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Steinhoff P, Reiner A. Physical activity and functional social support in community-dwelling older adults: a scoping review. BMC Public Health 2024; 24:1355. [PMID: 38769563 PMCID: PMC11103817 DOI: 10.1186/s12889-024-18863-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/15/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Globally, the population of older people is increasing and is estimated to reach nearly 2.1 billion by 2050. Physical activity (PA) is one of the key components for successful ageing. However, PA decreases with age and many older adults do not meet PA guidelines. Previous research has shown that social support (SOSU) is related to PA in older people. The aim of this scoping review is to identify and map all of the available evidence and to explore the association between functional SOSU and PA in older adults. Functional SOSU consists of emotional, informational, instrumental and companionship SOSU and social comparison. METHODS A scoping review was conducted using the Joanna-Briggs manual. Quantitative and qualitative studies investigating associations between functional SOSU and PA levels in older adults (mean age ≥ 60 years) were identified through a systematic search in seven electronic databases up to August 2023. After removing duplicates, 20,907 articles were screened for titles and abstracts. The results were analysed separately for different types of SOSU. RESULTS 116 articles met the inclusion criteria; 72% were quantitative studies and 28% were qualitative studies. Most studies used self-reported PA measures, only 23% of the studies used objective-reported PA measures. Most studies of SOSU for PA reported positive associations but the evidence is inconclusive when the source of support is considered. PA is positively associated with general, emotional, informational, and companionship SOSU, while instrumental support may occasionally be negatively associated. Companionship support is particularly influential on PA, especially in group settings, as it promotes social connectedness. Qualitative studies show that social comparison also supports PA. Different forms of SOSU generally show positive associations with PA. CONCLUSIONS While the evidence on the association between functional SOSU and PA is mixed, most studies show that there is a positive association. PA may also be a strategy for improving social contact and social integration. This study offers a comprehensive overview of measures for SOSU and PA and thereby informs future research and policy-making.
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Affiliation(s)
- Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany.
| | - Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
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Zimmermann K, Muramatsu N, Molina Y, Carnahan LR, Geller SE. Application of the consolidated framework for implementation research to understand implementation context of a cardiovascular disease risk-reduction intervention in rural churches. Transl Behav Med 2023; 13:236-244. [PMID: 36694377 DOI: 10.1093/tbm/ibac110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Rural populations in the USA face higher rates of cardiovascular disease (CVD) incidence and mortality relative to non-rural and often lack access to health-promoting evidence-based interventions (EBIs) to support CVD prevention and management. Partnerships with faith organizations offer promise for translating preventative EBIs in rural communities; however, studies demonstrating effective translation of EBIs in these settings are limited. We used the Consolidated Framework for Implementation Research (CFIR) and a multiple case study approach to understand the role of internal organizational context within 12 rural churches in the implementation of a 12-week CVD risk-reduction intervention followed by a 24-month maintenance program implemented in southernmost Illinois. The study involved qualitative analysis of key informant interviews collected before (n = 26) and after (n = 15) the intervention and monthly implementation reports (n = 238) from participating churches using a deductive analysis approach based on the CFIR. Internal context across participating churches varied around organizational climate and culture in four thematic areas: (i) religious basis for health promotion, (ii) history of health activities within the church, (iii) perceived need for the intervention, and (iv) church leader engagement. Faith organizations may be ideal partners in rural health promotion research but may vary in their interest and capacity to collaborate. Identifying contextual factors within community organizations is a first step to facilitating rural, community-based EBI implementation and outcomes.
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Affiliation(s)
- Kristine Zimmermann
- Department of Family and Community Medicine, Division of Health Research and Evaluation, University of Illinois College of Medicine Rockford, Rockford, IL, USA.,Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA
| | - Naoko Muramatsu
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA
| | - Yamilé Molina
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA.,University of Illinois Cancer Center, Chicago, IL, USA
| | - Leslie R Carnahan
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, USA.,University of Illinois Cancer Center, Chicago, IL, USA
| | - Stacie E Geller
- Department of Obstetrics and Gynecology, College of Medicine, University of Illinois, Chicago, USA.,Center for Research on Women and Gender, College of Medicine, University of Illinois, Chicago, USA
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Lee S, Niakosari Hadidi N, Lindgren BR, Kelley R, Lindquist R. Peer Group Support Intervention to Reduce Cardiovascular Disease Risk for African American Men According to Life's Simple 7 in Faith-Based Communities. Res Theory Nurs Pract 2022; 36:RTNP-2021-0111.R1. [PMID: 35705256 DOI: 10.1891/rtnp-2021-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Adverse cardiovascular health disparities persist for African American men. Although changing health behaviors is perhaps one of the most effective methods to prevent cardiovascular disease (CVD)-related deaths, previous behavior change programs targeting single or multiple CVD risk factors in target groups have had mixed success. The purpose of this pilot study was to determine whether a multi-faceted peer group intervention model based on American Heart Association's Life's Simple 7 was feasible, safe, acceptable, and efficacious in producing meaningful risk reduction for African American men. METHODS A convenience sample of 24 African American men with at least one CVD risk factor participated quasi-experimental study having peer intervention vs. nonequivalent comparison groups, with pretest-posttests at two church sites in Minneapolis, MN (MPLS) and Washington, D.C. (DC). Feasibility, safety, acceptability, and potential efficacy were assessed by examining completion of peer group sessions, adverse events, attendance, attrition, within and between-group changes in measures using nonparametric statistics. RESULTS All twenty-four men completed the study with no study-related adverse symptoms and medical events. The peer groups had moderate to high attendance, and the peer program evaluation was highly positive among participants. Between baseline and 6-months, there were significant differences between the intervention and the comparison group in cholesterol levels and weights (p = .041, p = .034, respectively) at one site (DC). There were no significant between-group changes at the other site (MPLS). IMPLICATION FOR PRACTICE The multi-faceted peer support intervention was feasible, acceptable, and shown to have potential efficacy to reduce CVD risk for highly motivated African American men. Future studies with a larger sample size are needed to test the effectiveness of this intervention model to reduce CVD risk among African American men.
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Affiliation(s)
- Sohye Lee
- Assistant Professor, University of Memphis, Loewenberg College of Nursing, 4055 North Park Loop, Memphis, TN 38152, USA
| | - Niloufar Niakosari Hadidi
- Associate Professor, University of Minnesota, School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA
| | - Bruce R Lindgren
- Senior Biostatistician, University of Minnesota, Masonic Cancer Center, 425 E River Pkwy, Minneapolis, MN 55455, USA
| | | | - Ruth Lindquist
- Professor Emeritus, University of Minnesota, School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard Street SE,, Minneapolis, MN 55455, USA
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Abdul Basir SM, Abdul Manaf Z, Mohd. Noor N, Mat Ludin AF, Shahar S, Abdul Manaf MR. The Challenges and Strategies towards Healthy Eating during COVID-19 Home Confinement Period among Working Adults with BMI ≥ 25 kg/m 2 Enrolled in a Weight Loss Program: Qualitative Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116656. [PMID: 35682248 PMCID: PMC9180068 DOI: 10.3390/ijerph19116656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has been affecting our lifestyles, such as work, living, and health. In Malaysia, the Restriction of Movement Order (RMO) was first announced in March 2020 to curb the spread of the virus. Since then, many Malaysians have been confined to their own home. This new lifestyle can cause a change of eating habits where healthy eating may be a challenge. Hence, our qualitative study explored the challenges and strategies for healthy eating during the first wave of the COVID-19 home confinement period among working adults overweight and obese in Malaysia. Eleven participants were individually interviewed through phone calls. The interviews were audio-recorded, transcribed verbatim, and then coded with NVIVO 12 based on thematic analysis. We found that social pressure, changes in the social setting, more free time to access food, and extra stock of unhealthy foods at home were among the challenges to healthy eating. Some participants countered these perceived challenges by reducing unhealthy food stock, limiting kitchen visits, and utilizing self-monitoring apps to monitor their calorie intake. Social media was not consistently perceived to influence their eating behavior during this period. We conclude that COVID-19 home confinement has created challenges to healthy eating habits among overweight and obese adults with overweight and obesity. Our study provides evidence that vulnerable groups such as overweight and obese individuals require specific nutritional support during pandemic-related confinement to enhance eating self-efficacy.
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Affiliation(s)
- Siti Munirah Abdul Basir
- Centre for Healthy Aging and Wellness and Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Selangor, Malaysia; (S.M.A.B.); (S.S.)
| | - Zahara Abdul Manaf
- Centre for Healthy Aging and Wellness and Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Selangor, Malaysia; (S.M.A.B.); (S.S.)
- Correspondence: ; Tel.: +60-392897677
| | - Norhayati Mohd. Noor
- Center of Community Education and Wellbeing, Faculty of Education, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia;
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Aging and Wellness and Biomedical Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Selangor, Malaysia;
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness and Dietetic Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Aziz, Kuala Lumpur 50300, Selangor, Malaysia; (S.M.A.B.); (S.S.)
| | - Mohd Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Selangor, Malaysia;
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Haughton J, Takemoto ML, Schneider J, Hooker SP, Rabin B, Brownson RC, Arredondo EM. Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program. Implement Sci Commun 2020; 1:51. [PMID: 32885207 PMCID: PMC7427873 DOI: 10.1186/s43058-020-00043-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women. Methods We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers' behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: (1) health behavior change training for pastors and staff, (2) tailored messaging, (3) developing community collaborations, and (4) gaining denominational support. Conclusions While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.
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Affiliation(s)
- Jessica Haughton
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA
| | | | - Jennifer Schneider
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA USA
| | - Borsika Rabin
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO USA.,Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO USA
| | - Elva M Arredondo
- School of Public Health, San Diego State University, San Diego, CA USA
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Objective Church Environment Audits and Attendee Perceptions of Healthy Eating and Physical Activity Supports within the Church Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103598. [PMID: 32443819 PMCID: PMC7277806 DOI: 10.3390/ijerph17103598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/13/2020] [Accepted: 05/16/2020] [Indexed: 11/17/2022]
Abstract
Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees' perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was used to analyze associations between the church environment and outcomes. Physical elements of churches were positively related to attendees' perceptions of church environment supports for PA (B = 0.03, 95% CI = 0.01, 0.05) and HE (B = 0.05, 95% CI = 0.01, 0.09) and there was a significant interaction between perceptions of HE supports and HE church environment. Self-efficacy and behaviors for PA and HE did not show an association with the church environment. Future research should establish a temporal relationship between the church environment and these important constructs for improving health. Future faith-based interventions should apply infrastructure changes to the church environment to influence important mediating constructs to health behavior.
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Bernhart JA, La Valley EA, Kaczynski AT, Wilcox S, Jake-Schoffman DE, Peters N, Dunn CG, Hutto B. Investigating Socioeconomic Disparities in the Potential Healthy Eating and Physical Activity Environments of Churches. JOURNAL OF RELIGION AND HEALTH 2020; 59:1065-1079. [PMID: 30132179 PMCID: PMC6384145 DOI: 10.1007/s10943-018-0687-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Faith-based settings have the potential to improve health in underresourced communities, but little research has quantified and compared health-promoting elements in church environments. This study examines the number of potential indoor and outdoor physical activity opportunities, healthy eating opportunities, healthy living media, and total environmental resources present in churches (n = 54) in a rural, southeastern US county and the relationship between these resources and neighborhood income. In our sample, most churches offered potential indoor and outdoor opportunities for physical activity and healthy eating opportunities, with more variability in the number of healthy living media items on display compared to other environmental components. Common potential opportunities present in churches for physical activity included a fellowship hall and green/open space, while potential opportunities for healthy eating frequently included a refrigerator and sink. Compared to those in medium- and high-income neighborhoods, churches in low-income neighborhoods scored higher on measures of potential outdoor physical activity opportunities and lower on measures of total potential environment resources, healthy eating opportunities, healthy living media, and indoor physical activity opportunities, though only indoor physical activity opportunities reached statistical significance. Potential opportunities for using existing resources in and around churches for health promotion should be investigated further, particularly in rural areas.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Elizabeth A La Valley
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nathan Peters
- School of Human Movement, Sport and Leisure Studies, Bowling Green University, Bowling Green, OH, USA
| | - Caroline G Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Faries MD, McClendon M, Jones EJ. Destroying God's Temple? Physical Inactivity, Poor Diet, Obesity, and Other "Sin" Behaviors. JOURNAL OF RELIGION AND HEALTH 2020; 59:522-534. [PMID: 28213631 DOI: 10.1007/s10943-017-0368-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
On average, our participants (N = 112), who self-proclaimed to be Christians, believed that physically inactive lifestyles, unhealthy eating, overeating, and being obese destroy the body, God's temple. However, these beliefs were less definitive, than those of other common "sin" behaviors, such as drug use, smoking, and excessive drinking of alcohol. In addition, destroying the body with physical inactivity or poor diet was not necessarily viewed as sinful. Subsequently, these beliefs did not relate to self-reported physical activity, dietary behavior, or body mass index. It is possible that inactivity, poor dietary habits, and obesity are not internalized into the spiritual perspective as destroying the body, God's temple, in the same way as other "sin" behaviors.
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Affiliation(s)
- Mark D Faries
- Family and Community Health, Texas A&M AgriLife Extension, College Station, TX, USA.
| | - Megan McClendon
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX, USA
| | - Eric J Jones
- Department of Kinesiology and Health Science, Stephen F. Austin State University, Nacogdoches, TX, USA
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Abbott LS, Slate EH, Lemacks JL. Influencing cardiovascular health habits in the rural, deep south: results of a cluster randomized trial. HEALTH EDUCATION RESEARCH 2019; 34:200-208. [PMID: 30601979 PMCID: PMC6736056 DOI: 10.1093/her/cyy052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 12/06/2018] [Indexed: 06/09/2023]
Abstract
Cardiovascular disease (CVD) is a major cause of death among people living in the United States. Populations, especially minorities, living in the rural South are disproportionately affected by CVD and have greater CVD risk, morbidity and mortality. Culturally relevant cardiovascular health programs implemented in rural community settings can potentially reduce CVD risk and facilitate health behavior modification. The purpose of this study was to examine the effects of a cardiovascular health promotion intervention on the health habits of a group of rural African American adults. The study had a cluster randomized controlled trial design involving 12 rural churches that served as statistical clusters. From the churches (n = 6) randomized to the intervention group, 115 participants were enrolled, received the 6-week health program and completed pretest-posttest measures. The 114 participants from the control group churches (n = 6) did not receive the health program and completed the same pretest-posttest measures. The linear mixed model was used to compare group differences from pretest to posttest. The educational health intervention positively influenced select dietary and confidence factors that may contribute toward CVD risk reduction.
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Affiliation(s)
- Laurie S Abbott
- College of Nursing, Florida State University, 98 Varsity Way, Tallahassee, FL, USA
| | - Elizabeth H Slate
- Department of Statistics, Florida State University, 117 N. Woodward Ave., Tallahassee, FL, USA
| | - Jennifer L Lemacks
- Department of Nutrition and Food Systems, University of Southern Mississippi, 118 College Drive, Hattiesburg, MS, USA
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Saunders RP, Wilcox S, Jake-Schoffman DE, Kinnard D, Hutto B, Forthofer M, Kaczynski AT. The Faith, Activity, and Nutrition (FAN) Dissemination and Implementation Study, Phase 1: Implementation Monitoring Methods and Results. HEALTH EDUCATION & BEHAVIOR 2018; 46:388-397. [PMID: 30577714 DOI: 10.1177/1090198118818235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Faith-based settings offer opportunities for reaching populations at risk for chronic conditions and are optimal settings for dissemination and implementation (D&I) research. Faith, Activity, and Nutrition (FAN) is an evidence-based program designed to promote physical activity (PA) and healthy eating (HE) through church policy, systems, and environmental change. We report implementation fidelity for Phase 1 of the FAN D&I project, a countywide effort. The group randomized study included pre- and postintervention assessments of core PA and HE components. We compared implementation in early intervention ( n = 35) versus delayed intervention (control, n = 19) churches; assessed individual church implementation; and examined the effects of level of implementation on church member outcomes. Implementation assessments were conducted with the FAN coordinator via telephone survey. Study outcomes were assessed with church members 8 to 12 months following baseline assessment via self-administered surveys. We found significantly higher levels of implementation for PA opportunities, PA and HE guidelines, PA and HE messages, and PA and HE pastor support in intervention versus control churches and showed church-level variation in PA and HE implementation. PA self-efficacy varied by level of implementation; high and low implementers did not differ in proportion of church members physically inactive, although low implementers had fewer members inactive than controls. The high level of implementation in intervention churches shows promise for broader dissemination of FAN.
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Affiliation(s)
| | - Sara Wilcox
- 1 University of South Carolina, Columbia, SC, USA
| | | | | | - Brent Hutto
- 1 University of South Carolina, Columbia, SC, USA
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Harmon BE, Strayhorn S, Webb BL, Hébert JR. Leading God's People: Perceptions of Influence Among African-American Pastors. JOURNAL OF RELIGION AND HEALTH 2018; 57:1509-1523. [PMID: 29388002 PMCID: PMC6026478 DOI: 10.1007/s10943-018-0563-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Religious leaders, particularly African-American pastors, are believed to play a key role in addressing health disparities. Despite the role African-American pastors may play in improving health, there is limited research on pastoral influence. The purpose of this study was to examine African-American pastors' perceptions of their influence in their churches and communities. In-depth interviews were conducted with 30 African-American pastors and analyzed using a grounded theory approach. Three themes emerged: the historical role of the church; influence as contextual, with pastors using comparisons with other pastors to describe their ability to be influential; and a reciprocal relationship existing such that pastors are influenced by factors such as God and their community while these factors also aid them in influencing others. A conceptual model of pastoral influence was created using data from this study and others to highlight factors that influence pastors, potential outcomes and moderators as well as the reciprocal nature of pastoral influence.
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Affiliation(s)
- Brook E Harmon
- Division of Social and Behavioral Sciences, University of Memphis School of Public Health, 200 Robison Hall, Memphis, TN, 38152, USA.
| | - Shaila Strayhorn
- Division of Social and Behavioral Sciences, University of Memphis School of Public Health, 200 Robison Hall, Memphis, TN, 38152, USA
| | - Benjamin L Webb
- School of Education, Health and Human Behavior, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - James R Hébert
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Wilcox S, Saunders RP, Kaczynski AT, Forthofer M, Sharpe PA, Goodwin C, Condrasky M, Kennedy VL, Jake-Schoffman DE, Kinnard D, Hutto B. Faith, Activity, and Nutrition Randomized Dissemination and Implementation Study: Countywide Adoption, Reach, and Effectiveness. Am J Prev Med 2018; 54:776-785. [PMID: 29656913 PMCID: PMC6203293 DOI: 10.1016/j.amepre.2018.02.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 02/01/2018] [Accepted: 02/01/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Faith-based organizations can contribute to improving population health, but few dissemination and implementation studies exist. This paper reports countywide adoption, reach, and effectiveness from the Faith, Activity, and Nutrition dissemination and implementation study. DESIGN This was a group-randomized trial. Data were collected in 2016. Statistical analyses were conducted in 2017. SETTING/PARTICIPANTS Churches in a rural, medically underserved county in South Carolina were invited to enroll, and attendees of enrolled churches were invited to complete questionnaires (n=1,308 participated). INTERVENTION Churches (n=59) were randomized to an intervention or control (delayed intervention) condition. Church committees attended training focused on creating opportunities, setting guidelines/policies, sharing messages, and engaging pastors for physical activity (PA) and healthy eating (HE). Churches also received 12 months of telephone-based technical assistance. Community health advisors provided the training and technical assistance. MAIN OUTCOMES MEASURES The Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided measurement of adoption and reach. To assess effectiveness, church attendees completed post-test only questionnaires of perceptions of church environment, PA and fruit and vegetable (FV) self-efficacy, FV intake, and PA. Regression models controlled for church clustering and predominant race of congregation, as well as member age, gender, education, and self-reported cancer diagnosis. RESULTS Church adoption was 42% (55/132). Estimated reach was 3,527, representing 42% of regular church attendees and 15% of county residents. Intervention church attendees reported greater church-level PA opportunities, PA and HE messages, and PA and HE pastor support (p<0.0001), but not FV opportunities (p=0.07). PA self-efficacy (p=0.07) and FV self-efficacy (p=0.21) were not significantly higher in attendees of intervention versus control churches. The proportion of inactive attendees was lower in intervention versus control churches (p=0.02). The proportion meeting FV (p=0.27) and PA guidelines (p=0.32) did not differ by group. CONCLUSIONS This innovative dissemination and implementation study had high adoption and reach with favorable environmental impacts, positioning it for broader dissemination. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02868866.
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Affiliation(s)
- Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Ruth P Saunders
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Melinda Forthofer
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Patricia A Sharpe
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Cheryl Goodwin
- Fairfield Behavioral Health Services, Winnsboro, South Carolina
| | - Margaret Condrasky
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, South Carolina
| | | | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Deborah Kinnard
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Kaczynski AT, Jake-Schoffman DE, Peters NA, Dunn CG, Wilcox S, Forthofer M. Development and Testing of the Church Environment Audit Tool. Am J Health Behav 2018; 42:17-26. [PMID: 29663977 PMCID: PMC6202683 DOI: 10.5993/ajhb.42.3.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES In this paper, we describe development and reliability testing of a novel tool to evaluate the physical environment of faith-based settings pertaining to opportunities for physical activity (PA) and healthy eating (HE). METHODS Tool development was a multistage process including a review of similar tools, stakeholder review, expert feedback, and pilot testing. Final tool sections included indoor opportunities for PA, outdoor opportunities for PA, food preparation equipment, kitchen type, food for purchase, beverages for purchase, and media. Two independent audits were completed at 54 churches. Interrater reliability (IRR) was determined with Kappa and percent agreement. RESULTS Of 218 items, 102 were assessed for IRR and 116 could not be assessed because they were not present at enough churches. Percent agreement for all 102 items was over 80%. For 42 items, the sample was too homogeneous to assess Kappa. Forty-six of the remaining items had Kappas greater than 0.60 (25 items 0.80-1.00; 21 items 0.60-0.79), indicating substantial to almost perfect agreement. CONCLUSIONS The tool proved reliable and efficient for assessing church environments and identifying potential intervention points. Future work can focus on applications within faith-based partnerships to understand how church environments influence diverse health outcomes.
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Affiliation(s)
- Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nathan A Peters
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Caroline G Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Melinda Forthofer
- Department of Public Health Sciences, University of North Carolina-Charlotte, Charlotte, NC, USA
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Hermstad A, Honeycutt S, Flemming SS, Carvalho ML, Hodge T, Escoffery C, Kegler MC, Arriola KRJ. Social Environmental Correlates of Health Behaviors in a Faith-Based Policy and Environmental Change Intervention. HEALTH EDUCATION & BEHAVIOR 2018; 45:672-681. [PMID: 29504466 DOI: 10.1177/1090198118757826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diet and physical activity are behavioral risk factors for many chronic diseases, which are among the most common health conditions in the United States. Yet most Americans fall short of meeting established dietary and physical activity guidelines. Faith-based organizations as settings for health promotion interventions can affect members at multiple levels of the social ecological model. The present study investigated whether change in the church social environment was associated with healthier behavior at church and in general at 1-year follow-up. Six churches received mini-grants and technical assistance for 1 year to support policy and environmental changes for healthy eating (HE) and physical activity (PA). Socioenvironmental (social support and social norms) and behavioral (HE and PA at church and in general) outcomes were derived from baseline and 1-year follow-up church member surveys ( n = 258). Three of six churches demonstrated significant improvements in all three socioenvironmental aspects of HE. Two of five churches exhibited significant socioenvironmental improvements for PA at follow-up. Church social environmental changes were related to health behaviors at church and in general ( p < .05). Change in social support for HE, social support for PA, and social norms for PA were each associated with three church-based and general behavioral outcomes. Social norms for healthy eating were related to two general behavior outcomes and social norms for unhealthy eating to one general behavioral outcome. Study findings demonstrate that socioenvironmental characteristics are essential to multilevel interventions and merit consideration in designing policy and environmental change interventions.
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Lemacks JL, James RE, Abbott L, Choi H, Parker A, Bryant A, Ralston PA, Rigsby AG, Gilner P. The Church Bridge Project: An Academic-Community Perspective of a Church-Based Weight Management Pilot Intervention among Young Adult African Americans. Prog Community Health Partnersh 2018; 12:23-34. [PMID: 29755046 PMCID: PMC6767920 DOI: 10.1353/cpr.2018.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Churches are effective community partners and settings to address weight management among African Americans. There is limited information on the use of churches to reach young adult populations and church collaborations with primary care clinics. OBJECTIVES The Church Bridge Project represents a community-academic partnership that presents the recruitment process of a church-based weight management intervention and describes baseline data of participants recruited from churches and primary care providers. We also discuss research contributions, challenges and limitations, study applicability, and practice implications from an academic and community perspective. METHODS Church leaders were involved in the entire research process. The theory-driven intervention included 12 diabetes prevention program-adapted education and motivational interviewing (MI)-guided sessions. Participants were recruited through primary care providers and church leaders. Demographics, medical and weight history, stage of change for weight loss, social support, and self-efficacy for diet and physical activity, weight, and girth circumferences were measured. Baseline descriptive data were analyzed. RESULTS Of 64 potential participants, 42 (65.6%) were enrolled in the study and 16 (25.0%) completed baseline data collection. No participants were recruited through primary care providers. Recruited participants were similar to the target population except for being all obese and mostly female. The mean ± SD age of participants was 34.31 ± 8.86 years with most reporting having more than a high school education (n = 14 [87.5%]), individual yearly income of less than $59,000 (n = 12 [75.0%]), and been married or living with a partner (n = 9 [56.3%]). Most reported a history of hypertension and an immediate family history of diabetes and hypertension. Most participants were classified as class III obesity. CONCLUSIONS Young adults and primary care providers are difficult to engage in church-based interventions. Church leaders were comfortable with a collaborate model for decision making, but not an empower model. Churches remain a successful method to reach African Americans; however, more research is needed to motivate young adults to participate in health intervention research.
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Story CR, Knutson D, Brown JB, Spears-Laniox E, Harvey IS, Gizlice Z, Whitt-Glover MC. Changes in social support over time in a faith-based physical activity intervention. HEALTH EDUCATION RESEARCH 2017; 32:513-523. [PMID: 29126170 PMCID: PMC5914453 DOI: 10.1093/her/cyx062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Chandra R Story
- Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Douglas Knutson
- Department of Psychology, Southern Illinois University at Carbondale, Carbondale, IL, USA
| | - Jameisha B Brown
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A & M University, College Station, TX, USA
| | - Erica Spears-Laniox
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A & M University, College Station, TX, USA
| | - Idethia Shevon Harvey
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A & M University, College Station, TX, USA
| | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Story CR, Gross TT, Harvey IS, Whitt-Glover MC. Pastoral perceptions of the learning and developing individual exercise skills (L.A.D.I.E.S.) intervention: a qualitative study. HEALTH EDUCATION RESEARCH 2017; 32:81-95. [PMID: 28052931 PMCID: PMC5914337 DOI: 10.1093/her/cyw054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/29/2016] [Indexed: 06/06/2023]
Abstract
African-American women experience higher rates of obesity compared to other racial/ethnic groups. High levels of reported church attendance among African-Americans have led to the proliferation of faith-based health programs. Pastors can influence success for faith-based programs. The purpose of this study was to assess pastors' perceptions of the L.A.D.I.E.S. intervention, designed to increase physical activity levels in sedentary African-American women. For the L.A.D.I.E.S. intervention, 31 churches (n = 418 women) were randomized at the church level to a faith-based, non-faith-based or self-guided program. All 31 pastors were invited by telephone to participate in the current study. Using a qualitative design, semi-structured interviews were conducted with 11 pastors from participating churches. Thematic analysis and the ecological model were used to examine the findings. According to the pastors, women showed heightened awareness of the importance of health and physical activity, and increased levels of fellowship. L.A.D.I.E.S. also encouraged healthy church climates and new health ministries. Lessons learned included the need for an expanded participant base and curriculum. Pastors expressed appreciation for the culturally fitting approach of L.A.D.I.E.S. Findings have implications for faith-based and public agency partnerships.
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Affiliation(s)
- Chandra R. Story
- School of Applied Health and Educational Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Tyra T. Gross
- Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
| | - Idethia S. Harvey
- Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, USA and
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The impact of home, work, and church environments on fat intake over time among rural residents: a longitudinal observational study. BMC Public Health 2016; 16:90. [PMID: 26825701 PMCID: PMC4731896 DOI: 10.1186/s12889-016-2764-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 01/21/2016] [Indexed: 11/24/2022] Open
Abstract
Background Dietary behaviors are influenced by many individual and environmental factors. This study explores how dietary fat intake in high-risk midlife adults living in the rural south is influenced by three behavior settings, i.e. in the home, at work, and at church. Methods Self-report data were collected from rural African American or Caucasian adults age 40–70 at three time points at baseline, 6, and 12 months post baseline. Multilevel analyses investigated the impact of determinants of fat intake over time. Results Home and work environments varied significantly over time in regard to healthy eating while church environments remained stable. Age, gender, and self-efficacy for healthy eating were individual factors associated with fat intake. In the home, presence of more high fat items, a time-varying variable, was significant. In the work environment, having access to healthy foods as well as healthy eating programs has positive impact as did hearing healthy eating messages and availability of healthy foods at church. Conclusions Understanding stability and variability of dietary fat intake from a social ecologic perspective will aid in identifying targets of change for intervention. Understanding which components of key behavior settings are dynamic and which are relatively stable will help to disentangle the complexity of multi-level determinants of dietary behavior.
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Psychosocial constructs were not mediators of intervention effects for dietary and physical activity outcomes in a church-based lifestyle intervention: Delta Body and Soul III. Public Health Nutr 2016; 19:2060-9. [PMID: 26797387 DOI: 10.1017/s1368980015003602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Evaluating an intervention's theoretical basis can inform design modifications to produce more effective interventions. Hence the present study's purpose was to determine if effects from a multicomponent lifestyle intervention were mediated by changes in the psychosocial constructs decisional balance, self-efficacy and social support. DESIGN Delta Body and Soul III, conducted from August 2011 to May 2012, was a 6-month, church-based, lifestyle intervention designed to improve diet quality and increase physical activity. Primary outcomes, diet quality and aerobic and strength/flexibility physical activity, as well as psychosocial constructs, were assessed via self-report, interviewer-administered surveys at baseline and post intervention. Mediation analyses were conducted using ordinary least squares (continuous outcomes) and maximum likelihood logistic (dichotomous outcomes) regression path analysis. SETTING Churches (five intervention and three control) were recruited from four counties in the Lower Mississippi Delta region of the USA. SUBJECTS Rural, Southern, primarily African-American adults (n 321). RESULTS Based upon results from the multiple mediation models, there was no evidence that treatment (intervention v. control) indirectly influenced changes in diet quality or physical activity through its effects on decisional balance, self-efficacy and social support. However, there was evidence for direct effects of social support for exercise on physical activity and of self-efficacy for sugar-sweetened beverages on diet quality. CONCLUSIONS Results do not support the hypothesis that the psychosocial constructs decisional balance, self-efficacy and social support were the theoretical mechanisms by which the Delta Body and Soul III intervention influenced changes in diet quality and physical activity.
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Jacob Arriola KR, Hermstad A, St. Clair Flemming S, Honeycutt S, Carvalho ML, Cherry ST, Davis T, Frazier S, Liang L, Escoffery C, Kegler MC. Promoting Policy and Environmental Change in Faith-Based Organizations. Health Promot Pract 2015; 17:146-55. [DOI: 10.1177/1524839915613027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
High rates of heart disease, cancer, and stroke exist in rural South Georgia where the Emory Prevention Research Center’s Cancer Prevention and Control Research Network provided mini-grant funding to six churches to implement policy and environmental change to promote healthy eating and physical activity. This study sought to determine whether perceptions of the health promotion environment changed over time and whether perceived environmental change was associated with healthy behavior at church and in general. This study used a single-group pre–post design with 1-year follow-up. Parishioners ( N = 258) completed self-administered questionnaires assessing perceptions of the church health promotion environment relative to healthy eating and physical activity, eating behavior and intention to use physical activity facilities at church, and eating and physical activity behaviors generally. Results indicate that perceived improvements in church nutrition environments were most strongly associated with decreases in unhealthy food consumed and stronger intentions to use physical activity resources at church ( ps ≤ .05). Perceived changes in the physical activity environment were unrelated to church or general behavior. Findings suggest that church environments may play an important role in supporting healthy eating and physical activity at church; however, whether the influence of the church environment extends to other settings is unknown.
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Harmon BE, Adams SA, Scott D, Gladman YS, Ezell B, Hebert JR. Dash of faith: a faith-based participatory research pilot study. JOURNAL OF RELIGION AND HEALTH 2014; 53:747-59. [PMID: 23224838 PMCID: PMC3773027 DOI: 10.1007/s10943-012-9664-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The Dash of Faith pilot used a community-based participatory research approach to design an experiential dietary intervention based on two African-American churches, one intervention and one comparison. Congregation members identified components that were incorporated into 12 weekly and 4 monthly sessions, with a goal of increasing fruit and vegetable and lowering fat intake. At 2 months, a marginally significant (p = 0.07) increase in fruit and vegetable consumption was observed in the intervention group but was not maintained at study conclusion. We propose that these mixed findings may be attributable, in part, to bias introduced by the participatory nature of the design.
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Affiliation(s)
- Brook E Harmon
- South Carolina Statewide Cancer Prevention and Control Program, Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Ste 200, Columbia, SC, 20208, USA,
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Harmon BE, Blake CE, Thrasher JF, Hébert JR. An evaluation of diet and physical activity messaging in African American churches. HEALTH EDUCATION & BEHAVIOR 2014; 41:216-24. [PMID: 24195841 PMCID: PMC3967747 DOI: 10.1177/1090198113507449] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of faith-based organizations as sites to deliver diet and physical activity interventions is increasing. Methods to assess the messaging environment within churches are limited. Our research aimed to develop and test an objective assessment methodology to characterize health messages, particularly those related to diet and physical activity, within a sample of African American churches. Written messages (bulletins, brochures, magazines) were systematically collected over 1 year and analyzed with a coding scheme that had high interrater reliability (average κ = .77). Within all health messages (n = 1109), diet and physical activity messages were prevalent (47% and 32%, respectively). Consistent with prior qualitative research, messages related to meals and to providing food to people in need were frequently found (54% and 25% of diet messages, respectively). Contrary to past research, sports and physical activity as praise (e.g., praise dancing) were the most prevalent physical activity messages (36% and 31% of physical activity messages, respectively). Bulletins, flyers, and brochures were the media in which diet and physical activity messages were most frequently found (14%, 33%, and 24%, respectively), and the church was the most frequent source (41%). Only diet and physical activity messages focused on disease prevention were more likely to originate from national health organizations than from the church (26% vs. 16%). Churches varied in the topics, media types, and sources of health messages, an important factor to consider when planning and implementing health promotion research. Future research should determine whether the enhancement of church messaging environments can produce behavioral change.
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Affiliation(s)
- Brook E. Harmon
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813
| | - Christine E. Blake
- University of South Carolina, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, 800 Sumter St, Room 216, Columbia, SC, United States 29208
| | - James F. Thrasher
- University of South Carolina, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, 800 Sumter St, Room 216, Columbia, SC, United States 29208
| | - James R. Hébert
- University of South Carolina, South Carolina Statewide Cancer Prevention and Control Program, Discovery I, Suite 200, Columbia, SC, United States 29208
- University of South Carolina, Department of Epidemiology and Biostatistics, Arnold School of Public Health, 800 Sumter St, Room 205, Columbia, SC, United States 29208
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Harmon BE, Blake CE, Armstead CA, Hébert JR. Intersection of identities: food, role, and the African-American pastor. Appetite 2013; 67:44-52. [PMID: 23538172 PMCID: PMC3758249 DOI: 10.1016/j.appet.2013.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 02/08/2013] [Accepted: 03/14/2013] [Indexed: 10/27/2022]
Abstract
African-American pastors can foster health-related innovations as gatekeepers and advocates within their churches. Personal experiences with food and health likely influence their support of such programs. Identities or meanings attached to societal roles have been shown to motivate individuals' attitudes and behaviors. Understanding role and eating identities of African-American pastors may have important implications for participation in faith-based health promotion programs. This study aimed to describe the eating and pastoral identities of African-American pastors, explore intersections between these identities, and highlight implications for nutrition programs. In-depth interviews with 30 African-American pastors were audio-recorded and transcribed verbatim. Data were analyzed using theory-guided and grounded-theory approaches. Pastors described affinity across one or more dimensions including healthy, picky, meat, and over-eater identities. In describing themselves as pastors, the dimensions pastor's heart, teacher, motivator, and role model emerged. Pastors who described themselves as healthy eaters were more likely to see themselves as role models. Pastors with healthier eating identities and more complex pastoral identities described greater support for health programming while unhealthy, picky, and over-eaters did not. These findings provide guidance for understanding eating and role identities among pastors and should be considered when designing and implementing faith-based programs.
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Affiliation(s)
- Brook E Harmon
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
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Ford CD. Building from within: pastoral insights into community resources and assets. Public Health Nurs 2013; 30:511-8. [PMID: 24579711 DOI: 10.1111/phn.12048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore perceptions of community pastors regarding the extent of community resources and assets in a rural, Southern, African American community. DESIGN AND SAMPLE Utilizing a qualitative, descriptive design, interviews were conducted with six African American pastors. MEASURES Interviews were conducted using a semi-structured interview guide based on an assets-oriented approach. RESULTS Pastors discussed various resources and assets, probable within the community that may be considered as support for program development. Key themes included: (1) community strengths, (2) community support, and (3) resources for a healthy lifestyle. The church was identified, throughout the interviews, as a primary source of strength and support for community members. CONCLUSIONS In this study of African American pastors, various perceptions of community resources were identified. Findings indicate that a sample, rural, Southern, African American community has a wealth of resources and assets, but additional resources related to health promotion are still necessary to produce optimal results. Specific programs to prevent chronic conditions such as cardiovascular disease can provide an effective means for addressing related health disparities. Programs implemented through churches can reach large numbers of individuals in the community and provide an important source of sustainable efforts to improve the health of African Americans.
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Baruth M, Wilcox S, Saunders RP, Hooker SP, Hussey JR, Blair SN. Perceived environmental church support and physical activity among Black church members. HEALTH EDUCATION & BEHAVIOR 2013; 40:712-20. [PMID: 23463792 DOI: 10.1177/1090198113477110] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Churches are an appealing setting for implementing health-related behavior change programs. PURPOSE The objective of the study was to examine the relationship between perceived environmental church support for physical activity (PA) and PA behaviors. METHOD Black church members from South Carolina (n = 309) wore an Actigraph accelerometer prior to the initiation of an intervention. Relationships between moderate to vigorous PA (MVPA; counts ≥1,952), light PA (LPA; counts 100-1951), sedentary behavior (counts <100), and perceived environmental church support for PA (total, spoken informational, written informational, instrumental) were examined. Support × Gender interactions examined whether relationships differed by gender. RESULTS The mean age was 54.0 ± 12.3 years and mean body mass index was 32.9 ± 7.2 kg/m(2). On average, participants engaged in 14.4 ± 13.7 minutes/day of MVPA, 289.8 ± 82.4 minutes/day of LPA, and were sedentary 548.9 ± 102.2 minutes/day. Total, spoken informational, and written informational church support were significantly related to higher levels of LPA and lower levels of sedentary behavior in men but not women. The relationship between written informational support and MVPA approached significance for men but not women. Instrumental church support was not associated with PA behaviors. CONCLUSION The church environment may have an important influence on Black church members' PA behavior, particularly men's, and thus should be targeted in interventions.
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