Partnering with African American churches to achieve better health: Lessons learned during the Black Churches United for Better Health 5 a Day Project
Department of Surgery, Duke University, Durham, North Carolina, United StatesJournal of Cancer Education (Impact Factor: 1.23). 02/2000; 15(3):164-7. DOI: 10.1080/08858190009528686
African Americans (AAs) are at increased risk for many diseases, including cancer, but health promotion efforts often fail to reach them. Effective partnerships can be established with African American churches to deliver health-based interventions. In an NCI-funded study aimed at increasing fruit and vegetable consumption among rural AAs, investigators at three academic institutions and the North Carolina State Health Department partnered successfully with 50 churches to promote dietary change. This study adds to the increasing body of research in support of the African American church as an able partner in delivering health-based interventions. In conducting interventions and research through this channel, the health professional should gain support from regional secular associations; respect the power of the pastor; incorporate the strengths of the congregation; respect the mission of the church; establish open communication and develop trust; provide ample support and training to assure fidelity to interventions and integrity of data; and be patient and persevere.
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- "These interventions must be culturally sensitive and address the barriers to behavior change in communities of color. One approach is working with faith communities where churches can serve as an effective channel for health promotion efforts (Campbell et al., 2007; Demark-Wahnefried et al., 2000). The WATCH (Wellness for African Americans Through Churches) Project was effective at increasing both CRC screening and PA in rural African American churches (Campbell et al., 2004). "
ABSTRACT: Action Through Churches in Time to Save Lives (ACTS) of Wellness was a cluster randomized controlled trial developed to promote colorectal cancer screening and physical activity (PA) within urban African American churches. Churches were recruited from North Carolina (n = 12) and Michigan (n = 7) and were randomized to intervention (n = 10) or comparison (n = 9). Intervention participants received three mailed tailored newsletters addressing colorectal cancer screening and PA behaviors over approximately 6 months. Individuals who were not up-to-date for screening at baseline could also receive motivational calls from a peer counselor. The main outcomes were up-to-date colorectal cancer screening and Metabolic Equivalency Task (MET)-hours/week of moderate-vigorous PA. Multivariate analyses examined changes in the main outcomes controlling for church cluster, gender, marital status, weight, and baseline values. Baseline screening was high in both intervention (75.9%, n = 374) and comparison groups (73.7%, n = 338). Screening increased at follow-up: +6.4 and +4.7 percentage points for intervention and comparison, respectively (p = .25). Baseline MET-hours/week of PA was 7.8 (95% confidence interval [6.8, 8.7]) for intervention and 8.7 (95% confidence interval [7.6, 9.8]) for the comparison group. There were no significant changes (p = .15) in PA for intervention (-0.30 MET-hours/week) compared with the comparison (-0.05 MET-hours/week). Among intervention participants, PA increased more for those who participated in church exercise programs, and screening improved more for those who spoke with a peer counselor or recalled the newsletters. Overall, the intervention did not improve PA or screening in an urban church population. These findings support previous research indicating that structured PA opportunities are necessary to promote change in PA and churches need more support to initiate effective peer counselor programs.
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- "In addition to the importance of the institution, the role of the faith leader in health promotion initiatives is well documented. For many interventions, having the support or endorsement of the pastor dictates FBO-level buy-in, assists with recruitment, and helps to build trust among the FBO members(Campbell et al., 2007; Demark-Wahnefried et al., 2000; Peterson et al., 2002). Like other formal leaders in community settings (e.g. "
ABSTRACT: Background: Churches are a viable community partner for reaching large populations for health promotion interventions. Despite their usefulness, little is known about the institutional capacity or beliefs of churches toward health. The purpose of this qualitative study was to examine how a churches' doctrine, parent organization (e.g. conference/diocese), and leader training (e.g. seminary school) perceive and support health-related issues. Design & Methods: Clergy (n=24) from multiple denominations participated in a semi-structured interview. The interviewer asked questions about the doctrine/philosophy of their church on health, parent organization support for health, and education and training on health. Interviews were recorded, transcribed and coded. Results: Clergy reported that stewardship and holistic views on health were a part of their churches' doctrine. Health insurance programs and clergy wellness initiatives were the most common form of health-related support from parent organizations. The majority of clergy reported minimal or no instruction on health during their education/training, and desired instruction on self-care in seminary school. These results indicate there are a number of institutional influences on health and wellness within churches. Conclusions: Future programs could include policy and environment level initiatives to address clergy health, and the development of culturally tailored intervention concurrent with church doctrine.
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- "Despite clear efficacy, as in the DASH example, effectiveness has been difficult to achieve. This has been attributed to social and cultural barriers [55, 56] including different body-image ideals and food attitudes, to having fewer models for PA, and to normative views of overweight and obesity . Thus, to successfully address health disparities, multiple sociocultural factors need to be addressed. "
ABSTRACT: Hypertension (HTN) is a highly prevalent risk factor for cardiovascular (CV), cerebrovascular, and renal diseases and disproportionately affects African Americans (AAs). It has been shown that promoting the adoption of healthy lifestyles, ones that involve best practices of diet and exercise and abundant expert support, can, in a healthcare setting, reduce the incidence of hypertension in those who are at high risk. In this paper, we will examine whether similar programs are effective in the AA church-community-based participatory research settings, outside of the healthcare arena. If successful, these church-based approaches may be applied successfully to reduce the incidence and consequences of hypertension in large communities with potentially huge impact on public health.
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