African American Church Members Research Articles

Equipping Faith-Based Communities for Cancer Support Ministry: A Pilot Study of Cancer Support Training for Members of African-American Churches in the USA.

Church-academic partnerships focused on cancer, generally target cancer screening and prevention, with few focusing explicitly on cancer survivors. With the population of cancer survivors steadily increasing, highlighting the value of faith-based cancer support ministry is paramount. However, many churches may not have the resources to integrate relevant cancer support ministry and may need to identify ways to reach cancer survivors. We piloted cancer support training to help church members to start a cancer support ministry with African-American churches in Milwaukee, WI. We sought to measure the feasibility of a two-day training workshop to build the capacity of churches through recruiting and training church members on how to foster social support and to disseminate cancer information and resources throughout their churches. Our study was guided by the social networks and social support framework, which we applied to cancer survivorship. Our study supports the feasibility of engaging churches in a virtual training to support the development of cancer support ministries to address the needs of African-American cancer survivors. Based on our recruitment success, workshop attendance, evaluation and retention, our results suggest that a two-day workshop was successful in facilitating the initiation of cancer support ministries within African-American churches.

Dyadic Peer Support to Improve Diet and Physical Activity Among African American Church Members: An Exploratory Study.

This study examined how African American church members communicated and cooperated as dyads to attain health goals. Participants completed nine weeks of group classes then worked as dyads for nine weeks. Communication logs and interviews were used to assess: (1) dyad communication and (2) dyad cooperation. Thirty-two dyads from three churches completed the study. Dyads communicated an average of two times per week. Dyads experienced challenges and provided encouragement. Findings indicate African American church members cooperate and communicate as family, friend, and acquaintance dyads to achieve health goals.

The Importance of the Social Environment in Achieving High Levels of Physical Activity and Fruit and Vegetable Intake in African American Church Members.

African Americans experience a high burden of chronic diseases and cancers that are prevented and ameliorated with physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study is to identify individual, social, and neighborhood variables associated with African Americans attaining high levels of both behaviors. This study is a cross-sectional analysis. Cohort of African Americans adults recruited from black churches in the Greater Houston area. Self-administered questionnaires collected in 2012 assessed correlates and behavioral outcome variables (PA and FV consumption). A combined 4-category behavioral outcome was created: high PA/high FV, low PA/high FV, high PA/low FV, and low PA/low FV. Standard and stepwise multinomial logistic regression examined the association between the various variables and the behavioral outcome. This sample (n = 1009) had a mean age of 49 years, was mostly female, and obese. Compared to the low PA/low FV intake group, the high PA/high FV intake group had significantly lower odds of individual-level variables (worrying about getting cancer, perceived stress, loneliness, and financial strain) and higher odds of social-level variables (social status, social cohesion, social organization involvement, and social norms). Only social-level variables remained significantly associated with higher odds of high PA/high FV intake in stepwise regression. These findings indicate that social influences may be most critical for high PA and FV intake in African Americans adults.

A Small-Changes Weight Loss Programfor African-American Church Members.

To test whether a previously tested, small-changes weight loss program could be translated for use in African American churches. The program consisted of 12 group sessions held weekly at a partner church. Key intervention messages were disseminated via Facebook. A single-arm pretest-posttest evaluation included assessments at baseline, program completion (3-month), and after three months with no contact (6-month). Participants (N = 17; 16 women, age 57.5±12.1 years, body mass index 36.5 kg/m2±5.4, hemoglobin A1c 6.3±0.5, blood pressure 132±14/82±7) attended an average of 77% (mdn=9) of treatment sessions and 94% and 100% completed the 3- and 6-month assessment visits. All participants reported they were "somewhat" or "very satisfied" with the program. There was minimal interaction with Facebook with an average of 0.5 comments and 3.9 reactions per post. Three- and six-month reductions (all p's≤.01) were observed for weight (mdn=-2.7 kg; mdn=-2.6 kg), waist circumference (mdn=-3.8cm; mdn=-5.1cm), and hemoglobin A1c (mdn=-0.5; mdn=-0.3). At 3-months, there were significant reductions in systolic (mdn=-10.7 mmHg) and diastolic blood pressure (mdn=-8.0) but not at 6 months. This study suggests that a faith-based, faith-placed intervention utilizing a small-changes approach in African American churches may achieve sustained weight loss in parishioners with obesity.

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 religiously-tailored, multilevel intervention in African American churches to increase HIV testing: Rationale and design of the Taking It to the Pews cluster randomized trial

HIV continues to disproportionately impact African American (AA) communities. Due to delayed HIV diagnosis, AAs tend to enter HIV treatment at advanced stages. There is great need for increased access to regular HIV testing and linkage to care services for AAs. AA faith institutions are highly influential and have potential to increase the reach of HIV testing in AA communities. However, well-controlled full-scale trials have not been conducted in the AA church context. We describe the rationale and design of a 2-arm cluster randomized trial to test a religiously-tailored HIV testing intervention (Taking It to the Pews [TIPS]) against a standard information arm on HIV testing rates among AA church members and community members they serve. Using a community-engaged approach, TIPS intervention components are delivered by trained church leaders via existing multilevel church outlets using religiously-tailored HIV Tool Kit materials and activities (e.g., sermons, responsive readings, video/print testimonials, HIV educational games, text messages) to encourage testing. Church-based HIV testing events and linkage to care services are conducted by health agency partners. Control churches receive standard, non-tailored HIV information via multilevel church outlets. Secondarily, HIV risk/protective behaviors and process measures on feasibility, fidelity, and dose/exposure are assessed. This novel study is the first to fully test an HIV testing intervention in AA churches – a setting with great reach and influence in AA communities. It could provide a faith-community engagement model for delivering scalable, wide-reaching HIV prevention interventions by supporting AA faith leaders with religiously-appropriate HIV toolkits and health agency partners.

A Church-Based Diabetes Risk Factor Prevention Program Improves Psychosocial Factors and Food-Related Behaviors

ABSTRACT Objective. To evaluate the impact of a faith-based diabetes risk prevention program. Design. Nine predominately African American (AA) churches were randomized to one of three groups – group 1 (intervention group) received the Healthy Bodies Healthy Souls faith-based intervention and Project POWER (HBHS+PP), group 2 received PP only, and group 3 received a delayed intervention (comparison group). Results. Church members in the HBHS+PP intervention group significantly decreased systolic and diastolic blood pressure (p = 0.02 and 0.01, respectively), showed greater improvement in food-related self-efficacy (p = 0.04), had a trend toward increased purchasing of healthy foods (p = 0.06), and decreased their purchasing of less healthy foods (p = 0.02) compared to churches receiving PP alone or the delayed intervention. Conclusions. The combined HBHS+PP program shows promise toward promoting a healthier lifestyle and behaviors in AA church members.

Results of ALIVE: A Faith-Based Pilot Intervention to Improve Diet Among African American Church Members

Results of ALIVE: A Faith-Based Pilot Intervention to Improve Diet Among African American Church Members Elizabeth Lynch, PhD, Erin Emery-Tiburcio, PhD, Sheila Dugan, MD, Francine Stark White, MDiv, Clayton Thomason, JD, LaDawne Jenkins, MA, Catherine Feit, Elizabeth Avery-Mamer, MA, Yamin Wang, MA, Laurin Mack, PhD, and Alan Ragland, DMin What Is the Purpose of This Study? • The ALIVE intervention is a church-based dietary intervention to increase vegetable consumption among African American church members that was designed by a partnership between researchers, African American pastors, and church leaders in the Chicagoland area. • The ALIVE intervention reflected local community knowledge and values because it was designed and delivered by pastors and church members using a community-based participatory research approach. • The ALIVE study measured the feasibility of implementing and evaluating the ALIVE intervention. What Is the Problem? • African Americans have a higher prevalence of cardiovascular disease than other racial groups. Improving diet in African Americans could reduce this disparity. • Dietary interventions have been less successful with African Americans than other subgroups possibly owing to insufficient cultural tailoring and skepticism about medical research among African Americans. • A promising cultural tailoring strategy is to conduct interventions in the trusted setting of the Black church. A number of dietary interventions have been conducted in Black churches and many have resulted in increased vegetable consumption but few have been designed and/or conducted in partnership with church community members. • A community-based participatory approach to intervention development and implementation has the potential to increase church member engagement and intervention effectiveness. What Are the Findings? • The ALIVE intervention resulted in a mean increase of one vegetable serving over 9 months as well as improvements in total diet quality and reductions in weight and blood pressure. • ALIVE was successfully adapted to a range of church settings. Who Should Care Most? • African American congregations. • Health professionals. • Researchers and community members interested in reducing health disparities. [End Page 3] Recommendations for Action • Health disparity researchers should use a community-based participatory research approach to develop culturally tailored interventions to improve health equity. • Programs aimed at reducing health disparities and promoting wellness should leverage preexisting social structures and values within subgroups to promote education and motivation for health behavior change. [End Page 4] Elizabeth Lynch Department of Preventive Medicine, Rush University Medical Center Erin Emery-Tiburcio Department of Behavioral Sciences, Rush University Medical Center Sheila Dugan Department of Physical Medicine and Rehabilitation, Rush University Medical Center Francine Stark White Third Baptist Church of Chicago Clayton Thomason Department of Preventive Medicine, Rush University Medical Center LaDawne Jenkins Department of Preventive Medicine, Rush University Medical Center Catherine Feit Department of Preventive Medicine, Rush University Medical Center Elizabeth Avery-Mamer Department of Preventive Medicine, Rush University Medical Center Yamin Wang Department of Preventive Medicine, Rush University Medical Center Laurin Mack Department of Behavioral Sciences, Rush University Medical Center Alan Ragland Third Baptist Church of Chicago Copyright © 2019 Johns Hopkins University Press

Results of ALIVE: A Faith-Based Pilot Intervention to Improve Diet Among African American Church Members.

A key intervention to address Black-White health disparities in cardiovascular disease (CVD) is to improve diet quality, especially vegetable consumption, among African Americans. However, effective and sustainable interventions are lacking for this population. Conduct a proof-of-concept study to measure the feasibility of implementing and rigorously assessing a novel, culturally tailored church-based intervention to improve vegetable consumption and total diet quality among African Americans. The study was designed and implemented by a community-based participatory research (CBPR) partnership between researchers, pastors, and church leaders. The Abundant Living in Vibrant Energy (ALIVE) intervention included a Bible study and small group-based nutrition education delivered by pastors and church members in 24 two-hour sessions over 9 months as well as church-wide activities. Overall, 206 people enrolled across five African American churches. Participants attended 56% of sessions. The mean number of daily vegetable servings at baseline was 3.04; this increased by one serving at the 9-month follow-up (p < .001). Vegetable servings increased by more than one in 47% of participants. Total diet quality also increased (p < .01) and significant reductions were found in weight (-1.0 kg; p < .001), systolic blood pressure (-3.91 mm Hg; p = .002), and diastolic blood pressure (-2.18 mm Hg; p = .001). The ALIVE intervention was flexibly adapted by a range of churches; successfully implemented by pastors, deacons, and church leaders; and rigorously evaluated across a range of church settings. Further study of this intervention is warranted given the evidence for potential efficacy and a high level of external validity.

Heaven and Health: How Black, Latino, and Korean Christians View the Relationship between Faith and Health

Religious congregations have increasingly been viewed as potential access points to health care in underserved communities. Such a perspective stems from a robust literature identifying the unique civic role that churches potentially play in African American and Latino communities. Yet, research on congregational health promotion has often not considered how congregants view the connections between religious faith, physical health, and the church community. In order to further interrogate how congregants view the church's role in health promotion, we compare views on the relationship between faith and health for two groups that are overrepresented in American Christianity and underrepresented in medical careers (African Americans and Latinos) with a group that is similarly religious but comparatively well-represented in medical professions (Korean Americans). Drawing on data from focus groups with 19 pastors representing 18 different congregations and 28 interviews with church members, we find that churches across all three groups promote initiatives to care for the physical health of their members. Nonetheless, notable differences exist in how each group frames the interface between religious faith and physical health. African Americans and Latinos highlighted the role of faith in providing physical healing while Korean Americans saw the support of the religious community as the main benefit of their faith. Distrust of medicine was primarily articulated by members of African American churches. The results offer important implications for the future potential and nature of health initiatives in racial minority communities.

A Community-Driven Implementation of the Body and Soul Program in Churches in the Twin Cities, Minnesota, 2011-2014.

BackgroundAfrican Americans have high disease and death rates due to cancer and cardiovascular disease. Health promotion efforts to improve diet have the potential to reduce these rates.Community ContextGiven their importance in the community and the extent of their reach, churches are effective avenues for health promotion efforts targeting African Americans. The objectives of this project were to promote healthy eating among African American church members, engage African American churches in the implementation of Body and Soul (an evidenced-based program that encourages healthy eating), and implement the program in the community with minimal resources.MethodsFrom 2011 through 2014 we conducted a community engagement project to implement the 12-week Body and Soul program, which includes demonstrations of healthy recipes and peer counseling, in 20 churches. Participants (n = 310) completed baseline and follow-up surveys on their eating habits and experience with peer counseling. Church coordinators (n = 11) completed a survey evaluating the program.OutcomeParticipants’ weekly servings of fruit (baseline, 4.3; follow-up, 5.4; P < .001) and vegetables (baseline, 4.5; follow-up, 5.3; P < .001) increased. Church coordinators reported enthusiasm about Body and Soul at their church, and 10 of 11 church coordinators indicated that their pastor encouraged members to attend Body and Soul events. Program success was promoted by engaging the pastor in program activities and by scheduling events soon after church services. Implementation challenges were variation in peer counseling among churches and low turnout at follow-up events.InterpretationThe project was successfully implemented in the 20 churches, and increases in healthy eating were observed. This project demonstrated that Body and Soul can be implemented in communities with little funds or other resources.

Feeling No Ways Tired

A considerable amount of the literature on African American activism has been focused on the mainstream political participation and the civil rights and Black Power movements. Subsequent research in this era has primarily focused on the church and post–civil war reconstruction efforts. Few contemporary studies have assessed activist efforts among African Americans and the factors that may influence their involvement. The current study investigates what factors are related to activism among African American church members. To better understand the factors that influence activism, 187 African American church members from two Midwestern cities were sampled. Employing Pearson correlations and hierarchical regression analysis revealed that racial centrality, psychological empowerment, and activism each significantly influence activist behavior among African Americans. Given the zeitgeist of the times (i.e., Ferguson, Eric Garner, and the Black Lives Matter movement), further research is needed to understand what factors may encourage African Americans to become involved and effectuate change in their respective communities.

Abstract B50: A church-based diet, physical activity, and stress intervention results in lower waist to hip ratios and reduced chronic inflammation in African-American males

Abstract Introduction: Acute inflammation, the body's response to infection or physical insult, helps to control infection, heal wounds, and promote tissue regeneration. When normal systems of negative feedback fail to turn off inhibitory signaling, persistent chronic inflammation results. Such chronic inflammation has been shown to be associated with cancers of many anatomic sites and other chronic diseases that are both more prevalent and more virulent among African Americans in the Southeastern United States. Also, chronic inflammation has been associated with poor diet, low levels of physical activity, and high levels of psychosocial stress. Using principles of community-based participatory research (CBPR), this randomized controlled trial (RCT) was designed and administered jointly by members of African-American churches and academic researchers. Its goal was to test the effectiveness of a community-based diet, physical activity and stress reduction intervention in reducing inflammation in overweight and obese African-American adults. Methods: The RCT was conducted in greater Columbia, SC from 2010 to 2014. Churches were randomized to receive the intervention either immediately or with a 12-month delay. The latter served as the study's control arm. Church members were the unit of measurement for all health-related outcomes. Three lay health leaders, who constituted the Church Education Team (CET) and facilitated the study, were selected by the pastor of each church. The first intervention phase consisted of 12 weekly group classes led by a trained community health educator and involving hands-on cooking of mainly vegetable-based meals, sharing of healthy recipes, increasing physical activity, and mindfulness-based stress reduction. The second phase included monthly boosters conducted over an additional 9 months, and was meant to reinforce and expand on topics introduced in the more intensive, 12-week phase. Anthropometric measures were taken along with C-reactive protein (CRP), interleukin (IL)-6 and Monocyte Chemoattractant Protein (MCP)-1. A composite inflammatory score was computed by summing the z-scores for CRP, IL-6 and MCP-1. Linear regression models were fit to test intervention effectiveness and to identify predictors of success. Results: Males in the intervention arm had lower mean adjusted CRP values compared to controls (2.6 vs. 3.7mg/L, p=0.05) at 12-week follow-up (immediately after weekly intervention classes). After 1-year follow-up, a difference of similar magnitude, but not statistically significant, was observed (2.6 vs. 3.9, p=0.17). A nearly statistically significant difference in the composite inflammatory biomarker score also was observed between intervention and control arms among males (-0.38 vs. 0.17, p=0.07). Adjustment for ratings of intervention attendance and sustainability revealed a statistically significant difference in waist-to-hip ratio (WHR) between intervention and control group subjects (0.84 vs. 0.86, p=0.03) at 12-week follow-up among all participants. Conclusion: This RCT showed a significant reduction in CRP among males, but not females; and WHR reductions among all participants at 12-week follow-up. Results also included a large dropout and relatively large differences in factors related to retention and participants' investment in the process. Therefore, alternatives to randomization as a method of treatment allocation may be more appropriate from a public health perspective, especially in communities with large cancer-related health disparities. Citation Format: James R. Hebert, Michael D. Wirth, Brook E. Harmon, Nitin Shivappa, Thomas G. Hurley, Lisa C. Davis, Cheryl A. Armstead, Angela E. Murphy. A church-based diet, physical activity, and stress intervention results in lower waist to hip ratios and reduced chronic inflammation in African-American males. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B50.

Physical Health Screenings Among African-American Church and Community Members.

This study sought to identify characteristics, including religiosity, related to having received health screenings among persons who attend African-American churches or receive church-based community outreach services. A sample of 602 was recruited during two phases as part of a larger project. Blood pressure, cholesterol, and blood glucose screenings were the most frequently reported screenings ever and in the last 12months. Although religiosity was significantly related to several of the health screenings in bivariate analysis, it is not a predictor of health screenings in multivariate analyses. Innovative strategies are needed to promote screenings such as church-based health fairs.

The Impact of Faith Beliefs on Perceptions of End-of-Life Care and Decision Making among African American Church Members.

African Americans underuse palliative care and hospice services because of a combination of factors including faith beliefs. As the spiritual family for many African Americans, the church presents an opportunity to improve communication about palliative care and hospice and end-of-life (EOL) decision making. We conducted a focus group study to understand the cultural and spiritual perspectives that influence decisions about palliative care and hospice among African American church members who visit and support persons with life-limiting illnesses. Our specific aims were to elicit their perceptions, beliefs, and attitudes about: (1) the relation between faith beliefs and EOL care; (2) emotional and family influences on EOL decision making; (3) palliative care and hospice resources; and (4) opportunities to improve communication among lay persons and health professionals and within families. Seven focus groups using purposeful sampling. We partnered with two African American churches. Of 51 persons, 27 were deacons or deaconesses, 17 were members of health or bereavement ministries, and 7 were other members of the congregations. We found that faith beliefs of African Americans can support discussions about palliative care and hospice. Participants perceived that many of their congregants harbor beliefs, perceptions, and feelings about death and dying that were often not communicated to family members or to health providers. Among African Americans, faith beliefs, emotional issues, family dynamics, and insufficient knowledge of palliative care and hospice are intertwined and influence decision making about palliative care and hospice. Our findings confirm the influence of faith beliefs of African Americans on decisions about palliative care and hospice and demonstrate the opportunity to improve communication about palliative care and hospice and EOL through collaborations with the African American church.

Insult and Insecurity: Discernment, Trust, and the Uncanny in Two US Pentecostal Communities

Within many North American evangelical Christian communities, discernment denotes attentiveness to an interior voice that believers learn to identify as God’s. This article adopts a comparative perspective on everyday domains of perception and feeling that practices of discernment implicitly distinguish as unmarked by God’s activity, and as characterized by specific forms of anxiety from which believers desire to be redeemed. In a majority White Pentecostal congregation in suburban Buffalo, New York, believers cast emotional insecurity as a condition demanding redemption, while members of African American churches in the inner city hope to be redeemed from sensitivity to insults. While practices of discernment counter such anxieties by fostering forms of intimacy and trust, they also reinforce anxiety by focusing believers’ attention on how familiar relations may be distorted in uncanny ways.

The acceptability to African-Americans of a structured conversation guide to improve advance care planning in the setting of cancer: A focus-group study.

11 Background: African-Americans are less likely than whites to participate in advance care planning (ACP), which may contribute to disparities in the receipt of goal-concordant care. Literature points to multiple factors: the impact of religion, mistrust, different preferences for life-sustaining measures, family-decision making styles and poor knowledge about ACP. Early ACP conversations are associated with improved outcomes at the end of life, including goal-concordant care. A systematically-developed, serious illness conversation guide (“guide”) for oncologists, embedded in a systems-based approach to improving illness care, has demonstrated more frequent, higher-quality, and earlier ACP conversations in a predominantly white and middle class cohort of cancer patients. This study aimed to explore the acceptability and need for modification of the guide in more diverse populations. Methods: We conducted a series of focus groups with panels of clinicians and researchers, African-American church members, and seriously ill patients and their caregivers to assess barriers to ACP and preferences concerning modifications to the guide. We used template analysis to code themes at the individual, interpersonal and systems levels. Results: At the individual level, participants confirmed the importance of religion and the impact of perceived discrimination (e.g., receipt of inferior care) and superstition (e.g., talking about death may make it happen). Interpersonal-level factors influencing ACP included family, trust, and concerns about provider abandonment. Participants confirmed systems-level barriers of access and mistrust in the healthcare system and highlighted community outreach as a key part of the process. Participants reported positive responses to the tone and content of the guide and found the guide to be acceptable when it included a question that elicited coping mechanisms, including religion. Conclusions: Participants in our study found the use of a serious illness conversation guide to identify patient goals and priorities acceptable, and emphasized the importance of adding a question focused on coping and religion.

Perceptions of HIV/AIDS Testing Among Urban and Rural African American Church Members

Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members. Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n = 114) in the Southern U.S. Results: The quantitative findings indicated that the urban participants reported significantly higher rates of testing than the rural participants, but the groups had equally high HIV knowledge and positive perceptions of HIV/AIDS testing. In-depth, individual interviews (24 urban; 24 rural) were conducted to gain a better understanding of the factors that contribute to perceptions of HIV/AIDS testing and knowledge of HIV/AIDS. Transcripts were axially coded for a priori themes and then analyzed for emergent categories of responses. These interviews indicated that the participant’s perceptions of HIV/AIDS testing were in general, not influenced by the church and that there were no noticeable distinctions regarding why HIV/AIDS testing was sought. The combined results of this study suggested that the churches surveyed were not promoting HIV/AIDS awareness and that the participants felt that the church should do more as it relates to HIV/AIDS. Conclusions: Since the AA church plays an important role in the lives of many AAs, it potentially can, particularly in rural areas, bring forth social change by advocating HIV/AIDS testing and prevention efforts in order to reduce the rate of HIV infections.

Global Action to reduce HIV stigma and discrimination

Global Action to reduce HIV stigma and discrimination

C-reactive protein levels in African Americans: a diet and lifestyle randomized community trial.

Chronic inflammation is linked to poor lifestyle behaviors and a variety of chronic diseases that are prevalent among African Americans, especially in the southeastern U.S. The goal of the study was to test the effect of a community-based diet, physical activity, and stress reduction intervention conducted in 2009-2012 on reducing serum C-reactive protein (CRP) in overweight and obese African-American adults. An RCT intervention was designed jointly by members of African-American churches and academic researchers. In late 2012, regression (i.e., mixed) models were fit that included both intention-to-treat and post hoc analyses conducted to identify important predictors of intervention success. Outcomes were assessed at 3 months and 1 year. At baseline, the 159 individuals who were recruited in 13 churches and had evaluable outcome data were, on average, obese (BMI=33.1 [±7.1]) and had a mean CRP level of 3.7 (±3.9) mg/L. Reductions were observed in waist-to-hip ratio at 3 months (2%, p=0.03) and 1 year (5%, p<0.01). In female participants attending ≥60% of intervention classes, there was a significant decrease in CRP at 3 months of 0.8 mg/L (p=0.05), but no change after 1 year. No differences were noted in BMI or interleukin-6. In overweight/obese, but otherwise "healthy," African-American church members with very high baseline CRP levels, this intervention produced significant reductions in CRP at 3 and 12 months, and in waist-to-hip ratio, which is an important anthropometric predictor of overall risk of inflammation and downstream health effects. This study is registered at www.clinicaltrials.gov NCT01760902.