Church-based Health Promotion Research Articles

Religious Involvement, Vegetarian Diet, and Mental Well-Being Among Seventh-day Adventists in Peru.

Mental well-being is conditioned by several factors, including religious involvement and diet. However, this evidence does not exist among members of the Seventh-day Adventist Church (SDA) in Latin America, particularly Peru. This study evaluated the association between religious involvement and vegetarian diet with mental well-being in members of the SDA Church in Peru. In this cross-sectional study, the sample included 767 participants, aged 18 to 59years. A face-to-face and online survey was administered that included information on the dietary regimen and sociodemographic characteristics. Religious involvement and mental well-being were measured using the 12-item version of the General Health Questionnaire (GHQ-12) and the Duke University Religion Index (DUREL), respectively. A multivariate analysis was conducted to investigate the factors associated with mental well-being. Being female (β = 1.80, p < 0.001), coming from the highland region (β = 1.98, p < 0.001), having a basic educational degree (β = 1.85, p < 0.001), a higher level of religious involvement (β = 0.34, p < 0.001), and being vegetarian (β = 1.21, p < 0.001) were associated with greater mental well-being. This evidence highlights the implication of religious participation and a vegetarian diet in mental health, not only among SDA church members but also in a broader context. However, it should be recognized that direct transfer of church-based health promotion interventions and strategies to the general population can present challenges; therefore, it is suggested that these strategies should be adapted and adjusted to consider differences in the community context.

Factors That Prevent Mosquito-Borne Diseases among Migrant Workers in Taiwan: Application of the Health Belief Model in a Church-Based Health Promotion Study.

Background: Southeast Asian countries have long been considered epidemic areas for mosquito-borne diseases (MBDs), and most imported cases of infectious diseases in Taiwan are from these areas. Taiwanese migrant workers are mainly of Southeast Asian nationality, and of these, 22% are Filipino. Migrant workers’ knowledge of MBDs and self-protection behaviors are beneficial to disease prevention and treatment. This study aims to understand the effectiveness of a health education intervention (HEI) for Filipino migrant workers in Taiwan and explores the factors affecting preventive practices. Methods: The study was conducted between May to September 2018. Participants were recruited from two Catholic churches in Taichung City. A professional delivered a 30 min HEI in person, and a structured questionnaire was used to acquire and assess participants’ knowledge, health beliefs, and preventive behaviors for MBDs before and after the intervention. Results: A total of 291 participants were recruited. The intervention program showed a positive impact on the migrant worker’s knowledge and the perceived severity, perceived benefits, perceived barriers, and preventive practices. Knowledge, perceived severity, and perceived barriers were factors influencing preventive practices in Filipino migrant workers. Conclusions: The results of this study demonstrated that we can direct our efforts towards three areas: improving foreign migrant workers’ awareness of diseases, emphasizing the severity of the disease, and eliminating possible hindrances in the future. As one example, migrant workers could be proactively provided with routine medical examinations and multilingual health education lectures to improve knowledge and preventive practices to contain the spread MBDs.

Reconceptualizing church-based mental health promotion with African Americans: A social action theory approach

ABSTRACTAfrican Americans are at risk for poor mental health outcomes and disparities in treatment. Because of the importance of religion in the lives of many African Americans Church-Based Health Promotion (CBHP) programs have emerged as a promising way to address disparate mental health issues affecting this population. Many of the theories currently used to ground CBHP efforts focus on individual level health behavior change. This study suggests a re conceptualization of CBHP to include a focus on family, group, congregation, and community level outcomes as opposed to individual health behaviors to maximize the impact on African Americans. The case is made for the use of Social Action Theory by examining several mental health promotion programs, their theoretical foundations, and suggested SAT adaptations. Implications for the development of CBHP interventions directed towards African Americans and a focus on group and community level outcomes are discussed.

Physical activity and masculinity in rural men: a qualitative study of men recruited from churches.

The majority of rural US men fail to meet physical activity (PA) guidelines and are at risk for chronic diseases. This study sought to understand rural men's perceptions about PA and PA engagement and the influence of masculinity and social norms. From 2011 to 2014, 12 focus groups were conducted with men prior to a church-based health promotion intervention. Men were recruited from Illinois' rural, southernmost seven counties, where 40% of men report no exercise in the past 30 days. We used inductive content analysis methods to identify PA-related themes, and subsequently used elements of the Health, Illness, Men, and Masculinities framework as a lens to explore subthemes. We identified four themes: (i) knowledge of the positive impact of PA on health, (ii) perceptions of appropriate types of PA for men, (iii) the importance of purposeful PA and (iv) the desire to remain strong and active, particularly during aging. These findings can inform strategies for messaging and interventions to promote PA among rural men. Health promotion efforts should consider the intersections between rurality and masculinity as it relates to rural men's perceptions of PA, include information about purposeful PA and encourage them to engage in PA with a support person.

Church-based Health Promotion in Jamaica for the Ageing Population

Church-based Health Promotion in Jamaica for the Ageing Population

Changes in social support over time in a faith-based physical activity intervention.

African-American women report higher levels of chronic conditions and church attendance relative to the overall US population. Therefore, efforts have increased over the past decade to design church-based health promotion programs. The present study compared changes in religiosity, religious social support and general social support across time within a church-based physical activity study. In a clustered randomized controlled trial, 31 churches and ∼15 African-American women per church were recruited to participate. Churches were randomized to one of three 10-month programs to promote physical activity: faith-integrated (FI), non-faith integrated (NFI) or self-guided control program (C). Comparisons were made between baseline and 10-month time points to assess differences over time. A significant reduction in general social support was observed across all groups. Private religious practices and religious emotional support received increases in C and FI, respectively. Prior research findings and the current study highlight difficulty in demonstrating strong, unilateral changes in religiosity, social support and health. Additional research is needed to identify more accurate measures of these concepts. Findings from the current study have implications for the role of social support in future church-based health promotion studies.

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment

Church-Based Health Promotion Focused on Advance Care Planning and End-of-Life Care at Black Baptist Churches: A Cross-Sectional Survey.

African Americans with serious illnesses receive substandard palliative care (PC) and end-of-life care (EOLC) with a disproportionate number having worse symptom-related suffering, poorer health-related communication and knowledge of advance care planning (ACP) wishes, and increased utilization of hospitals and intensive care units at EOL. Previous research emphasizes the importance of spirituality and the church in African American communities. We are pioneering an innovative partnership between two Baptist African American churches and an interdisciplinary research team with a goal of developing and implementing a community-based, church-centered ACP program. We hypothesize that a church-based approach-which embraces and celebrates religion and spirituality as a means to discuss ACP and EOLC-can improve the quality of EOLC. The aim of the study was to determine parishioner experiences and beliefs about EOLC and their potential desire for a church-based program that would address ACP and EOLC. A cross-sectional survey of parishioners at two large black Baptist churches across four weekend services in December 2014 was conducted using a five-question, Likert-scale survey completed on a note card. There were 930 responses submitted. Approximately 70% of parishioners care, or have cared, for someone with multiple medical problems and/or who is dying, and a vast majority (97%) believed that good EOLC is "important" or "very important." Only 60% of respondents noted having spoken with someone who could make decisions for them if they are unable to speak for themselves and that number decreased to 28% of respondents between the ages of 65 and 80. A majority (93%) would welcome church-provided information about EOLC. A majority of parishioners care for someone with multiple health problems and believe that good EOLC is important. However, significantly less had designated a surrogate decision maker, particularly in parishioners over the age of 65. Respondents would welcome a church-based program focused on improving EOLC.

Life after Stroke: Coping mechanisms among African Caribbean Women.

In the UK, stroke is the third most common cause of death for women and the incidence in African Caribbean women is higher than that in the general population. Stroke burden has major consequences for the physical, mental and social health of African Caribbean women. In order to adjust to life after stroke, individuals affected employ a range of strategies which may include personal, religious (church) or spiritual support (i.e. prayer), individual motivation or resignation to life with a disability. This study explored these areas through the coping mechanisms that African Caribbean women utilised post stroke in the context of stroke recovery and lifestyle modification efforts needed to promote healthy living post stroke. A qualitative approach using interpretative phenomenological analysis was adopted. Seven women were recruited into the study. Semi-structured, in-depth interviews were audio recorded and were transcribed verbatim. Data were analysed using a four-stage framework: familiarisation, sense making, developing themes, and data refinement and analysis. Three main themes on coping emerged: the need to follow medical rules to manage stroke, strength and determination, and the use of religion and faith to cope with life after stroke. These findings illustrate both a tension between religious beliefs and the medical approach to stroke and highlight the potential benefits that religion and the church can play in stroke recovery. Implications for practice include acknowledgement and inclusion of religion- and church-based health promotion in post-stroke recovery.

Recruitment and Participation of African American Men in Church-Based Health Promotion Workshops.

Health promotion interventions in African American communities are frequently delivered in church settings. The Men's Prostate Awareness Church Training (M-PACT) intervention aimed to increase informed decision making for prostate cancer screening among African American men through their churches. Given the significant proportion and role of women in African American churches, the M-PACT study examined whether including women in the intervention approach would have an effect on study outcomes compared with a men-only approach. The current analysis discusses the men's participation rates in the M-PACT intervention, which consisted of a series of 4 bimonthly men's health workshops in 18 African American churches. Data suggest that once enrolled, retention rates for men ranged from 62 to 69 % over the workshop series. Among the men who were encouraged to invite women in their lives (e.g., wife/partner, sister, daughter, friend) to the workshops with them, less than half did so (46 %), suggesting under-implementation of this "health partner" approach. Finally, men's participation in the mixed-sex workshops were half the rate as compared to the men-only workshops. We describe recruitment techniques, lessons learned, and possible reasons for the observed study group differences in participation, in order to inform future interventions to reach men of color with health information.

Health promotion in local churches in Victoria: an exploratory study.

Church-based health promotion has increasingly gained attention in strategies to address health disparities. In Australia, we have limited understanding of the role of local churches in health promotion and without this, how they might be involved in meaningful partnerships to tackle public health challenges. The objective of this qualitative study was to explore how churches are involved in health promotion in the state of Victoria. The research involved in-depth interviews with ministers from 30 churches in urban and rural Victoria, and case studies with 10 of these churches to enable further exploration. These case studies, conducted in 2010, included interviews with church staff, focus groups with volunteers, participant observation and document analysis. Analysis was iterative, utilising open, axial and thematic coding. Three different expressions of church - traditional, new modern and emerging - were identified and found to differentiate the levels and types of health promotion activity. Case studies illustrate the different expressions of how church mission influences health promotion activity. The traditional churches were involved particularly in disease screening and health education activities with their own, predominantly older congregation members. The new modern churches tended to have the material and human resources to be harnessed in health promotion activities involving congregation members and others. Emerging churches, in contrast, engaged in broad health-promoting activities, including disease prevention, lifestyle activities and socio-ecological approaches at a community level. These research findings highlight the opportunities and challenges of engaging with local churches in health promotion efforts and public health programmes to address health inequities.

Use of an interactive, faith-based kiosk by congregants of four predominantly, african-american churches in a metropolitan area.

Chronic diseases are prevalent in ethnic communities. Churches represent a potent resource for targeted health promotion. A faith-based kiosk was developed as an informational tool and placed in four predominantly (>80%) African-American churches. Congregants were surveyed to describe kiosk-use, kiosk-user characteristics, health status, and self-reported behavior changes attributed to the kiosk. We analyzed 1,573 questionnaires. Mean age of respondents was 46.4 years and >70% were women. “Older” congregations (mean age ≥46.1 years) had more reports of diabetes (p = 0.002) and heart diseases (p = 0.01) than younger churches (mean age ≤44.1), whereas asthma was more prevalent in the latter (p < 0.001). Prevalence of obesity (40%) was similar across churches (p = 0.570). Kiosk-use was reported by 420 (26.7%) respondents. Compared to non-users, kiosk-users were >40 years (p < 0.001), and reported >two health conditions, adjusted Odds Ratio (95% Confidence Interval) = 1.43 (1.0–2.0), p = 0.05. Male kiosk-users preferred to select disease-specific content, aOR = 1.87 (1.10–3.17), p = 0.02, while females tended to select information about supportive community resources, aOR = 0.49 (0.23–1.04), p = 0.062. Knowledge of kiosk-user characteristics and the “health status” of a congregation, provide an opportunity for targeted, church-based health promotion.

Church-Based Health Promotion Program Impact on Ethnically Diverse Older Adults' Social Support, Religiosity, and Spirituality

A church-based health promotion program of the United Methodist Church was implemented to address the holistic health of adults 50 years and older (n = 142). African American congregation members (n = 65) were paired with white congregation members (n = 77) for a total of 12 groups. Over a year, biracial groups participated in weekly two-hour meetings. A one-group pretest-posttest design was used to determine impacts on participants' religiosity, spirituality, and social support; and if impacts varied by race. At follow-up, program components were assessed. Tangible social support overall improved, and participants experienced meaningful socialization, spiritual opportunities, and improved perceptions of other race groups.

Examining Characteristics of Congregation Members Willing to Attend Health Promotion in African American Churches

Although churches are an important partner for improving health within the African American community, it is not known how congregants are best reached by health promotion activities and thus how best to target members in recruitment. This study examined how characteristics of churches and congregants' beliefs and interests in faith-based health promotion related to their willingness to attend church-based health promotion activities. We surveyed adult congregants (n = 1,204) of 11 predominately African American churches in North Carolina. Surveys collected data within four domains: demographics (age, sex, education), behavioral (church attendance, respondent food choices, and physical activity), cognitive (church-based health promotion belief, Bible-based healthy living interest, healthy living resource interest), or environmental (family health, church travel distance, church health ministry activity, church members' food choices). Analyses used a dichotomous outcome, interest in attending programs offered by the health ministry. Domain-specific models were constructed. Logistic generalized estimating equations adjusted for clustering. Of the 1,204 congregants, 72% were female, 57% were 50 years or older, 84% had a high school education or more, and 77% had a chronic health condition. In bivariate analyses and in models adjusting for all four domains, cognitive factors had the highest odds of willingness to attend. Congregants' belief in the church's role in health promotion and their desire to learn about healthy behaviors highlight the role of the African American church as a partner in addressing health disparities and the need to capitalize on this expectation through stronger partnerships between medical and faith communities.

HEALTHY LEADERS: MULTILEVEL HEALTH PROMOTION CONSIDERATIONS FOR DIVERSE UNITED METHODIST CHURCH PASTORS

Community psychologists often work with institutions and leaders, such as clergy, to bring about social change. Studies finding high rates of chronic disease among clergy have called for the design of clergy health interventions. However, among clergy there is substantial diversity. We conducted four focus groups with a cross‐section of United Methodist clergy and one focus group each with female, local, young, and large‐sized church pastors. We compared themes from the specific versus broader focus groups. Findings are as follows: female pastors felt guilty for taking personal time and experienced pressure to prove themselves; local pastors reported financial strain and utilized a variety of interpersonal relationships; young pastors indicated child‐related stress but also greater interest in nutrition, exercise, and church‐based health promotion; and large‐sized church pastors expressed increased confidence in negotiating personal time and reported more sharing of pastoral duties. We organized themes by levels of the socioecological framework to guide intervention design.

Positive self-perceptions as a mediator of religious involvement and health behaviors in a national sample of African Americans.

Self-esteem and self-efficacy are theorized to serve as mediators of the relationship between religious involvement and health outcomes. Studies confirming these relationships have produced mixed evidence. This study examined whether self-esteem and self-efficacy mediate the relationship between religious involvement (beliefs, behaviors) and a set of modifiable health behaviors in a national probability sample of African Americans. African Americans, in general, are relatively high in religious involvement and have higher than average rates of chronic disease. Participants were interviewed by telephone, and a Religion-Health Mediational Model was tested using structural equation modeling. Results suggest that self-esteem and self-efficacy at least in part mediate the relationship between religious beliefs (e.g., relationship with God) and greater fruit and vegetable consumption, and lower alcohol consumption. Religious behaviors (e.g., service attendance) were found to have direct, unmediated effects on health behaviors. Findings have implications for church-based health promotion in African American communities such as education or support groups.

Pilgrimage to Wellness: An Exploratory Report of Rural African American Clergy Perceptions of Church Health Promotion Capacity

Churches serve vital roles in African American communities, where disease burden is disproportionately greater and healthcare access is more limited. Although church leadership often must approve programs and activities conducted within churches, little is known about their perception of churches as health promotion organizations, or the impact of church-based health promotion on their own health. This exploratory study assessed perceptions of church capacity to promote health among 27 rural, African American clergy leaders and report the relationship between their own health and that of their congregation. Results indicate a perceived need to increase the capacity of their churches to promote health. Most common were conducting health programs, displaying health information, kitchen committee working with the health ministry, partnerships outside of the church, and funding. Findings lay the foundation for the development of future studies of key factors associated with organizational change and health promotion in these rural church settings.

Interest in Health Promotion Among Korean American Seventh-day Adventists Attending a Religious Retreat

Little is known about interest in faith-based health promotion programs among Asian American populations. Among the Christian denominations, the Seventh-day Adventist (SDA) church is known to place a strong doctrinal emphasis on health. To understand appropriate ways to develop and implement health promotion programs and to conduct research among Korean American SDAs. We collaborated with the North American Division of Korean SDA Churches which sponsors annual week-long religious retreats for their church members. We developed and administered a 10-page questionnaire at their 2009 retreat in order to assess socio-demographic and church characteristics, religiosity, perceived relationship between health and religion, and interest and preferences for church-based health promotion programs. Overall, 223 participants completed our survey (123 in Korean and 100 in English). The sample consisted of regular churchgoers who were involved in a variety of helping activities, and many holding leadership positions in their home churches. The vast majority was interested in receiving health information at church (80%) in the form of seminars, cooking classes and workshops (50-60%). Fewer respondents were interested in support groups (27%). Some interests and preferences differed between English and Korean language groups. Korean American SDA church retreat participants from a large geographic area are very interested in receiving health information and promoting health at their churches and can potentially serve as "agents of influence" in their respective communities.

Church-Based Health Programs for Mental Disorders Among African Americans: A Review

African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.

Church-Based Health Programs for Mental Disorders Among African Americans: A Review

Objective: African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. Methods: A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Results: Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Conclusions: Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans. (Psychiatric Services 63:243–249, 2012; doi: 10.1176/appi.ps.201100216)