African American Faith Research Articles

Engaging African American Faith Leaders as Partners in Ethical Research

This paper outlines an initiative to adapt the Community Partnered Research Ethics Training (CPRET) for the cultural context of the CHURCH (Congregation as Healers Uniting to Restore Community Health) project. The CHURCH project is a community-partnered participatory research project that seeks to promote the mental well-being of African American populations by developing, implementing, and evaluating a mental health training curriculum for faith leaders in Black churches. Participatory research, in which community stakeholders collaborate with researchers as equal partners to address problems impacting marginalized communities, has recently become more popular in academia. Training is necessary to equip community partners with the skills and knowledge required for full research participation. Community partners frequently encounter ethical issues in participatory research, but limited training resources are available to proactively prevent and address such issues. The CPRET was developed through a collaboration between the Clinical and Translational Science Institute and the Human Research Protection Office and Community Research Advisory Board at the University of Pittsburgh. It surveys research processes and core research ethics principles, and it stimulates discussion regarding best practices by engaging participants in scenario-based exercises in which they identify ethical and unethical research. By describing how we utilized the CPRET in the CHURCH project and presenting a summary of participant feedback, we aim to build resources for community-engaged scholars seeking to engage community members in ethical research.

Tailoring African American Faith Community-Based Diabetes Self-Management Education.

African Americans (AA) experience a disparate effect of type II diabetes (T2D). For this nurse-led pilot study, a pre-validated 6-week diabetes self-management education (DSME) program was implemented in a faith community setting and tailored to the participants' faith and culture by using short scriptural lessons, prayers, and individual sharing. Participants demonstrated improvements in fasting blood glucose (p = .042), diabetes knowledge (p = .002), and psychosocial self-efficacy (p = .001). Although generalizability of findings is limited, the structure and methods used in tailoring this DSME program could be transferable to other faith-based settings.

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.

Voices of Black Folk: The Sermons of Rev. A. W. Nix, by Terri Brinegar

Voices of Black Folk: The Sermons of Rev. A. W. Nix, by Terri Brinegar

Black Religion and Reparations: Pragmatic Trajectories and Widening Support

This article examines reparations advocacy by a vanguard of African American faith leader proponents, from Bishop Henry McNeil Turner’s late-19th century demands for federal payments toward emigrationism and Black Atlantic linkages, to 21st century Black clergy involvements in national level, local level, and sector-specific reparations policy activism. Attention is paid to evolving theoretical and operational framings of this reparations advocacy and to variances in levels of American religious and political receptivity to reparations proposals. The conclusion drawn from available evidence here is that reparations advocacy by Black religious leaders has proven more pragmatic than purist, as concerns increasingly have shifted toward maximizing public support and prospects for reparations deliverables.

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.

Let’s Talk About ACP Pilot Study: A Culturally-Responsive Approach to Advance Care Planning Education in African-American Communities

The COVID-19 Pandemic has emphasized the importance of attending to racial inequity in end-of-life care, as the world has witnessed the disproportionate negative impact on Black and Brown people and communities. Advance care planning (ACP) is of particular concern for this population. This article introduces an ACP toolkit developed as a culturally responsive educational approach to assist African-American faith leaders to inform and educate congregants on end-of-life care options and the process to complete advance care documents. The purpose of this article is to describe the development of The Let’s Talk about ACP toolkit and to discuss the results of the pilot study workshop. The procedures of the pilot study included a critical evaluation of an innovative curriculum and workshop process for engaging African Americans around advocacy for the healthcare experience they prefer. Factors such as cultural, generational, and spiritual beliefs and values influenced decision-making. Distrust was one of the most prominent factors raised by participants. Providing resources and tools that encompass culturally responsive approaches to educate and encourage use can help bridge the gap. The next steps for this innovative practice approach is to refine the practice approach and replicate the finding among larger community settings.

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.

Engaging Underrepresented Caregiving Communities in Dementia Research

Family and friend caregivers of persons with dementia from underrepresented and traditionally underserved backgrounds are significantly underrepresented in dementia and caregiving research despite heightened disease risk, poorer outcomes, and disproportionate use of services within these populations. Efforts to develop and disseminate methods that foster greater inclusion of underrepresented caregiving populations in research are essential to ensuring that culturally specific understandings, priorities, and needs of these groups are systematically understood and addressed. In this symposium, we present a variety of studies that illustrate successful efforts to include dementia caregivers from underrepresented backgrounds in research. Two presentations focus on African American caregivers, one on caregivers residing in highly under-resourced areas, one on Latino caregivers, and one on sexual and gender minority (SGM) caregivers. The first presentation describes a capacity building approach through African American faith communities to develop a research registry and address informational needs regarding dementia. The second presentation focuses on eliciting African American caregivers experiences of crisis events. Presentation three describes a coalitional, community-informed approach to engaging caregivers in highly under-resourced areas to investigate experiences with post-acute care. The fourth presentation describes a community-network approach to implementing a text-message based support intervention among Latino caregivers; and the fifth presentation illustrates the utility of digital methods for engaging SGM dementia caregivers. Collectively, these presentations demonstrate a variety of approaches to engaging dementia caregivers from underrepresented and traditionally underserved backgrounds in research that are specific to individual communities and local contexts – as well as the findings that result from these efforts.

Injury of African American Women by Financial Exploitation

Financial exploitation (FE) is one of the most common forms of older adult mistreatments. The World Bank defines FE as financial violence and the World Health Organization describes FE as financial or material abuse. Both international organizations recognize that FE causes deprivation/neglect leading to physical and emotional injury to victims. Older African Americans (OAA) are disproportionately affected by FE, impacting their health and welfare. A qualitative phenomenological study explored the lived experiences of FE among OAA. A Community Based Participatory Research approach was used to partner with a predominately African American-faith based community. Participant recruitment (n=12) was through community sponsored seminars that included verbal presentations, group discussions; individual surveys, Older Adult Financial Exploitation Measure (OAFEM). OAFEM data was analyzed to identify risks. Analysis of the interviews included Open and Axial coding, and data categorization. Using NVivo, Stevick-Colaizzi-Keen analysis as modified by Moustakas, five themes emerged.

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.

Psychiatrist Works to Bridge Gap Between Faith, MH

Psychiatrist Works to Bridge Gap Between Faith, MH

African American Faith Leaders' Experience, Knowledge, and Perceptions of Hospice and Palliative Care (RP525)

African American Faith Leaders' Experience, Knowledge, and Perceptions of Hospice and Palliative Care (RP525)

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.

HIV stigma reduction and health literacy education program with a cross-generational populaton in an African American faith-based church

The aim of this study was to implement a HIV stigma reduction/health literacy educational program to investigate HIV stigma reduction and HIV knowledge and health literacy expansion within a cross-generational African American faith center on the west side of Chicago. The study included a community-based mixed method design, enveloped with elements of “stigma reduction, intergroup contact and religious social capital” theories, analyzed a sample size of fourteen (N = 14) faith center participants’ pre- and post-assessment scores and their direct quotes gathered from focused observations. The study presented significant difference found in HIV knowledge (p = .007), and (HIV) health literacy (p = .041). Additionally, significant difference was found in four out of fifteen HIV stereotypes subscales scores on the Stereotype About AIDS Questionnaire. The study suggests that HIV stigma has potentiality to reduce within the African American faith center population contrary to previous studies where HIV stigma reduction was not evident. The intervention model provided a protocol for partnership development between this faith center and the local community hospital infectious disease program to address HIV stigma, HIV knowledge and health literacy (HIV health literacy).

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.