be more incremental than immediate. Additional refinement will be needed to scale up the intervention for “real world” application, including making our technology more user-friendly and including additional health topics beyond cancer. The SPRINT training helped our team consider broader scale-up and dissemination in a constituent-informed way. We discuss how insights from the training helped to refine our plans for future intervention scale-up. Citation Format: Laundette P. Jones, Jimmie L. Slade, Felicia Davenport, Sherie Lou Z. Santos, Cheryl L. Holt. Planning for scale-up of an evidence-based intervention in community settings: Project HEAL insights from the SPRINT Initiative [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A024.

Planning for Community Scale-Up of Project HEAL: Insights From the SPRINT Initiative

Project HEAL (Health through Early Awareness and Learning) is an evidence-based intervention rooted in health behavior change theory and aims to increase cancer awareness and early detection through African American faith-based organizations. This study explored the potential for broader scale-up and dissemination of Project HEAL with the team's participation in a training program called Speeding Research-Tested INTerventions (SPRINT). The SPRINT training was framed using tools from the Business Model Canvas and the Value Proposition Canvas to guide trainees in designing (1) compelling value propositions, (2) a minimal viable product, and (3) questions to gain critical insight from various stakeholders during a process called Customer Discovery. We report on our experiences and insights on intervention scale-up that we gained from the training, including key findings from 41 discovery interviews conducted with various stakeholders of the church. We learned several valuable lessons from the discovery interviews such as scale-up will likely be more incremental than immediate. Additional refinement is needed to scale up the intervention for "real-world" application, such as making our technology more user-friendly and including additional health topics beyond cancer. We discuss how insights from the training refined our plans for future scale-up and dissemination in a constituent-informed way.

Teen Pregnancy Prevention and African American Faith-Based Organizations: Lessons Learned from the Southern Nevada Teen Pregnancy Prevention Project

African American faith-based organizations have long been recognized as vital resources in the African American community. Within the Social Determinants of Health Framework, various barriers and facilitators to implementing HIV and STI prevention activities within these faith-based organizations have been identified. The Southern Nevada Teen Pregnancy Prevention project implemented an evidence-based teen pregnancy prevention intervention targeting African American youth ages 14-19 years in African American faith-based organizations in Clark County, NV. This manuscript presents the lessons learned from this project. In addition to confirming some of the barriers and facilitators previously identified in the literature, this manuscript also identifies additional barriers and facilitators based on the experiences of this project, which can further enhance future work with these organizations.

Culturally Competent Health Education in African-Americans’ Faith-based Communities for Better Health Outcomes: A Literature Review

Obesity is a compelling health issue among African-Americans, who have the highest prevalence of excess weight among all ethnic and racial groups in the United States. This soaring obesity rate contributes to poor health outcomes and significantly inflates the risks for many chronic diseases, including cardiovascular diseases, diabetes, and certain forms of cancer. The literature provides evidence for the success of health programs aimed at promoting healthy behavior and lifestyles in African-American faith-based organizations, as the influential role of churches in African-American communities is well documented. However, few studies have investigated the criteria essential for improved efficiency of health interventions addressing the problem of obesity in the church-based environment. This paper examines the sociocultural and environmental factors associated with enhanced efficiency of health-promotion programs to reduce obesity in African-American faith-based communities. The databases PubMed, CINAHL Complete, Cochrane Library, and PsycINFO were searched, and ten relevant articles published during the last five years were selected. The findings corroborate prior research about the instrumental role of churches to promote a healthy lifestyle and reduce obesity among African-Americans. We identify that a partnership between health educators and the community is crucial to achieve a high success rate in church settings. These results indicate that better success is achieved when the church leadership and churchgoers' input are integrated into the program’s design. Furthermore, health educators need to have a good grasp of the participants’ cultural perceptions, understanding, and expectations of obesity. We recommend that future researchers examine the cultural and spiritual strengths of these faith-based communities and the best strategies to use in order to achieve long-term weight loss.

Health Ministry and Activities in African American Faith-Based Organizations: A Qualitative Examination of Facilitators, Barriers, and Use of Technology.

African American faith-based organizations (FBOs) play an important role in addressing health disparities. Increasingly, churches offer health fairs, screenings, or education through health ministries. However, little is known about linking these organizations with evidence-based interventions (EBIs) developed by research. This study explored 1) factors that facilitate or impede health ministry activities, including the adoption of EBIs, and 2) opportunities to use technology to support/enhance the capacity of FBOs to sustain health-related activities. We conducted 18 key informant interviews with African American pastors and FBO leaders and six focus groups with members. A popular health ministry strategy was distribution of print materials. There was limited awareness of EBIs and how to access them. Challenges included maintaining qualified volunteers, financial resources, and technical assistance needs. Participants used technology and social media but older adults did so less often. Findings have implications for dissemination/implementation research in FBOs, in relation to the translational continuum.

A Mid-South Perspective: African American Faith-based Organizations, HIV, and Stigma

Shelby County, Tennessee has the fastest growing rate of HIV infection in the state, and the majority of new infections are in African Americans. In 2011, a Centers for Disease Control and Prevention report stated that Memphis (the largest city in Shelby County) ranked seventh highest in new HIV infections. Little research has addressed HIV-related themes in African American culture that could hinder HIV prevention measures. Our qualitative study engaged African American, faith-based leaders in areas with high rates of HIV in meaningful conversations regarding their attitudes toward HIV and those who are infected. Although faith-based leaders felt they had a role in HIV prevention, only 4% in our study had participated in HIV prevention activities, but they were open to HIV prevention programs. We found that faith-based leaders had limited knowledge of health disparities and ongoing stigma concerning HIV, which served as a major barrier to HIV prevention.

Social Determinants of HIV-Related Stigma in Faith-Based Organizations.

To examine the association between social factors in faith-based settings (including religiosity and proximity to people living with HIV/AIDS) and HIV stigma. A total of 1747 congregants from primarily African American faith-based organizations of Project FAITH (Fostering AIDS Initiatives That Heal), a South Carolina statewide initiative to address HIV-related stigma, completed a survey. Female gender (P = .001), higher education (P < .001), knowing someone with HIV/AIDS (P = .01), and knowing someone who is gay (P < .001), but not religiosity, were associated with lower levels of stigma and with lower odds of stigmatizing attitudes (P < .05). Opportunities for connection with people living with HIV/AIDS tailored to the social characteristics of faith-based organizations may address HIV stigma in African American communities.

Positive and Negative Religious Beliefs Explaining the Religion–Health Connection Among African Americans

Theory and literature suggests that the reason religiously involved people tend to have good health outcomes is because they have healthy lifestyles and behaviors in accord with religious beliefs. Other literature suggests that religious involvement may play a negative role in health outcomes due to beliefs about illness originating as punishment for sins. These ideas were tested as part of a theoretical model of the religion–health connection in a national sample of African Americans. Outcomes included a variety of health-related behaviors. Study participants (N = 2,370) randomly selected from a U.S. national call list completed a telephone survey assessing religious involvement, health behaviors, and demographic characteristics. Structural equation modeling was used to analyze study data. Findings indicate that perceived religious influence on health behavior mediated the relationship between religious beliefs and behaviors and higher fruit consumption and lower alcohol use and smoking. Belief that illness is the result of punishment for sin mediated the relationship between (a) religious beliefs and higher vegetable consumption and lower binge drinking and (b) religious behaviors and lower vegetable consumption and higher binge drinking. These findings could be applied to health education activities conducted in African American faith-based organizations, such as health ministries, in the effort to eliminate health disparities.

Obesity interventions in African American faith-based organizations: a systematic review.

African Americans, especially women, have higher obesity rates than the general US population. Because of the importance of faith to many African Americans, faith-based organizations (FBOs) may be effective venues for delivering health messages and promoting adoption of healthy behaviours. This article systematically reviews interventions targeting weight and related behaviours in faith settings. We searched literature published through July 2012 for interventions in FBOs targeting weight loss, diet and/or physical activity (PA) in African Americans. Of 27 relevant articles identified, 12 were randomized controlled trials; seven of these reported a statistically significant change in an outcome. Four of the five quasi-experimental and single-group design studies reported a statistically significant outcome. All 10 pilot studies reported improvement in at least one outcome, but most did not have a comparison group. Overall, 70% of interventions reported success in reducing weight, 60% reported increased fruit and vegetable intake and 38% reported increased PA. These results suggest that interventions in African American FBOs can successfully improve weight and related behaviours. However, not all of the findings about the success of certain approaches were as expected. This review identifies gaps in knowledge and recommends more rigorous studies be conducted to strengthen the comparative methodology and evidence.

Engaging African American Faith-Based Organizations in Adolescent HIV Prevention.

To reduce current HIV disparities among African American youth, it is imperative to find effective ways to extend the reach of evidence-based HIV prevention. One promising community resource to support this effort is faith-based organizations (FBOs), a credible and respected resource in the African American community. This paper describes the experiences, perceptions, and challenges that African American FBOs and faith leaders face in engaging in adolescent HIV prevention and highlights facilitators and barriers to implementing HIV prevention in African American FBOs. The findings suggest that African American FBOs and faith-based leaders are uniquely positioned to be instrumental resources in reducing African American youth HIV disparities.

Translating evidence-based interventions for implementation: Experiences from Project HEAL in African American churches.

BackgroundCommunity-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease. However, many times, such interventions are tested in randomized trials, become evidence-based, and then fail to reach further use in the community. Project HEAL (Health through Early Awareness and Learning) is an implementation trial that aims to compare two strategies of implementing evidence-based cancer communication interventions in African American faith-based organizations.MethodThis article describes the community-engaged process of transforming three evidence-based cancer communication interventions into a coherent, branded strategy for training community health advisors with two delivery mechanisms. Peer community health advisors receive training through either a traditional classroom approach (with high technical assistance/support) or a web-based training portal (with low technical assistance/support).ResultsWe describe the process, outline the intervention components, report on the pilot test, and conclude with lessons learned from each of these phases. Though the pilot phase showed feasibility, it resulted in modifications to data collection protocols and team and community member roles and expectations.ConclusionsProject HEAL offers a promising strategy to implement evidence-based interventions in community settings through the use of technology. There could be wider implications for chronic disease prevention and control.

Implementing a Mental Health Ministry Committee in Faith-Based Organizations: The Promoting Emotional Wellness and Spirituality Program

Social workers have successfully collaborated with African-American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African-American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a preexisting relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation.

Informing Faith-Based HIV/AIDS Interventions: HIV-Related Knowledge and Stigmatizing Attitudes at Project F.A.I.T.H. Churches in South Carolina

Project F.A.I.T.H. (Fostering AIDS Initiatives that Heal) was established in January 2006 to reduce the stigma of human immunodeficiency virus (HIV) among African American faith-based organizations in South Carolina. During its first year, Project F.A.I.T.H. funded 22 churches to provide HIV-related programs and services to their congregations and surrounding communities. To determine the baseline level of HIV-related knowledge and stigmatizing attitudes, we conducted a survey with parishioners, pastors, and care team members at Project F.A.I.T.H. churches. During 2007, 20 Project F.A.I.T.H. churches conducted cross-sectional surveys with 1,445 parishioners, 61 pastors, and 109 care team members measuring their HIV-related knowledge and stigmatizing attitudes. While most parishioners were very knowledgeable about HIV transmission via unprotected sex and needle sharing during injection drug use, they were less knowledgeable about transmission via casual contact, mosquitoes, donating blood, and an HIV test. Overall, HIV-related stigma was low at Project F.A.I.T.H. churches. However, males and older parishioners (aged > or = 65 years) were significantly less knowledgeable and had greater HIV-related stigma than females and younger parishioners. Pastors and care team members at Project F.A.I.T.H. churches were significantly more knowledgeable and harbored significantly less stigma than their parishioners. To effectively address HIV-related stigma at African American churches, educational programs must reinforce the ways in which HIV can and cannot be transmitted, and pay particular attention to educating males and older populations. These findings may be helpful to HIV-prevention efforts targeting African American faith-based organizations in South Carolina and elsewhere.

Role of Faith-Based Organizations in Supporting Efforts to Reintegrate Residents Returning from Prison

California is experiencing an unprecedented influx of recently released ex-offenders from the penal system. Nowhere is this public health burden felt more than in Alameda County, where 16,800 adult parolees preside. The public health impact of ex-offenders has potentially serious social, political, economic and health implications. Faith-based communities in Oakland are an untapped resource that can assist in reentry efforts for ex-offenders and their families. In 2008, the Alameda County Public Health Department (ACPHD) commissioned Regional Congregations and Neighborhood Organizations Training Center (RCNO) and its local affiliate, Bay Area Action Council (BAAC), to survey 50 Alameda County African American faith-based organizations. The purpose of this study was to obtain baseline information regarding the feasibility of utilizing faith-based community assets to develop new public health strategies. The results of this descriptive key informant study indicates that faith-based organizations in Oakland have the potential to establish partnerships to improve the public health and safety of residents returning from prison, their families, and the communities that receive them from prison. Our findings indicate that 13 (27.1%) of the 48 faith-based organizations in the study have transitional housing capacity. The resources available and the challenges of maximizing faith-based organizational capacity are presented.

Collecting Health Data With Youth at Faith-Based Institutions: Lessons Learned

Faith-based organizations (FBOs) are ideal for health promotion but can present unique challenges in data collection. The present initiative included 6 years of awards to mostly small, rural, predominantly African American FBOs to conduct tobacco prevention lessons for youth in Grades 4-6 while they were attending summer Vacation Bible School. In 2005, these awards included $1,500 disbursed to 64 geographically diverse FBOs who had never before received this funding. Lessons learned include the following: Plan for evaluation in every aspect of the project; pilot-test everything; use reminders judiciously; make backup plans at every step; personally collect data in a nonthreatening way; and safeguard data entry. Evaluation requires extensive time, money, and effort; so, in both the intermediate and the long run, this extra work is worth it.