African American Faith Communities Research Articles

Developing an HIV and Faith Ambassador Program in North Carolina.

This report from the field describes the development of the HIV & Faith Ambassadors Program to cultivate a cohort of Black faith leaders/communities and Black medical providers to address HIV-related stigma in African American faith communities in North Carolina.

"That Wasa State of Depression by Itself Dealing with Society": Atmospheric racism, mental health, and the Black and African American faith community.

Despite increased societal focus on structural racism, and its negative impact on health, empirical research within mental health remains limited relative to the magnitude of the problem. The current study-situated within a community-engaged project with members of a predominantly Black and African American church in the northeastern US-collaboratively examined depressive experience, recovery, and the role of racism and racialized structures. This co-designed study featured individual interviews (N = 11), a focus group (N = 14), and stakeholder engagement. A form of qualitative, phenomenological analysis that situates psychological phenomena within their social structural contexts was utilized. Though a main focal point of the study was depressive and significantly distressing experience, participant narratives directed us more towards a world that was structured to deplete and deprive-from basic neighborhood conditions, to police brutality, to workplace discrimination, to pervasive racist stereotypes, to differential treatment by health and social services. Racism was thus considered as atmospheric, in the sense of permeating life itself-with social, affective, embodied, and temporal dimensions, alongside practical (e.g., livelihood, vocation, and care) and spatial (e.g., neighborhood, community, and work) ones. The major thematic subsections-world, body, time, community, and space-reflect this fundamental saturation of racism within lived reality. There are two, interrelated senses of structural racism implicated here: the structures of the world and their impact on the structural dimensions of life. This study on the atmospheric nature of racism provides a community-centered complement to existing literature on structural racism and health that often proceed from higher, more population level scales. This combined literature suggests placing ever-renewed emphasis on addressing the causes and conditions that make this kind of distorted world possible in the first place.

Why and how to engage with African American faith communities in brain health research?

AbstractBackgroundDisparities in brain health outcomes often involve African American individuals. To achieve the highest impact for health care initiatives; effectively engaging with African American communities is crucial. One method to reach African American communities is to effectively collaborate with churches. Churches are often seen as the cornerstone of African American communities and should be regarded as a key partner in health care research. Churches have opportunities to respond to the health needs of their respective congregation and communities. For this presentation, we will outline effective strategies for engaging African American churches in promoting behavior change to enhance health equity for health care research.MethodsStrategies include: a) Learning the history of the church, b) Selecting the best person to represent your organization, c) Having a clear ask, d) Engaging in honest conversations with leadership, e) Being persistent and engaging in church sponsored activities, and f) Offering a sustainability plan.ResultsThe implementation of these strategies requires planning, time, and commitment. For example, Alter (nurse‐led dementia‐friendly congregation program) has implemented these strategies over a 2‐year period and excelled in promoting brain health and reducing dementia stigma in African American communities.ConclusionHealth professionals and researchers can use these strategies within their practices and research to improve health and promote health equity for African American individuals and communities.

African-American Lay Pastoral Care Facilitators’ Perspectives on Dementia Caregiver Education and Training

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary education. Data were collected through a telephone-based, focus group interview with nine ACTS 2 facilitators deploying grounded theory techniques. We identified six themes: personal reflections on facilitator roles and responsibilities, satisfaction with existing written materials, desire for supplementary audiovisual training materials, desire for additional training on data management and reporting, importance of peer support, and fostering a faith-integrated culture within the program. Our findings underscore the importance of engaging African American faith communities in fostering dementia caregiving skills training and support. We further highlight the implications of providing community-based training for African American facilitators to foster caregiver emotional well-being and physical health.

African American Faith Communities and Public Health: Working at the Intersections of COVID-19

The unprecedented global disruption caused by COVID-19 has illuminated structural racism and systemic inequities in healthcare, public health, and socioeconomic status. How these inequities are addressed will influence whether we can control or stop the pandemic. Prioritizing collaboration and equity and investing financial and social capital into community leadership is essential to mitigating and addressing both the short- and long-term repercussions of COVID-19. Through analysis of, and evidence from, the lived experiences of a national network of African American pastors, the authors recommend four strategies to expedite recovery from the pandemic in the African American community and to promote enduring beneficial societal change: (1) public health and faith communities should initiate and maintain ongoing relationships that are based on trust; (2) recognition and acknowledgement by public and health care organizations that faith community leaders possess unique knowledge of their communities; (3) inclusion of faith community leaders as full partners when planning and strategizing, making decisions, solving problems, and developing policies that affect community wellbeing; and (4) use of an intersecting approach that recognizes the multifactorial realities of COVID-19 and uses remedies that effectively address existing and new problems in a comprehensive, long-term manner.

Advance Care Planning and End of Life Care Literacy Initiatives in African American Faith Communities: A Systematic Integrative Review.

African Americans (AA) experience health inequalities that affect their utilization of advance care planning (ACP) and hospice and palliative care at end of life (EOL). Faith-based health promotion models may be applicable to ACP and EOL care literacy for this population. The purpose of this integrative review was to examine the literature highlighting participant responses to ACP and EOL care literacy initiatives in AA faith communities. An integrative literature review was conducted using the following databases: PubMed, CINAHL, Web of Science, and PsychINFO. Eight primary sources met inclusion criteria. Findings from these studies indicate that integration of AA religious beliefs and practices into ACP and EOL care educational programs may enhance the efficacy of these efforts in promoting ACP, advance directive completion, and hospice use. Building trust, creating community partnerships, and involving church leadership in ACP and EOL care literacy promotion efforts serve as important elements to inform future initiatives.

Promoting dementia awareness in African-American faith communities.

Alzheimer's disease and other dementia-related disorders are affecting the African-American community at alarming rates. African-American churches have traditionally been places of refuge where families go for support. However, many churches lack programs or resources to support families affected by dementia. In response, a nurse-led interdisciplinary collaborative partnered with churches to promote dementia awareness through education. The purpose of this analysis was to (a) describe the demographics of those seeking dementia education in African-American faith communities; (b) identify prior knowledge of dementia community resources; and (c) determine the preliminary usefulness of the education provided. Over the course of 16months, 202 individuals attended nine educational sessions hosted by five churches across metropolitan Atlanta. Quantitative surveys were used to collect demographics and evaluate the educational sessions. The majority of attendees were African-American adults (91%), women (75%), and unaware of dementia resources (66%). Several attendees identified themselves as church leaders, community/church members, caregivers, and/or healthcare professionals. Attendees expressed the educational content was applicable to themselves or their families. Results help identify ways to alter and/or strengthen the educational content and serve as a guide for developing culturally relevant, faith-based community programs.

Assessing the Feasibility of an Online Training Designed to Enable Community Health Workers to Deliver a Comprehensive, Evidence-Based Weight Loss Intervention for Rural African Americans of Faith.

Obesity is a critical modifiable risk factor in cancer prevention, control, and survivorship. Comprehensive weight loss interventions (e.g., Diabetes Prevention Program (DPP)) have been recommended by governmental agencies to treat obesity. However, their high implementation costs limit their reach, especially in underserved African American (AA) communities. Community health workers (CHWs) or trusted community members can help increase access to obesity interventions in underserved regions facing provider shortages. CHW-led interventions have increased weight loss. However, in-person CHW training can be costly to deliver and often requires extensive travel to implement. Web-based trainings have become common to increase reach at reduced cost. However, the feasibility of an online CHW training to deliver the DPP in AAs is unknown. The feasibility of an online CHW training to deliver the DPP adapted for AAs was assessed. The online training was compared to an in-person DPP training with established effectiveness. CHW effectiveness and satisfaction were assessed at baseline and 6weeks. Nineteen participants (in-person n = 10; online n = 9) were recruited. At post-training, all scored higher than the 80% on a knowledge test required to deliver the intervention. All participants reported high levels of training satisfaction (88.9% of online participants and 90% of in-person participants rated the training as at least 6 on a 1-7 scale) and comfort to complete intervention tasks (78% of online participants and 60% of in-person participants scored at least 6 on a 1-7 scale). There were no significant differences in outcomes by arm. An online CHW training to deliver the DPP adapted for AAs faith communities produced comparable effectiveness and satisfaction to an evidence-based in-person CHW training. Further research is needed to assess the cost-effectiveness of different CHW training modalities to reduce obesity.

Bridges to Care and Recovery: Addressing Behavioral Health and Mental Health Needs Through the Faith Community.

The Bridges to Care and Recovery program supports the behavioral health assessment, treatment, and recovery of individuals through partnerships with the African-American faith community. Church members receive mental health training and skill building, so they can serve as personal mental health educators and advocates. A Community Connector provides guidance and referral to behavioral health services, including access to free counseling. The program reduces the perceived stigma of mental illness and strengthens partnerships between behavioral health service providers and the African-American community.

A dementia-friendly church: How can the African American church support families affected by dementia?

Dementia, including Alzheimer's disease, is affecting the African American community at alarming rates, as African Americans have a greater risk of dementia than other races. The African American church has traditionally been a safe haven where families go for support and healing. However, many churches are not equipped to support families living with dementia. The purpose of this study was to explore ways African American churches can be dementia-friendly to support families affected by dementia. A qualitative descriptive design was used to collect data from 12 African American community stakeholders. Participants were inclusive of caregivers, church leaders, community members, and service providers. During the semi-structured interviews, participants were asked to share characteristics of a dementia-friendly church. Thematic analysis was performed using data from interviews, researcher's journal, and field notes. Responses described a dementia-friendly church as (a) resourceful; (b) welcoming and friendly; (c) inclusive and comfortable; (d) understanding and accepting; and (e) concerned about personal well-being. This study has wide implications not only for African American churches and families, but also for families living with dementia outside of African American faith communities. These findings allow for faith leaders and churches to begin the process of becoming dementia-friendly, thus enabling congregations, communities, and persons with dementia to continue living in meaningful ways. In conclusion, churches are a source of religious support and provide access to resources for families in difficult times. Thus, it is imperative for African American churches to explore ways to best support and meet the needs of families living with dementia.

Promoting advance care planning in African American faith communities: literature review and assessment of church-based programs.

Advance care planning is under-used among Black Americans, often because of experiences of racism in the health care system, resulting in a lower quality of care at the end of life. African American faith communities are trusted institutions where such sensitive conversations may take place safely. Our search of the literature identified five articles describing faith-based advance care planning education initiatives for Black Americans that have been implemented in local communities. We conducted a content analysis to identify key themes related to the success of a program’s implementation and sustainability. Our analysis showed that successful implementation of advance care planning programs in Black American congregations reflected themes of building capacity, using existing ministries, involving faith leadership, exhibiting cultural competency, preserving a spiritual/Biblical context, addressing health disparities, building trust, selectively using technology, and fostering sustainability. We then evaluated five sets of well-known advance care planning education program materials that are frequently used by pastors, family caregivers, nurse’s aides, nurses, physicians, social workers, and chaplains from a variety of religious traditions. We suggest ways these materials may be tailored specifically for Black American faith communities, based on the key themes identified in the literature on local faith-based advance care planning initiatives for Black churches. Overall, the goal is to achieve better alignment of advance care planning education materials with the African American faith community and to increase implementation and success of advance care planning education initiatives for all groups.

Dietary Intake Among Church-Affiliated African Americans: The Role of Intentions and Beliefs

Diabetes and heart disease disproportionately burden African Americans, who tend to have worse nutritional intake than Whites. Many Black churches are influential institutions in the Black community, with potential to assist with promotion of healthy eating behaviors. The purpose of the current study was to use the Theory of Planned Behavior (TPB) to examine intention to eat a healthy diet and dietary behaviors among church-affiliated African Americans. It was hypothesized that TPB constructs would positively predict intention to eat a healthy diet and that intention to eat a healthy diet would be a predictor of fat and fruit and vegetable intake. It was also hypothesized that control beliefs would predict reduced fat intake and increased fruit and vegetable intake. Path analyses indicated behavioral, normative, and control beliefs were predictive of intention to eat a healthy diet. Intention to eat healthy was a significant predictor of dietary intake behaviors. These findings provide support for the use of the TPB in examining diet among church-affiliated African Americans. This study represents an opportunity to inform dietary interventions for the African American faith community.

AFRICAN AMERICAN FAITH LEADERS IN FLINT, MICHIGAN, FACILITATING ACCESS TO SEXUAL HEALTH INFORMATION

In 2006, to respond to the HIV pandemic, the Flint-based YOUR Center collaborated with the National Coalition of Pastors’ Spouses to create an HIV Awareness and Prevention manual for African American faith communities. In 2006 this manual was transformed into Your Blessed Health (YBH), a community-level education and prevention intervention that provides HIV/STI health information to medically underserved communities throughout Michigan. Since then, YBH has trained over 200 faith leaders across 9 denominations in over 80 FBOs across Michigan to help disseminate information concerning the community-level impact of HIV. The YBH impact on congregants and community members has been detailed in peer-reviewed articles and presentations; however, the involvement of the faith leaders themselves has not been described. To address this gap in the literature, we conducted semi-structured interviews with African American faith leaders representing 20+ congregations in Flint who participated in YBH and welcomed the intervention into their congregations. Preliminary results show that faith leaders, whose median age is 65, embraced their role as conduits to health information in the interest of ministering to the “whole person”. They remain committed to educating themselves, and their congregants, to providing health information for various health and wellness issues. Detailing this impact is critical because community-health education and promotion literature suggests that older adult faith leaders can facilitate access to sexual health information through faith-based organizations, and may possess untapped potential as sources of health information across various health conditions. Older adult faith leaders are vital sources of information for medically underserved communities.

Assessing Health Needs in African American Churches: A Mixed-Methods Study.

Among major racial and ethnic groups in the USA, African Americans are the most religious, and faith-based organizations play an important role in health promotion for African Americans. This study aimed to assess health needs in African American churches using a mixed-methods approach. Based on quantitative and qualitative data collected from eight African American churches in Nebraska in 2017, the most prevalent chronic conditions among participating African American church members (n = 388) included hypertension (60.8%), allergies (41.0%), arthritis (36.4%), high cholesterol (35.8%), and diabetes (28.1%). Significant predictors of fair or poor health were identified as male sex, unemployment, delayed utilization of health care in the past 12months due to cost, lower frequency of church attendance, and feeling down, depressed, or hopeless in the past 2weeks. Pastors from participating churches identified cost as one of the primary barriers to providing church-based health services. There were substantial unmet health needs in African American faith communities, especially in the areas of chronic disease prevention and management, and churches would need more support to realize their full potential in faith-based health promotion.

A Systematic Comparison of African American and Non-African American Patients on Psychosocial Aspects of Hepatitis C Infection.

The purpose of this study was to compare African American and non-African American hepatitis C virus (HCV) patients on self-reported symptoms of HCV liver disease and psychosocial characteristics commonly affected by it in a sample of 309 patients enrolled in a randomized controlled trial. African Americans (n=196) rated a higher reliance on religion/spirituality for coping with HCV compared to non-African Americans. This study's findings are a basis for encouragement of public health efforts and programs to seek partnerships with African American faith and religious communities to identify and treat undiagnosed cases of HCV and promote HCV awareness.

Abstinence-Only Sex Education Fails African American Youth.

Sexually transmitted infections (STIs) disproportionately affect U.S. African American (AA) youth. In AA faith communities, cultural practices have contributed to increased STI rates because abstinence-only-until-marriage education programs do not teach the use of condoms or birth control for preventing STIs or pregnancy. Comprehensive sex education or abstinence-plus programs have been reported to increase STI knowledge and reduce risk-taking behaviors in adolescents and young adults. Evidence supports computerized education to increase STI knowledge and decrease risky sexual behaviors of AA churchgoing youth.

Racially Associated Disparities in Hospice and Palliative Care Access: Acknowledging the Facts While Addressing the Opportunities to Improve.

Journal of Palliative MedicineVol. 19, No. 2 EditorialsRacially Associated Disparities in Hospice and Palliative Care Access: Acknowledging the Facts While Addressing the Opportunities to ImproveRichard PayneRichard PayneSearch for more papers by this authorPublished Online:3 Feb 2016https://doi.org/10.1089/jpm.2015.0475AboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited by“Palliative Care Is the Only Medical Field That I Feel Like I'm Treated As a Person, Not As a Black Person”: A Mixed-Methods Study of Minoritized Patient Experiences with Palliative Care Julia I. Bandini, Lucy B. Schulson, Claude Messan Setodji, Jhacova Williams, Katherine Ast, and Sangeeta C. 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Nelson, Rebecca Wright, Marlena Fisher, Binu Koirala, Benjamin Roberts, Danetta H. Sloan, David S. Wu, and Patricia M. Davidson15 January 2021 | Journal of Palliative Medicine, Vol. 24, No. 2Developing and Testing the Feasibility of a Culturally Based Tele-Palliative Care Consult Based on the Cultural Values and Preferences of Southern, Rural African American and White Community Members: A Program by and for the Community Ronit Elk, Linda Emanuel, Joshua Hauser, Marie Bakitas, and Sue Levkoff26 March 2020 | Health Equity, Vol. 4, No. 1Integrative Palliative Care: A New Transformative Field to Alleviate Suffering Delia R. Chiaramonte and Shelley R. Adler18 September 2020 | The Journal of Alternative and Complementary Medicine, Vol. 26, No. 9Dealing with cultural diversity in palliative care21 August 2020 | BMJ Supportive & Palliative Care, Vol. 18Early for EveryoneAdvances in Neonatal Care, Vol. 20, No. 2Promoting advance care planning in African American faith communities: literature review and assessment of church-based programs7 December 2020 | Palliative Care and Social Practice, Vol. 14Apoyo con Cariño (support with caring): RCT protocol to improve palliative care outcomes for Latinos with advanced medical illness10 October 2018 | Research in Nursing & Health, Vol. 41, No. 6Racial and Ethnic Disparities in Palliative Care: A Systematic Scoping Review29 October 2018 | Families in Society: The Journal of Contemporary Social Services, Vol. 99, No. 4Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision MakingJournal of Pain and Symptom Management, Vol. 55, No. 5Quality of Hospice Care at Home Versus in an Assisted Living Facility or Nursing Home10 February 2018 | Journal of the American Geriatrics Society, Vol. 66, No. 4 Volume 19Issue 2Feb 2016 InformationCopyright 2016, Mary Ann Liebert, Inc.To cite this article:Richard Payne.Racially Associated Disparities in Hospice and Palliative Care Access: Acknowledging the Facts While Addressing the Opportunities to Improve.Journal of Palliative Medicine.Feb 2016.131-133.http://doi.org/10.1089/jpm.2015.0475Published in Volume: 19 Issue 2: February 3, 2016PDF download

Abstract A27: Effects of the Healthy Eating and Active Living in the Spirit (HEALS) educational and behavioral intervention on inflammation among an African American faith community

Abstract The Healthy Eating and Active Living in the Spirit (HEALS) educational and behavioral intervention (2009-2012) was designed to test the effect of a diet, physical activity, and stress reduction intervention on inflammation levels in African Americans at high risk of chronic inflammation and disease in a faith-based community. African-American churches, located in and around Columbia, South Carolina were randomized into a 12-month intervention arm or delayed-intervention arm that served as the study's control group. The 12-week intervention included weekly sessions on cooking, healthy recipes, physical activity, stress reduction, and tracking weight and blood pressure. After the 12-week intervention, participants were invited to attend monthly booster sessions for an additional 9 months to reinforce and expand on topics introduced in the initial 12-week phase. Control churches had to delay the intervention until after churches randomized to the intervention first completed the 12-month follow-up. Participants attended clinics at baseline, 12 weeks (immediately post-intervention for the intervention group), and at 1-year. Prior to each clinic visit participants completed a questionnaire packet to assess demographic characteristics, dietary intake, physical activity, depression/stress, health history, sleep habits, social support, and social desirability and approval. During clinic visits, participants had their blood pressure, height, weight, and percent body fat (via bioelectrical impedance assessment) measured. Physical activity levels were objectively measured using Bodymedia's SenseWear® physical activity armband monitors. Blood samples were collected to characterize inflammatory biomarkers (i.e., high-sensitivity c-reactive protein [CRP] and interleukin-6 [IL-6]). Of the 627 potential participants from randomized churches, 434 attended clinic 1 (baseline, 233 intervention, 201 controls). Clinic 2 (12-weeks from baseline) was attended by 155 intervention and 155 control arm participants. A total of 113 intervention arm and 128 control arm participants attended Clinic 3 (12 months from baseline). The average age of the study population was 56.9±11.3 and the population was primarily female (80%) and obese (BMI=32.6±6.9kg/m2). Baseline lifestyle factors associated with inflammatory biomarkers included total active energy expenditure (quartile 4 compared to quartile 1: CRP = 2.0 vs. 3.6 mg/L, p=0.01) and minutes of moderate-to-vigorous physical activity minutes (quartile 4 compared to quartile 1: CRP=1.7 vs. 4.5 mg/L, p<0.01; IL-6=1.5 vs. 2.1 pg/mL, p=0.01). Among male participants, the intervention group had significantly lower mean adjusted CRP values compared to controls (2.6 vs. 3.7mg/L, p=0.05) at the 12-week follow-up. However, this finding was not observed among female participants. At the 1-year follow-up no statistically significant differences for inflammatory markers between intervention and control arms were observed overall or separately in males and females. However, among male participants the difference in CRP between intervention and controls remained but was not statistically significant (2.6 vs. 3.9, p=0.17). A more beneficial effect from this diet, physical activity, and stress reduction behavioral and educational intervention was observed among African-American male participants than among African-American female participants. It is possible that a more intensive intervention is necessary to evince and sustain more noticeable changes in inflammation levels. Additionally, targeting those who are more motivated to make lifestyle changes may increase effectiveness of future lifestyle interventions. Citation Format: Michael D. Wirth, James R. Hebert, Heather M. Brandt, Lisa Davis, Briana Davis, Brook E. Harmon, Thomas G. Hurley, Ruby Drayton, Swann A. Adams, Steven N. Blair. Effects of the Healthy Eating and Active Living in the Spirit (HEALS) educational and behavioral intervention on inflammation among an African American faith community. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A27.

Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

A Rural African American Faith Community's Solutions to Depression Disparities

The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. The primary data sources for this qualitative research study were focus groups. Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community.