Engaging Faith-Based Organizations to Promote Health Through Health Ministries in Washington, DC

A Virtual Cardiometabolic Health Program Among African Immigrants in the US: A Pilot Cluster-Randomized Clinical Trial

Importance

Black persons, including immigrants, in the US disparately experience poor cardiometabolic health (CMH). Limited research on the effect of lifestyle interventions that improve CMH among African immigrant populations is available.

Objective

To test the effectiveness of a culturally adapted, virtual lifestyle intervention on control of blood pressure (BP) and hemoglobin A1c (HbA1c) levels among African immigrants with CMH risk factors.

Design, Setting, and Participants

Afro-DPP (Diabetes Prevention Program), a pilot cluster-randomized clinical trial, evaluated the effectiveness of a multicomponent CMH intervention. The study took place in 2 churches with predominantly African immigrant congregations in the Baltimore-Washington, DC, metropolitan area from January 1, 2022, to July 31, 2023. Participants were adults aged 25 to 75 years with at least 2 CMH risk factors who self-identified as African immigrants and belonged to the participating churches. Analyses followed the intention-to-treat principle.

Intervention

Participants received a 6-month culturally adapted lifestyle intervention based on the National DPP curriculum, delivered via virtual group sessions by a lifestyle coach of African origin. The delayed intervention began 6 months later with a follow-up time of 6 months. The intervention also included remote BP and weight monitoring.

Main Outcome and Measures

Primary outcomes were changes in systolic and diastolic BP and HbA1c levels from baseline to 6 months. Secondary outcomes included reduced body weight and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared).

Results

The analytic population included 60 participants (mean [SD] age, 50.6 [11.9] years; 40 [66.7%] women). In the first intervention group (n = 30), systolic BP decreased by 9.2 (95% CI, 2.5-15.9) mm Hg, diastolic BP by 6.1 (95% CI, 2.1-10.0) mm Hg, body weight by 4.9 (95% CI, 1.0-8.7) kg, and BMI by 1.1 (95% CI, 0.4-1.7) at 6 months. In the delayed intervention group (n = 30), systolic BP decreased by 11.4 (95% CI, 2.4-20.5) mm Hg, diastolic BP by 10.3 (95% CI, 5.4-15.2) mm Hg, and body weight by 3.3 (95% CI, 0.01-6.5) kg, while BMI increased by 0.3 (95% CI, -1.5 to 2.0).

Conclusions and Relevance

Trial findings indicate that interventions incorporating cultural adaptation and virtual components could help address CMH disparities in this population.

Trial Registration

ClincalTrials.gov Identifier NCT05144737.

Exploring Faith Leaders' Experiences in Supporting Individuals with Mental Health Challenges in Ottawa, Canada

Faith leaders are often called upon to provide mental health support to their congregants, yet there is limited research on how these leaders experience this aspect of their role. The objective of this study is to understand the experiences of faith leaders who are sought by individuals for mental health support. We report on the findings from a qualitative study based on interviews with faith leaders of different denominations in Ottawa, Canada. The results indicate that faith leaders are asked to provide support for a wide - but not comprehensive - range of mental health issues; that faith leaders experience various challenges in managing role boundaries; and that these leaders believe that training not only in mental health issues, but also on subjects of liability and self-care to maintain their own wellness would be valuable. We address implications for research and practice.

Community Engagement in Behavioral Medicine: A Scoping Review

BACKGROUND

Behavioral medicine has made key contributions toward improving health outcomes. Engaging community partners in research is critical to addressing persistent health inequities. The aim of this scoping review was to explore how researchers engaged community partners within the field of behavioral medicine research from 2005 to 2023.

METHOD

Publication databases and gray literature were searched for research that engaged community partners to address questions relevant to behavioral medicine. Articles were screened by title and abstract, and then by full text. Articles meeting the inclusion criteria were coded using the framework provided by the Engagement Navigator to identify engagement approaches, methods, and tools and when they were used during the research.

RESULTS

Of 1486 articles initially identified, 58 met the inclusion criteria. Most articles used well-known approaches (e.g., community-based participatory research; 67%), methods (e.g., advisory committees; 59%), and tools (e.g., interviews; 41%), and engaged with healthcare service providers (62%) and/or patients (53%). Community partners were most often included in research planning and design (79%), and less often in dissemination (45%).

CONCLUSION

Community engagement has considerable potential to address health inequities. Our assessment of the approaches, methods, and tools used by behavioral medicine researchers to engage with a diverse range of community partners points toward promising strategies for enhancing the impact of community engagement. Researchers should incorporate explicit descriptions of community engagement strategies in publications, an outcome that could be facilitated by clear publishing guidelines, structured reporting tools, and clear messaging from funders about the value of community engagement in behavioral medicine research.

Reflection on Ramadan Fasting Research Related to Sustainable Development Goal 3 (Good Health and Well-Being): A Bibliometric Analysis

There is a large body of research on Ramadan intermittent fasting (RIF) and health in Muslim communities, that can offer insights to promote the achievement of Sustainable Development Goal 3 (SDG 3), which encompasses good health and well-being. Based on recent bibliometric evidence, we hypothesized that RIF research is highly relevant to SDG 3, particularly Targets 3.1, 3.2, 3.4, and 3.5. Therefore, this bibliometric study quantified RIF literature supporting SDG 3 and associated targets over the past seven decades and explored themes and trends. All types of research articles were extracted from the Scopus database from inception to March 2022. Microsoft Excel, Biblioshiny, and VOSviewer were used to qualitatively and quantitatively examine RIF research trends supporting SDG 3 and associated targets. We identified 1729 relevant articles. The number of publications notably increased since 1986, with a dramatic increase in 2019-2020. RIF research predominantly supported Target 3.4 (reducing risk for non-communicable diseases), with research hotspots being diabetes, diabetes medications, pregnancy, physiology, metabolic diseases, and obesity and metabolism. This target was also the most commonly supported by dedicated authors and institutions publishing on RIF, whereas other SDG 3 targets were negligibly addressed in comparison. Our comprehensive bibliometric analysis of RIF literature showed growing support for SDG 3 through positive contributions to half of the SDG 3 targets, although Target 3.4 received the most attention. We also identified knowledge gaps that may shape further research directions on RIF and promote the achievement of SDG 3 in Muslim communities.

Informing the UK Muslim Community on Organ Donation: Evaluating the Effect of a National Public Health Programme by Health Professionals and Faith Leaders

There is a significant shortage of transplantable organs in the UK particularly from Black, Asian and Minority Ethnic (BAME) groups, of which Muslims make a large proportion. The British Islamic Medical Association (BIMA) held a nationwide series of community gatherings with the aim of describing the beliefs and attitudes to organ donation amongst British Muslims and evaluate the efficacy of a national public health programme on views and uncertainties regarding religious permissibility and willingness to register. Eight public forums were held across the UK between June 2019 and March 2020 by the British Islamic Medical Association (BIMA). A panel of experts consisting of health professionals and Imams discussed with audiences the procedures, experiences and Islamic ethico-legal rulings on organ donation. Attendees completed a self-administered questionnaire which captured demographic data along with opinions before and after the session regarding religious permissibility and willingness to register given permissibility. A total of 554 respondents across seven UK cities were included with a M:F ratio 1:1.1. Only 45 (8%) respondents were registered as organ donors. Amongst those not registered multiple justifications were detailed, foremost of which was religious uncertainty (73%). Pre-intervention results indicated 50% of respondents were unsure of the permissibility of organ donation in Islam. Of those initially unsure or against permissibility or willingness to register, 72% changed their opinion towards deeming it permissible and 60% towards a willingness to register indicating a significant change in opinion (p < 0.001). The effectiveness of our interventions suggests further education incorporating faith leaders alongside local healthcare professionals to address religious and cultural concerns can reduce uncertainty whilst improving organ donation rates among the Muslim community.