Faith-based Health Research Articles

ENGAGING HIGH SCHOOL STUDENTS TO INCREASE RESEARCH-FOCUSED SMARTWATCH USE BY MULTICULTURAL, RURAL OLDER RESIDENTS

Abstract At the southern tip of Lake Okeechobee in south central FL is a rural, underresourced, racially/ethnically diverse region. Persons age 65/older (21%) are primarily African American (57%), Hispanic American (29%) and Afro-Caribbean (4%). Health disparities prevalent in the “Glades” region extend to low rates of digital access (60%) and digital literacy (55%). When asking residents “what mattered most” (Boykin & Schoenhofer, 2001), two issues were identified as most important to the older adult stakeholders: increasing technological competence and maintaining brain health. We tested aims developed with the community advisory board, which tapped into a little-used resource: local high school students, who trained older adults in use of smartwatches to monitor exercise, respond to prompts regarding ecological momentary assessments, and complete n-back cognitive assessments. Faith-based health educators facilitated the home-based visits between 33 older residents and 22 students, and collected pre-post written measures addressing technological self-efficacy, cognition, and health literacy. The older adults (91%, 30/33) responded to smartwatch prompts with a 77.80% response rate, which was consistent with current EMA standards: An 80% response rate has been recommended as the target for EMA studies (Turner et al., 2017), and a meta-analysis reported 75% in the pooled response rate (Jones et al., 2019). Of interest was that self-reported cognition and the Mini-Cog scores were not related (Pearson’s correlational analysis) to number of smartwatch prompts answered or health literacy. Six categories of recommendations ranging from student concerns to resident suggestions emerged from this work, which will be shared in this presentation.

Advancing implementation science in community settings: the implementation strategies applied in communities (ISAC) compilation

BackgroundImplementation strategies have predominantly been operationalized and studied in clinical settings. Implementation strategies are also needed to improve evidence-based intervention (EBI) integration in community settings, but there is a lack of systematic characterization of their use, which limits generalizability of findings. The goals of this study were to determine which implementation strategies are most used to deliver primary prevention EBIs in community settings, develop a compilation and pragmatic strategy selection process with accompanying guidance tools, and understand practitioners’ preferences for dissemination.MethodsPurposive and snowball sampling was used to recruit community setting researchers and practitioners delivering primary prevention EBIs (nutrition, physical activity, tobacco prevention) in community settings: education, social services, city planning and transportation, workplaces, recreation/sport, faith-based, and other public health organizations. Semi-structured interviews were conducted using a guide based on the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework. Participants were asked to describe barriers experienced and strategies used to overcome them within each RE-AIM dimension. Practitioners were also asked about preferred dissemination strategies, prompted by Diffusion of Innovations theory concepts of sources (who provides information) and channels (how information is provided). A rapid deductive approach was used to analyze findings with a coding matrix aligned with the interview guide.ResultsResearchers (n = 10) and practitioners (n = 8) across all targeted settings and intervention outcomes completed interviews. Interviewees shared unique implementation strategies (N = 40) which were used to overcome barriers related to multiple RE-AIM dimensions, most commonly implementation (n = 29) and adoption (n = 27). Most frequently mentioned implementation strategies were conduct pragmatic evaluation (n = 31), provide training (n = 26), change adaptable program components (n = 26), and leverage funding sources (n = 21). Webinars (n = 6) and listservs/newsletters (n = 5) were the most mentioned dissemination channels; national public health organizations (n = 13) were the most mentioned sources.ConclusionsResults reflect commonly used implementation strategies in community settings (e.g., training, technical assistance) and add novel strategies not reflected in current taxonomies. Dissemination preferences suggest the need to involve broad-reaching public health organizations. The resultant compilation (Implementation Strategies Applied in Communities) and strategy selection process provide resources to assist researchers and practitioners in applying strategies and improving EBI delivery in community settings.

Church Leaders' Health Behaviors and Program Implementation in the Faith, Activity, and Nutrition Program.

Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders' health-related behaviors, differences in health behaviors by sociodemographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention. Pastors (n=93) and church coordinators (n=92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the intervention. Church coordinators reported program implementation for their church. Sociodemographic differences and associations between changes in health behaviors and program implementation were tested with regression models. Changes in health-related variables were examined using paired t-tests and McNemar's test. Pastors (41% women, 42% Black/African American) had a mean BMI of 30 kg/m2; 45% met F&V guidelines and 24% met PA guidelines. Black/African American pastors were less likely to meet F&V guidelines and had lower self-rated health than their counterparts. Pastor PA improved over time, but pastor health behaviors were not associated with program implementation. Church coordinators' (95% women, 39% Black/African American) mean BMI was 28 kg/m2; 27% met F&V guidelines and 63% met PA guidelines. Black/African American church coordinators had higher BMIs and lower self-rated health than their counterparts. Church coordinator F&V intake improved over time; self-rated health was positively associated with PA program implementation. This study underscores the need for preventive interventions for church leaders.

Incidence of high blood pressure among Kenyan adults living with HIV: a longitudinal cohort analysis from 2004-2023.

People with HIV (PWH) face a heightened risk of cardiovascular diseases, partly due to increased high blood pressure risk. This study assessed high blood pressure burden (i.e., incidence, prevalence) among PWH in Kenya over time. Longitudinal, open cohort study. We estimated the incidence and prevalence of high blood pressure in a large sample of Kenyans with HIV from the Coptic Hope Center using electronic medical records from 2004-2023. We defined incident high blood pressure as first visit after baseline at which each patient had a systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Our sample included 38,709 PWH seeking care at Coptic Hope Center clinics in Kenya (2004-2023). Nearly 40% of patients had high blood pressure at first visit. Among the 60% of patients initially normotensive, almost 40% developed high blood pressure within 20 years. The yearly prevalence of high blood pressure ranged from 8-58%. Average SBP was higher among patients who had their first visit from 2019-2023 compared to those visiting in the early 2000 s and 2010 s. Our findings reveal a high and rising burden of high blood pressure among PWH in a large, faith-based health system in Kenya. This underscores the need for stronger integration of care for individuals with concurrent HIV, high blood pressure, and other non-communicable diseases. Current systems are insufficient for achieving blood pressure control among PWH. Further research and funding for efforts to address HIV and NCD care in Kenya are warranted.

‘We do not include tests and treatment for those [STI] conditions’: the trouble in navigating access and care for STIs among gay, bisexual men and transgender and other MSM in Kenya and Rwanda

Abstract Background Lesbian, gay, bisexual men, and transgender persons (LGBT) in Kenya and Rwanda have a hard time accessing healthcare, in particular sexual health screening. We used a social norms and values framework to examine determinants of access to healthcare, with specific attention to sexual healthcare. Methods We draw on cross-sectional mixed methods research in Kenya and Rwanda that examined the lived experiences of sexual and gender minorities in access to health services. A cross-sectional quantitative survey in Rwanda (n = 499) and Kenya (n = 1,550) was conducted with LGBT people. We conducted key informant interviews (n = 81), in-depth interviews (n = 48), digital storytelling (n = 3), and focus group discussions (n = 30). We used a mixed-methods thematic and content analysis to integrate quantitative and qualitative findings. Findings Accessibility and quality of care were the main barriers to healthcare services. The results indicate widespread discrimination and stigma toward LGBT people in service provision. Approximately half of the survey participants, 47%, reported challenges accessing health services, and 25% indicated they experienced discrimination in healthcare. Qualitative results link low quality of care to stigma and discrimination. “Mostly at the hospitals, there are times people take too much time discussing who we are instead of giving us the treatment we seek, and send us to mental health to first deal with our sexuality issues since they think it is a ‘sickness.’” (Focus group, Muhanga, Rwanda). Our study highlights challenges in navigating sexual healthcare in government, faith-based, and donor-funded health facilities. Conclusions Access to healthcare services, particularly sexual health screening and prevention, is a growing issue for LGBT people in Kenya and Rwanda. Stigma acts as a significant barrier to high-quality healthcare. Sensitivity training and educational opportunities for healthcare professionals are urgently needed to address stigma.

Healthcare Providers’ Engagement in Strategic Purchasing of Outpatient Services: A Cross-sectional Analysis of the National Health Scheme in Kenya

Abstract Background: National Health Insurance Fund (NHIF) outpatient services operate under capitation, and are strategically designed to enhance quality, equity, and affordability. However, despite this strategy, providers often demand out-of-pocket payments. This study investigates provider participation in strategic purchasing and its impact on NHIF’s outpatient service delivery. Methods: A cross-sectional analytical study was conducted among 66 healthcare managers from facilities accredited to provide NHIF outpatient services in two counties in Kenya. The data were collected using structured questionnaires. Logistic regression analysis was performed to assess the association between study variables. Results: Most respondents were male (36, 55%). The provision of NHIF outpatient services was significantly correlated with the monitoring provider performance by NHIF and the county department of health (Pmultivariate=0.024). There was a 31-fold increase in the likelihood of provision for monitored facilities. A significant difference (p=0.005**) was observed in monitoring health facilities. Monitoring was more common among private healthcare providers than public and faith-based health facilities. Conclusion: The involvement of healthcare providers in strategic purchasing has not yet been achieved. County and NHIF quality assurance departments should regularly monitor providers’ performance to ensure the delivery of equitable and high-quality healthcare.

Cancer-Related Health and Educational Needs and Faith-Based Health Beliefs in an Urban Muslim Population

Cancer screening behaviors in Muslims are under-researched, and there is limited data on how it relates to their unique cultural and religious beliefs. We assessed cancer prevention and screening-related health needs in the Washington DC area. We developed the needs assessment questionnaires and recruitment strategy in collaboration with key faith leaders from four mosques in our catchment area. A total of 203 participants were recruited through community outreach and engagement approaches and were included in the discussion when developing the needs assessment to ensure questions were religiously and culturally sensitive. Of the 203 participants, 56% of women reported receiving screening for a mammogram, while 83% of women reported receiving a screening for cervical cancer. Among men, 45% reported receiving a prostate cancer antigen test to screen for prostate cancer. Among both men and women, 35% reported ever receiving a screening for colorectal cancer. Women reported relying more on their faith when dealing with health concerns than men. Those who did not get screened for breast, colorectal, and cervical cancer relied more on their faith than those who did get screened for these cancers. Participants expressed interest in having health initiatives around cancer education, screening, and survivorship inside mosques. Faith beliefs can influence cancer screening behaviors; however, the relationship between these two variables needs further examination. Continued engagement with key faith leaders can help in leveraging religious beliefs to promote health education and cancer screening.

Barriers and Facilitators to 24-Month Maintenance of the Faith, Activity, and Nutrition Program in the U.S.

Little is known about the barriers and facilitators to organizational maintenance of faith-based health promotion programs. This study used qualitative data (collected from 2016–2019) from pastors (n = 81) and program coordinators (n = 103) to identify barriers and facilitators to 24-month maintenance of a faith-based physical activity (PA) and healthy eating (HE) intervention in South Carolina. Barriers differed for PA versus HE: resistance to change impeded HE while church characteristics tended to impede PA. Similar themes emerged for PA and HE facilitators: healthy opportunities, church communication, and consistency. Future research should build upon this study to tailor faith-based health promotion programs for long-term sustainability.

Public-Private engagement and health systems resilience in times of health worker strikes: a Ghanaian case study.

In low and middle-income countries like Ghana, private providers, particularly the grouping of faith-based non-profit health providers networked by the Christian Health Association of Ghana (CHAG), play a crucial role in maintaining service continuity during health worker strikes. Poor engagement with the private sector during such strikes could compromise care quality and impose financial hardships on populations, especially the impoverished. This study delves into the engagement between CHAG and the Government of Ghana (GoG) during health worker strikes from 2010 to 2016, employing a qualitative descriptive and exploratory case study approach. By analysing evidence from peer-reviewed literature, media archives, grey literature and interview transcripts from a related study using a qualitative thematic analysis approach, this study identifies health worker strikes as a persistent chronic stressor in Ghana. Findings highlight some system-level interactions between CHAG and GoG, fostering adaptive and absorptive resilience strategies, influenced by CHAG's non-striking ethos, unique secondment policy between the two actors and the presence of a National Health Insurance System. However, limited support from the government to CHAG member facilities during strikes and systemic challenges with the National Health Insurance System pose threats to CHAG's ability to provide quality, affordable care. This study underscores private providers' pivotal role in enhancing health system resilience during strikes in Ghana, advocating for proactive governmental partnerships with private providers and joint efforts to address human-resource-related challenges ahead of strikes. It also recommends further research to devise and evaluate effective strategies for nations to respond to strikes, ensuring preparedness and sustained quality healthcare delivery during such crises.

Providing mental healthcare through faith-based entities in Africa: a systematic review

Background: Psychological disturbances and mental illnesses are prevalent on the continent of Africa. There are shortages of mental health services and a lack of quality providers with limited training and supervision. It is perceived that faith-based entities for psycho-emotional health and wellbeing are filling the gap with positive impact. However, the risks associated with unconventional or extreme spiritual practices will be evaluated. The contributions of these entities, their roles in the global and African health system, and their implications for community development and policy making are highlighted. Methods: A mixed-methods systematic review was conducted in two phases to synthesise qualitative and quantitative data. The review sought evidence on faith-based health providers of mental health services in Africa looking at types, magnitude, and quality and included both peer-reviewed and grey literature published between 2007 and 2024 in English. A narrative thematic analysis was used for the qualitative part and meta-analyses was used for the quantitative part to back up the narrative element of this study. Results: This review identified 55 relevant items from 13 African countries. The results showed that faith-based, mental-health providers deliver a range of six types of alternative mental healthcare, faith-based, home care, and faith-based, biomedical, mental healthcare. The magnitude of these faith-based, mental health services were considered according to frequency of use and availability (accessibility, affordability, and acceptability), however evidence was limited. When the quality of the mental healthcare was assessed, some studies showed positive mental health outcomes from the utilisation of faith-based, mental healthcare, but some studies revealed bad quality practices due to harmful treatment. Conclusion: There are limitations regarding the vast array of faith-based, health providers and the mental healthcare they provide which include harmful practices used in Africa. Training interventions are needed to avoid harmful treatment. Faith-based, mental healthcare offers culturally influenced practices for mental-health which should be leveraged. Integration of faith-based, mental healthcare into any primary, health system is advised in order to attain universal health coverage. Finally, possible regulation of traditional and faith healing methods for emotional struggles could be implemented at a policy level.

Faith-based pharmaceutical supply chains and their role in African pharmaceutical systems: a qualitative systematic review

For the health system to function well, the population must have equitable access to quality, affordable pharmaceutical supplies; however, pharmaceutical systems in Africa are challenged by inadequate funding, drug stock outs and irregular supplies, a shortage of trained pharmacy personnel, and a lack of systems for drug regulation and quality. Faith-based health providers, as private, not-for-profit actors, have long complemented public sector efforts in the supply of pharmaceuticals in Africa. However, the contribution of faith-based health providers in pharmaceutical systems has not been formally studied. This study examines the nature and function of faith-based healthcare providers in improving access to pharmaceutical supplies in Africa. To do so, we conducted an exploratory qualitative systematic review to identify documents that contain information on faith-based involvement in pharmaceutical supply in Africa. The review identified 20 articles for inclusion. These articles were analyzed using thematic, narrative analysis. The analysis revealed a significant evidence gap relating to the contribution of private-not-for-profit, faith-based providers to African pharmaceutical systems. The review suggests that while faith-based drug supply organizations have existed for a long time and contribute significantly to national pharmaceutical systems, there is very little known about the nature of faith-based pharmaceutical providers and how they complement public sector pharmaceutical systems. In many contexts, faith-based involvement in pharmaceutical systems improved access for the general population and increased the supply of pharmaceuticals in national systems. Faith-based drug supply organizations also often provide pharmaceutical supplies to both rural and urban areas, often targeting rural and remote areas particularly. The review also indicates that faith-based drug supply organizations improved access to medicines and related commodities and, despite a lack of regulation in many contexts, have the potential to make a positive contribution to quality assurance of pharmaceuticals. In summary, the analysis confirmed that faith-based involvement in pharmaceutical supply chains contributes to strengthening the national health system by complementing the public pharmaceutical system through improved access to medicines and related commodities in Africa. These conclusions corroborate the need to continually document and acknowledge faith-based healthcare providers’ efforts which could guide the formulation of stringent, evidence-based strategies.

Effective localization: case study of a faith-based health partnership in Sierra Leone and Zimbabwe

Faith-based organizations (FBOs) and faith-based service providers play a critical role in public health prevention, promotion, treatment, and community development. Effective capacity strengthening efforts through FBO partnerships can make a vital contribution toward effective localization. This case study details the efforts and results of a writing and publishing workshop provided in partnership with Corus International (IMA World Health) and the Africa Christian Health Associations Platform (ACHAP) in March of 2023. This case study also reports on workshop participantsʼ perceptions of the partnershipʼs approach to capacity strengthening. Three major and related themes emerged from the workshopʼs informal Focus Group Discussion transcription: 1) a safe and nurturing environment, 2) openness and shared decision-making, and 3) organizational humility.

Responding to preventable causes of maternal and perinatal deaths in Homabay County

Background: The Kenya population and housing census (2019) ranked Homabay County among the 15 counties with the highest maternal mortality rate (MMR) of 516 deaths in 100,000 livebirths and neonatal mortality rate (NMR) of 26 in 1,000 livebirths. Baseline assessment reported gaps including dysfunctional maternal and perinatal death surveillance and response system, and untimely perinatal deaths audited. Other challenges contributing to near misses and mortality include erratic availability of blood/blood products, staff shortages affecting the offering of CEmONC services, interfacility referral challenges, not exploiting partnerships with private and faith-based health facilities in the county, and HCW knowledge and skills deficit, especially in management of common causes of death, such as postpartum hemorrhage and eclampsia Methods: MCGL’s objective was to work with the County’s leadership to revitalize the MPDSR system and work toward responding to the causes and avoidable factors contributing to the high burden of maternal and perinatal deaths in the County. MCGL trained HCWs on harvesting and handling of blood products, management of PPH and eclampsia, development of county referral strategy, linkage to private and faith-based HFs, capabilities, support weekly MPDSR committee meetings, develop, and roll out MPDSR of weekly monitoring tool, formation of QI teams, and support for social accountability activities. Results: Improved implementation of MPDSR action points included increased number of CEmONC health facilities, availability and access to blood during PPH emergencies, and point-of-care ultrasound machines in 13 health facilities. There was notable improvement of timely perinatal deaths of audits 47% (70/152). Conclusions: Deliberate and collective effort by the leadership with close follow-up can improve timely auditing and response , which improves the quality of care for mothers and newborns receiving HFs.

Mobilizing faith-based COVID-19 health ambassadors to address COVID-19 health disparities among African American older adults in under-resourced communities: A hybrid, community-based participatory intervention.

The COVID-19 pandemic disproportionately affected older adults, particularly those with pre-existing chronic health conditions. To address the health disparity and challenges faced by under-resourced African American older adults in South Los Angeles during this period, we implemented a hybrid (virtual/in-person), pre-post, community-based participatory intervention research project utilizing a faith-based lay health advisor model (COVID-19 Health Ambassador Program (CHAP)). We recruited COVID-19 Health Ambassadors (CHAs) and African American older adults (participants) from faith-based organizations who partook in CHA-led meetings and follow-ups that educated and supported the participants. This paper seeks to evaluate this intervention's implementation using the Consolidated Framework for Implementation Research (CFIR) as a reporting tool with an emphasis on fidelity, challenges, and adaptations based on data collected via stakeholder interviews and surveys. CHAP was delivered to 152 participants by 19 CHAs from 17 faith-based organizations. CHAs assisted with chronic disease management, resolved medication-related challenges, encouraged COVID-19 vaccination, reduced psychological stress and addressed healthcare avoidance behaviors such as COVID-19 vaccine hesitancy among the participants. Challenges encountered include ensuring participant engagement and retention in the virtual format and addressing technological barriers for CHAs and participants. Adaptations made to better suit the needs of participants included providing communication tools and additional training to CHAs to improve their proficiency in using virtual platforms in addition to adapting scientific/educational materials to suit our participants' diverse cultural and linguistic needs. The community-centered hybrid approach in addition to our partnership with faith-based organizations and their respective COVID-19 health ambassadors proved to be essential in assisting underserved African American older adults manage chronic health conditions and address community-wide health disparities during the COVID-19 pandemic. Adaptability, cultural sensitivity, and teamwork are key to implementing health interventions especially in underserved populations.

Review of “Addiction recovery and resilience: faith-based health services in an African American community”

Review of “Addiction recovery and resilience: faith-based health services in an African American community”

Leveraging on technology to achieve improved organizational performance: A focus on faith-based health organizations in western Kenya

Leveraging on technology to achieve improved organizational performance: A focus on faith-based health organizations in western Kenya

Does Strategic Leadership Impact Organizational Performance Outcomes Mediated by Crisis Management Practices in Faith-based Health Institutions in Malawi?

The paper aims to identify the links between strategic leadership practices, crisis management and organizational performance. Specifically, the paper will examine the characteristics of the top management team, their decision-making process and skills, and how they influence crisis management practices and organizational performance. All data were gathered by means of a methodical review of the literature. Based on the COVID-19 circumstance, it was observed that crisis management was difficult in many firms. The gap that was discovered during the COVID-19 timeframe served as the basis for the paper. This study is a component of the ongoing main research project. Top management makes decisions and presents them to staff members in strategic leadership. A crisis is an unwelcome event that could occur in an organization and affect the organization negatively or positively. In healthcare crisis management must be effective from the onset to achieve organizational performance outcomes. Therefore, strategic leadership will enhance crisis management to achieve organizational performance outcomes. Strategic leadership has been identified to have been critical in crisis management because it is visionary. The findings of this literature review identified that organizations must train employees to become strategic leaders because strategic leaders are visionary. Crisis management training should be conducted and have crisis management committees in place. Crisis preparation must be done in all organizations to manage any disaster/crisis.

Assessment of prices, availability and affordability of essential medicines in Juba County, South Sudan

BackgroundAccess to safe, effective, affordable, and high-quality medications has been included in the Sustainable Development Goals (SDGs) of the United Nations as a crucial step towards attaining universal health coverage. Access to medicines is a fundamental human right. If medicines are accessible and affordable, they save lives by reducing mortality and morbidity associated with acute and chronic diseases. WHO recommends that all countries voluntarily reach the minimum target of 80% availability of medicines by 2025. The primary purpose of this research is to assess access to essential medicines in Juba County, South Sudan.MethodsThis study was undertaken using the standard World Health Organization/Health Action International Organization (WHO/HAI) approach for surveying the prices, availability, and affordability of medicines. A survey was conducted in six payams of Juba County, South Sudan, and 55 health facilities were assessed.ResultsPrices for generic medicines were better in faith-based health facilities with a median price ratio of 1.95. Private pharmacies and private clinics had MPRs of 4.64 and 4.32, respectively. Local prices were high compared to International referent prices. Availability of medicines was highest in the faith-based health facilities (65.5%) and slightly lower in private pharmacies (55.4%), private clinics (57.7%) and public (50.4%) sectors. Most of the surveyed medicines were unaffordable. The medicines needed to treat non-communicable diseases cost up to 33.7-day wages for one full course of treatment.ConclusionsIn South Sudan, medicines are poorly available in all sectors. Medicines are affordable in the public sector but Most medicines are unaffordable in private pharmacies, private clinics and faith-based health facilities. Poor medicines availability in the public sector contributes to the overall unaffordability of medicines in all the other sectors.

Addressing Suicide Risk Among Immigrant Women Survivors of Intimate Partner Violence

Intimate partner violence (IPV) is a significant public health problem contributing to multiple morbidities. Immigrant women who experience IPV may be disproportionately vulnerable to poor mental health outcomes, including self-harm and suicidal ideation, due to cultural experiences and contextual factors that prevent them from accessing services. While existing studies identify the risks for suicidal ideation amongst survivors of IPV, there is limited knowledge on how to tailor strategies to support immigrant women survivors of IPV who experience suicidal ideation. This study was conducted as part of the formative phase of a longitudinal research project designed to develop and evaluate a safety planning intervention for immigrant women survivors of IPV. Using qualitative in-depth interviews, we explored the perspectives of immigrant women survivors of IPV (n = 46) from various countries of origin, ages, and educational backgrounds on effective strategies for supporting immigrant women who disclose suicidal ideation. Study participants discussed various strategies for supporting survivors including building trust, providing encouragement, strengthening social support networks, and reminding survivors of parental responsibilities. Participants also pointed to the importance of the following services: domestic violence support, faith-based health resources, supportive immigration programs, mental health support, and emergency and medical treatment. These findings are informative for researchers and practitioners who work with immigrant women survivors of IPV, and they can be used to develop appropriate safety protocols and support strategies for survivors who are experiencing or have previously experienced suicidal ideation to mitigate the risk of self-harm.

The Saint Louis bridges program: A mental health network of more than one hundred churches and the mental health community

This article describes the history and development of a faith-based mental health network of over one hundred Black churches in North St Louis City and County. The Bridges to Care and Recovery (BCR) program is a joint effort of the Black faith community, three community hospitals, local universities, a school of medicine and funding from the city /state departments of mental health. The mission of BCR is to improve the fragmented mental health services to the Black community and to address the stigma of mental illness. This innovative program provides a blueprint for other metropolitan areas to emulate. The present paper is a detailed description of the key elements and services of the Bridges program.