Partnerships between the faith-based and medical sectors: Implications for preventive medicine and public health

Partnerships Between Faith Communities and the Mental Health Sector: A Scoping Review

OBJECTIVE

Faith communities are increasingly providing services to address the mental health needs of their congregations and communities. However, many feel limited in their capacity to address serious illness and experience challenges to collaborating with the mental health sector. To inform the development of faith community-mental health sector partnerships, the authors conducted a scoping review to assess the characteristics and evidence base of partnership approaches to addressing mental health needs.

METHODS

A search of four databases identified peer-reviewed articles published between 2010 and 2023 on faith community-mental health sector partnerships in the United States.

RESULTS

In total, 37 articles representing 32 unique partnerships were reviewed. Most partnerships (N=19) used multicomponent approaches, particularly involving training the faith community (N=18), mental health education for the broader community (N=14), and direct counseling (N=11). Many partnerships (N=14) focused on African American communities. Partnerships that included an evaluation component (N=20) showed promising findings for improving mental health symptoms, mental health literacy, stigma, and referrals, among other outcomes. Several articles reported facilitators (e.g., support from faith leaders and reciprocal relationships and equal power) and barriers (e.g., limited time and funding and differing interests and attitudes) to developing partnerships.

CONCLUSIONS

The findings highlight how faith communities can be a critical partner in providing services across the continuum of mental health care and reveal the need for more rigorous evaluations of the effectiveness, feasibility, and sustainability of these partnerships. The results also identify strategies that may facilitate the development and strengthening of future faith community-mental health partnerships.

Neighborhood-level social determinants of health and cardioprotective behaviors among church members in New Orleans, Louisiana

BACKGROUND

Favorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana.

METHODS

Participants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data). Logistic regression models were used to assess the relation of neighborhood factors with the likelihood of engaging in cardioprotective behaviors: 1) a composite of healthy lifestyle behaviors [fruit and vegetable consumption, physical activity, and a tobacco/nicotine-free lifestyle], 2) medication adherence, and 3) receipt of routine medical care within the past year.

RESULTS

Participants (n = 302, mean age: 63 years, 77% female, 99% Black) were recruited from 12 churches in New Orleans. After adjusting for demographic and clinical factors, perceived neighborhood walkability or conduciveness to exercise (odds ratio [OR]=1.25; 95% CI: 1.03, 1.53), availability of fruits and vegetables (OR=1.23; 95% CI: 1.07, 1.42), and social cohesion (OR=1.55; 95% CI: 1.22, 1.97) were positively associated with the composite of healthy lifestyle behaviors. After multivariable adjustment, SDI was in the direction of association with all three cardioprotective behavior outcomes, but associations were not statistically significant.

CONCLUSIONS

In this predominantly Black, church-based population, neighborhood-level SDoH including the availability of fruits and vegetables, walkability or conduciveness to exercise, and social cohesion were associated with cardioprotective behaviors. Findings reiterate the need to address adverse neighborhood-level SDoH in the design and implementation of health interventions.

Public health partnerships with faith-based organizations to support vaccination uptake among minoritized communities: A scoping review

Faith-based vaccine initiatives are of growing interest to public health agencies who are looking to increase vaccine confidence among ethnoracially minoritized populations. Despite evidence that support faith-based organizations' (FBOs) partnerships with public health agencies (PHAs) to increase vaccine confidence, reviews on the scope and efforts to ensure equitable vaccination delivery for ethnoracially minoritized populations are scarce. We aimed to understand how public health agencies collaborate with FBOs or faith communities to improve vaccine confidence among minoritized communities in high-, low- and middle- income countries. We conducted a scoping review by searching OVID MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, and PROQUEST from 2011 to 2023. We included case studies, news reports, observational studies, experimental, and quasi-experimental studies and multimedia content that describes PHA-FBO partnerships that created vaccine initiatives for marginalized and minoritized communities. The data was extracted, summarized, and results were described narratively. We included 167 initiatives reported in 160 publications; 83.8% of the included articles were published between 2019 to 2023. The interventions carried out by PHA-FBO partnerships attempted to increase vaccine uptake using any or all the following methods. First, the initiatives provided digital and in-person platforms for interfaith learning and established training programs to empower faith leaders to become vaccine ambassadors. Second, the initiatives designed and disseminated education and awareness materials that aimed to be sensitive to religious and gender norms. Third, PHA-FBO partnered to apply equity and faith-based frameworks and provided wrap-around support to enable equitable vaccine access. Majority of the initiatives reported that PHA-FBO partnerships improved vaccine confidence and uptake (71.3%). About 22.2% of the initiatives reported quantitative outcomes post-intervention. PHA-FBO initiatives over the past decade increased vaccine uptake and acceptance among diverse ethnoracially minoritized populations. Reporting of faith-based initiatives are subject to publication bias and can be strengthened by examining more evaluation studies and establishment of key outcome indicators to critically appraise intervention outcomes.

Spirituality As A Determinant Of Health: Emerging Policies, Practices, And Systems

Reimagining public health's future should include explicitly considering spirituality as a social determinant of health that is linked to human goods and is deeply valued by people and their communities. Spirituality includes a sense of ultimate meaning, purpose, transcendence, and connectedness. With that end in mind, we assessed how recommendations recently issued by an expert panel for integrating spiritual factors into public health and medicine are being adopted in current practice in the United States. These recommendations emerged from a systematic review of empirical evidence on spirituality, serious illness, and population health published between 2000 and 2022. For each recommendation, we reviewed current federal, state, and local policies and practices recognizing spiritual factors, and we considered the ways in which they reflected the panel's recommendations. In this article, we highlight opportunities for broader application and scale while also noting the potential harms and benefits associated with incorporating these recommendations in various contexts. This analysis, while respecting the spiritual and religious diversity of the US population, identifies promising approaches for strengthening US public health by integrating spiritual considerations to inform person- and community-centered policy and practice.

Lessons Learned about Developing Faith and Public Health Partnerships to Address Health Disparities

Partnerships between public health and faith-based organizations draw on the strengths of both sectors to achieve a shared interest in promoting health and reducing disparities. However, information about implementation of faith and public health partnerships-particularly those involving diverse racial-ethnic groups-is limited. This paper reports on findings from qualitative interviews conducted with 16 public health and congregational leaders around the country as part of the early phase of the development of a faith and public health partnership to address health disparities in Los Angeles, CA. We identified eight themes regarding the barriers and facilitators to building faith and public health partnerships and distilled these into 10 lessons for developing such approaches. These interviews identified that engaging religious organizations often requires building congregational capacity of the congregation to participate in health programs; and that trust is a critically important element of these relationships. Further, trust is closely related to how well each organization involved in the partnership understands their partners' belief structures, approaches to addressing health and well-being and capacities to contribute to the partnership. Tailoring congregational health programs to match the interests, needs and capacity of partners was identified as an important approach to ensuring that the partnership is successful. But, this is complicated by working across multiple faith traditions and the racial-ethnic backgrounds, thus requiring increased and diverse communication strategies on the part of the partnership leadership. These lessons provide important information for faith and public health leaders interested in developing partnered approaches to address health in diverse urban communities.

Moral controversies and academic public health: Notes on navigating and surviving academic freedom challenges

Schools of public health often serve both as public health advocacy organizations and as academic units within a university. These two roles, however, can sometimes come into conflict. I experienced this conflict directly at the Harvard T. H. Chan School of Public Health in holding and expressing unpopular minority viewpoints on certain moral controversies. In this essay I describe my experiences and their relation to questions of academic freedom, population health promotion, and efforts at working together across differing moral systems.

Systematic review and meta-analysis of church-based interventions to improve cardiovascular disease risk factors

BACKGROUND

Church-based interventions have been shown to reduce cardiovascular disease (CVD) risk factors and could reduce health disparities in groups with a high burden of CVD. We aim to conduct a systematic review and meta-analysis to determine the effectiveness of church-based interventions for CVD risk factor improvement and to examine the types of interventions that are effective.

METHODS

Systematic searches of MEDLINE, Embase, and manual reference searches were conducted through November 2021. Study inclusion criteria were church-based interventions delivered in the United States to address CVD risk factors. Interventions targeted barriers to improving blood pressure, weight, diabetes, physical activity, cholesterol, diet, or smoking. Two investigators independently extracted study data. Random effects meta-analyses were conducted.

RESULTS

A total of 81 studies with 17,275 participants were included. The most common interventions included increasing physical activity (n = 69), improving diet (n = 67), stress management (n = 20), medication adherence (n = 9), and smoking cessation (n = 7). Commonly used approaches for implementation included cultural tailoring of the intervention, health coaching, group education sessions, inclusion of spiritual components in the intervention, and home health monitoring. Church-based interventions were associated with significant reductions in body weight (-3.1 lb, [95% CI, -5.8, -1.2], N = 15), waist circumference (-0.8 in, [CI, -1.4, -0.1], N = 6), and systolic blood pressure (-2.3 mm Hg, [CI, -4.3, -0.3], N = 13).

CONCLUSIONS

Church-based interventions targeting CVD risk factors are effective for reducing CVD risk factors, particularly in populations with health disparities. These findings can be used to design future church-based studies and programs to improve cardiovascular health.

Viewpoint diversity in public health

Schools of public health are often situated within universities but not infrequently also function as public health advocacy organizations. Viewpoint diversity on many issues is often limited within schools of public health and does not reflect the diversity one finds in society more generally. It is argued that welcoming, and even seeking out, viewpoint diversity within public health would contribute to understanding and knowledge, to the training public health leaders and academics who can serve the whole of society, and to working together across ideological lines to better contribute to population health.

Religious Beliefs Shaping Health Care and Transforming Health Concepts: The Case of Shanghai

This study examines the connection between health and religious beliefs in modern Chinese society and builds a model reimagining the conception of health. The study draws on interviews with 108 patients (52 were women and 56 were men) at Huashan Hospital (Shanghai City, China). The survey ran between May 10 and May 14, 2021. More than 50% of female and male respondents reported having religious beliefs. Most acknowledged the crucial role of faith and religious beliefs in overcoming treatment challenges and alleviating patient suffering. The role of faith and religious beliefs in physical/mental treatment and health maintenance received the highest average percent positive score among female respondents. According to the multiple regression results of demographic parameters (age, ethnicity, gender, education, and urban or rural residence), only gender had a statistically significant effect on the impact of religious beliefs on health care attitudes. The proposed model builds on the Confucian concept of Ren (humanity), which refers to a harmonious relationship between people within a family or society bound by specific rules. The results of this study can help expand awareness about religion and its role in healthcare as a means to support patients' spiritual and physical health.

"The First Person They Call is Their Pastor": The Role of New York City Faith Leaders in Supporting Their Congregation's Health and Well-Being During COVID-19

This article reports findings from a qualitative study of New York City faith leaders' efforts to mitigate the effects of the COVID-19 pandemic on their communities during the first two years of the pandemic. Faith leaders were recruited via reputational case sampling to participate in individual, key informant interviews. This study used a social-contextual approach to health promotion by exploring the influence of faith leaders and religious communities on health behaviors. Results suggest that engaged faith leaders worked individually and collaboratively to support the changing physical, emotional, and spiritual needs of their religious communities and those in the surrounding area. This study highlights the importance of faith leaders as supporters, communicators, and advocates, and provides directions for future research on the impact of faith leaders on individuals' experiences and health behaviors during a pandemic.

A glimmer of hope: My reflections on global health efforts in Haiti

Many factors impact access to care and global health equity, which can be transformed by nursing. When healthcare infrastructure is suboptimal, nursing's role expands exponentially. In this reflection, I share my experiences accessing healthcare as a child in a low-resource community and highlight nursing activities to improve global health equity. Nurses can facilitate change by becoming active in communities, humanitarian organizations, policymaking, and advocacy.

Influence of neighborhood-level social determinants of health on a heart-healthy lifestyle among Black church members: A mixed-methods study

Background

Few church-based health interventions have evaluated the influence of neighborhood-level social determinants of health (SDOH) on adopting heart-healthy lifestyles; none has occurred in Louisiana. We aimed to characterize neighborhood-level SDOH that may influence the ability to adopt a heart-healthy lifestyle among Black community church members in New Orleans, LA.

Methods

This mixed methods study used quantitative data (surveys) and qualitative data (focus groups) to explore SDOH at the neighborhood- and church-area- level, including factors related to the physical (e.g., walkability, accessibility to recreational facilities) and social (e.g., social cohesion, perceived safety) environments. Descriptive analyses were conducted for quantitative data. Qualitative data were coded and analyzed using grounded theory and thematic analysis.

Results

Among survey respondents (n = 302, 77 % female, 99 % Black), most reported having walkable neighborhood sidewalks and high neighborhood social cohesion. Two-thirds did not feel violence was a problem in their neighborhood and felt safe walking, day, or night. Focus group participants (n = 27, 74 % female, 100 % Black) reported facilitators to heart-healthy living, including social support promoting physical activity, intentionality in growing, buying, and preparing produce, and the neighborhood-built environment. Reported barriers included: crime, the COVID-19 pandemic, individual-level factors limiting physical activity, and city-wide disparities influencing health. Participants discussed strategies to promote healthy living, centered around the theme of establishing and rebuilding community relationships.

Conclusions

Future health interventions aimed at improving cardiovascular outcomes among church communities should continue to inquire about neighborhood-level SDOH and tailor interventions, as appropriate, to address barriers and leverage facilitators within these communities.

Taking a Shot: The Impact of Information Frames and Channels on Vaccination Willingness in a Pandemic

The reluctance of people to receive safe and recommended available vaccines is a well-documented public health challenge. As information and communication technologies evolve, this challenge gets more complex and even harder to manage during complex public health situations. In this experimental study, we examine the relationship between vaccine information frames (with scientific information vs. without scientific information) and channels (through government vs. religious organizations) and vaccination willingness in the U.S. in the context of a pandemic. Additionally, we evaluate the interaction between vaccine skepticism, vaccine information frames, and vaccine information channels on vaccination willingness. This experimental study uses data from Amazon Mechanical Turk (MTURK) to evaluate the relationships between vaccine skepticism, vaccine information frames, and channels on vaccination willingness. We find that contrary to our hypothesis, a vaccine advisory framed with scientific information decreases people's vaccination willingness compared to one framed without scientific information. Additionally, the impact of framing on vaccination willingness is conditioned on participants' skepticism-participants who hold skepticism toward the vaccine but received information framed with scientific information score significantly higher in vaccination willingness compared to participants who do not hold skepticism toward a vaccine. The results suggest that the factors impacting vaccination willingness are complex and nuanced. Thus, policymakers should be more strategic with the delivery of vaccination information, especially during complex health crises.

Cardiovascular health promotion: A systematic review involving effectiveness of faith-based institutions in facilitating maintenance of normal blood pressure

Globally, faith institutions have a range of beneficial social utility, but a lack of understanding remains regarding their role in cardiovascular health promotion, particularly for hypertension. Our objective was assessment of modalities, mechanisms and effectiveness of hypertension health promotion and education delivered through faith institutions. A result-based convergent mixed methods review was conducted with 24 databases including MEDLINE, Embase and grey literature sources searched on 30 March 2021, results independently screened by three researchers, and data extracted based on behaviour change theories. Quality assessment tools were selected by study design, from Cochrane risk of bias, ROBINS I and E, and The Joanna Briggs Institute's Qualitative Assessment and Review Instrument tools. Twenty-four publications contributed data. Faith institution roles include cardiovascular health/disease teaching with direct lifestyle linking, and teaching/ encouragement of personal psychological control. Also included were facilitation of: exercise/physical activity as part of normal lifestyle, nutrition change for cardiovascular health, cardiovascular health measurements, and opportunistic blood pressure checks. These demand relationships of trust with local leadership, contextualisation to local sociocultural realities, volitional participation but prior consent by faith / community leaders. Limited evidence for effectiveness: significant mean SBP reduction of 2.98 mmHg (95%CI -4.39 to -1.57), non-significant mean DBP increase of 0.14 mmHg (95%CI -2.74 to +3.01) three months after interventions; and significant mean SBP reduction of 0.65 mmHg (95%CI -0.91 to -0.39), non-significant mean DBP reduction of 0.53 mmHg (95%CI -1.86 to 0.80) twelve months after interventions. Body weight, waist circumference and multiple outcomes beneficially reduced for cardiovascular health: significant mean weight reduction 0.83kg (95% CI -1.19 to -0.46), and non-significant mean waist circumference reduction 1.48cm (95% CI -3.96 to +1.00). In addressing the global hypertension epidemic the cardiovascular health promotion roles of faith institutions probably hold unrealised potential. Deliberate cultural awareness, intervention contextualisation, immersive involvement of faith leaders and alignment with religious practice characterise their deployment as healthcare assets.

Promoting Health Literacy About Cancer Screening Among Muslim Immigrants in Canada: Perspectives of Imams on the Role They Can Play in Community

Purpose: Immigrants tend to have lower rates of cancer screening than non-immigrants in Canada. Inequity in screening rates may stem from religious factors, which religious leaders can influence. This study aimed to explore the knowledge and attitudes held by Muslim religious leaders about cancer screening, as well as the role religious leaders perceive they can play in improving cancer screening health literacy among South Asian Muslim immigrant women. Methods: We conducted interviews with 8 Muslim religious leaders in Calgary, Canada. Participants’ knowledge and attitudes were inductively summarized using descriptive analysis, while practices were deductively thematically analyzed using the Socioecological Model and the Communication for Development approaches. Results: We found participants mostly had some knowledge of cancer, but lesser knowledge of different screening tests and of low screening rates among immigrants. Participants proposed that their role as a speaker, access to facilities and community networks, and collaboration with universities and healthcare professionals could help overcome religious misinterpretations and promote cancer screening among South Asian Muslim immigrant women. Conclusion: Religious leaders were highly supportive of incorporating health messaging into faith-based messaging. Future work should focus on implementing the practices recommended in this study with South Asian Muslim immigrant women’s voices at their center.

Awareness, knowledge and screening for cervical cancer among women of a faith-based organization in Nigeria

Introduction

cervical cancer is the second most frequent cancer among women in Nigeria. With proper screening, the disease can be detected early enough and properly managed. However, there seems to be limited knowledge of cervical cancer among women and several barriers might prevent them from accessing the screening services. We determined the awareness, knowledge and screening for cervical cancer among women of a faith-based organization in Nigeria.

Methods

we employed descriptive survey research design and purposively sampled a Catholic Parish in Nsukka Local Government Area of Enugu State, Nigeria. All consenting women in the Parish were used for the study. We utilized researchers' structured instrument titled ‘Awareness and knowledge about Cervical Cancer and Screening’ to collect data. Frequencies, percentages and logistic regression were employed for data analysis.

Results

awareness of cervical cancer (70.8%) and its screening (68.1%) are high but there is generally poor level of knowledge (65.3%) of different aspects of cervical cancer among the women. Age (aOR: 7.183, 95% CI 1.769-29.168; p=.006), number of children (aOR: .074, 95% CI .009- .631; p=.017), and occupation (aOR: .032, 95% CI .004-.260; p= .001 and aOR: .050, 95% CI .007-.347; p=.002) were significantly associated with knowledge of cervical cancer. Majority of the women studied had never been screened for cervical cancer (91.7%) and the reasons for not screening ranged from lack of knowledge of; where to go for screening (69.7%) and the importance of being screened (40.9%) to not feeling susceptible to cervical cancer (18.2%).

Conclusion

there was generally poor knowledge of cervical cancer and its screening; and very poor screening practice. There is, therefore, an urgent need to improve women´s knowledge of cervical cancer and address the identified barriers in order to improve screening practices of the women.

Sustaining Successful Clinical-community Partnerships in Medically Underserved Urban Areas: A Qualitative Case Study

Clinical-community partnerships can improve access and receipt of preventive health services in community settings. Understanding how to sustain their potential benefits is warranted. Qualitative case-study of the Faith Community Health Partnership (FCHP), a collaboration between faith-community nurses and community organizations sustained over 25 years. We used content analysis principles to report on partnership sustainability themes identified through semi-structured interviews with FCHP partners (n = 18). Factors supporting partnership sustainability: Maintaining partners' commitment over time; strategic resource-sharing; facilitating engagement; and preserving partnership flexibility. Sustaining clinical-community partnerships is a dynamic and continuous process requiring significant time, effort, and resources on behalf of partners.

Examining the external validity of the CRUZA study, a randomized trial to promote implementation of evidence-based cancer control programs by faith-based organizations

The CRUZA trial tested the efficacy of an organizational-level intervention to increase capacity among Catholic parishes to implement evidence-based interventions (EBIs) for cancer control. This paper examines the external generalizability of the CRUZA study findings by comparing characteristics of parishes that agreed to participate in the intervention trial versus those that declined participation. Sixty-five Roman Catholic parishes that offered Spanish-language mass in Massachusetts were invited to complete a four-part survey assessing organization-level characteristics that, based on the Consolidated Framework for Implementation Research (CFIR), may be associated with EBI implementation. Forty-nine parishes (75%) completed the survey and were invited to participate in the CRUZA trial, which randomized parishes to either a "capacity enhancement intervention" or a "standard dissemination" group. Of these 49 parishes, 31 (63%) agreed to participate in the trial, whereas 18 parishes (37%) declined participation. Parishes that participated in the CRUZA intervention trial were similar to those that did not participate with respect to "inner organizational setting" characteristics of the CFIR, including innovation and values fit, implementation climate, and organizational culture. Change commitment, a submeasure of organizational readiness that reflects the shared resolve of organizational members to implement an innovation, was significantly higher among the participating parishes (mean = 3.93, SD = 1.08) as compared to nonparticipating parishes (mean = 3.27, SD = 1.08) (Z = -2.16, p = .03). Parishes that agreed to participate in the CRUZA intervention trial were similar to those that declined participation with regard to organizational characteristics that may predict implementation of EBIs. Pragmatic tools to assess external generalizability in community-based implementation trials and to promote readiness among faith-based organizations to implement EBIs are needed to enhance the reach and impact of public health research. Clinical Trial information: The CRUZA trial identifier number with clinicaltrials.gov is NCT01740219.

COVID-19 Amongst the Ultra-Orthodox Population in Israel: An Inside Look into the Causes of the High Morbidity Rates

The current paper focuses on the circumstances that have led to the high COVID-19 infection rates amongst the ultra-Orthodox population in Israel. The current study utilizes a qualitative design and is based on in-depth interviews, email correspondence and online records of 25 ultra-Orthodox individuals who either tested positive for COVID-19 or had contact with a verified COVID-19 patient. The data were analyzed through identification of main themes and an interpretation of their meanings. The findings showed that a wide range of causes led to the high infection rate, including aspects that derive from a structural element, a religious element and a social-ideological element—all of which are directly or indirectly connected to religion. These findings demonstrate the central role of religion in health outcomes among the ultra-Orthodox community in general and during pandemics in particular, and they shed light on the central role of religion in health outcomes among closed-religious communities. The findings further reveal the importance of cooperation between the state authorities and the religious ones, and of providing culturally adapted health service solutions in the fight against COVID-19 and promoting health more generally. Study limitations are discussed and recommendations for future research are provided.

Global health diplomacy: Provision of specialist medical services in the Republic of Botswana

Global Health Diplomacy (GHD) can be defined as the convergence between public health and international affairs. The following case report demonstrates the impact of "brain drain" on provision of specialist medical services in Botswana, a middle-income country in Southern Africa and how GHD is being used to address the challenge. Botswana's priorities include the attainment of Sustainable Development Goals (SDGs) by 2030 which are embedded within the Ministry of Health and Wellness (MOHW) strategy. MOHW strategies include access to health services, reduction in the cost of referral of specialist services, and strengthening primary health care (PHC), which is the vehicle for attaining Universal Health Coverage (UHC). Botswana has, in the past tried to bridge this gap through strategic partnerships with private institutions and bilateral treaties with other states such as the Republic of Cuba and the People's Republic of China. In the private sector, the Ministry has partnered with Indus Medical Group, and a range of private medical institutions both in-country and outside the country. However, challenges experienced with previous partnerships were that the objectives were more service-driven than capacity building, which proved to be unsustainable. The case report outlines the negotiation process between the Government of Botswana represented by MOHW, and St. Paul Medical Missions, a religion-based NGO from Egypt. It demonstrated the importance of all actors and countries being clear on their health priorities at the start of negotiations. GHD is a relatively new concept that can be explored by countries in forming durable partnerships.

Expanding Implementation Research to Prevent Chronic Diseases in Community Settings

Chronic disease prevention continues to be inadequate, overall and in achieving health equity, in spite of the many evidence-based practices and policies (EBPPs) available to address risk behaviors such as unhealthful eating, lack of physical activity, and tobacco use. Although clinical settings are needed for EBPPs that involve medical procedures such as immunization or early detection, dissemination of EBPPs can be effective in a variety of settings such as schools and childcare centers, worksites, social service organizations, and religious organizations. More implementation research is needed to meet challenges of effective application of EBPPs in such community settings, in which primary missions, capacity, cultures, and values do not focus on health services delivery. To address health equity, consideration of social and economic contexts of people reached in these settings is essential. This review presents lessons learned from past studies to guide future implementation research and practice across diverse settings and geographies.

Continuing cancer care in a religious facility: A feasible alternative in the COVID-19 Pandemic Era?

The advent of the COVID-19 pandemic has stretched most healthcare systems to the point that if no adaptations are made, failure will most likely happen. The Philippine healthcare system, with its meager resources, is very much vulnerable to this. During the start of the pandemic, Bataan General Hospital and Medical Center has been converted to a COVID-19 hub, leaving cancer care and treatment displaced. We describe our experience in the feasibility of using a religious facility as an interim place for continuing oncology treatment. An outpatient chemotherapy unit was set up using the main hall of the Residencia Sacerdotal, a religious facility, in Bataan. General practices for infection control, workflow and service delivery were in accordance with existing guidelines. A total of 56 adult patients and 22 pediatric patients were seen for chemotherapy during the period of April 28 to July 15, 2020. A total of 144 chemotherapy sessions for adults and 190 sessions for pediatric patients were done. Fifty nine patients (43 adults and 16 pediatric) were tested for COVID-19 RT PCR (GeneXpert®), as baseline prior to chemotherapy, and all were negative. During the course of treatment, adverse events were noted including infusion reactions, hematologic complications which resolved without any complications. No nosocomial infection was recorded both for patients and healthcare workers. To conclude, in the COVID-19 Pandemic Era adapting to the situation is the best way forward. In our setting, continuing cancer care in a religious facility is a feasible alternative.

Older Adults' Perceptions of a Church-Based Social Marketing Initiative to Prevent Falls Through Balance and Strength Classes

Despite evidence that balance and strength training and other multicomponent exercise classes reduce the risk and rate of falls and fall-related injuries, few older adults participate. To increase uptake of balance- and strength-based fall-prevention classes, we designed and implemented a social marketing program, delivered through churches. Diverse stakeholders in this social marketing initiative included class participants, instructors, church leaders and members, and public health and recreation partners. We used interpretive description to explore perceptions of the social marketing messages and the barriers and facilitators older church members encountered to balance-class enrollment and adherence. The results were three practical, clinically relevant thematic summaries of older adults' experience. The marketing initiative succeeded in helping older adults hear about the classes, decide whether classes fit their lifestyle and needs, and continue attendance.

The Faith Community and the SARS-CoV-2 Outbreak: Part of the Problem or Part of the Solution?

The current outbreak of the SARS-CoV-2 virus is a critical moment in time for institutional religion in the USA and throughout the world. Individual clergy and congregations, across faith traditions, have been sources of misinformation and disinformation, promoting messages and actions that engender fear, animosity toward others, and unnecessary risk-taking. But there is a positive role for religion and faith-based institutions here, and many examples of leaders and organizations stepping up to contribute to the collective recovery. Personal faith and spirituality may be a source of host resistance and resilience. Religiously sponsored medical care institutions are vital to health care response efforts. Ministries and faith-based organizations are source of religious health assets that can help to meet community-wide needs. There is a pastoral role for clergy and laypeople who are instrumental in providing comfort and strength to the suffering and fearful in our midst. The outbreak presents an ethical challenge to all of us to step outside of our own preoccupations and to be present and of service for others. This includes having the courage to represent the highest values of our faith in speaking out against religiously motivated foolishness and hatred and in calling for political and public health leaders to be truthful and transparent in their messages to us.

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

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.

An interfaith dialogue with Sir William Osler: crossing the divide of COVID-19 pandemic

With the recent COVID-19 pandemic and George Floyd protests, the USA (US) has become extensively polarized across social and political divides. The COVID-19 pandemic has left tens of thousands dead and several million American citizens without work. Furthermore, the months of quarantine and uncertainty with the COVID-19 virus impacted the economic stability and health of Americans. In recent weeks, the divides have only deepened with the death of George Floyd from police brutality, which ushered in worldwide protests addressing racial, social, and law enforcement issues for minority groups. Both developments have ushered in unprecedented challenges for addressing social disparities while controlling the spread and devastation of the COVID-19 pandemic. With social media and mass communication, polarization between opposing groups has only deepened the divide. An inclusive dialogue that recognizes the intellectual and interpersonal boundaries of opposing groups would provide an avenue towards mutual understanding and further collaboration towards a common goal and solution. A physician that exemplified many aspects interfaith dialogue in his clinical practice and personal life was the late Sir William Osler. This will be accomplished through a fictional dialogue between Sir William Osler and Dr. Mark Webb.

Engaging young African American women breast cancer survivors: A novel storytelling approach to identify patient-centred research priorities

Background

Patient‐centredness is considered an essential aspiration of a high‐quality health‐care system, and patient engagement is a critical precursor to patient‐centred care.

Objectives

To engage patients, health‐care providers and stakeholders in identifying recommendations to address research and practice gaps that impact young African American breast cancer survivors.

Methods

This paper reported an approach for research priority setting. This approach applies an engagement process (January‐September 2018) of using patient and stakeholder groups, patient storytelling workshops and a culminating storytelling conference in Wisconsin to generate relevant research topics and recommendations. Topics were prioritized using an iterative engagement process. Research priorities and recommendation were ranked over the conference by counting participants’ anonymous votes.

Results

One hundred attendees (43 patients/family members, 20 providers/researchers and 37 community members) participated in the conference. Five topics were identified as priorities. The results showed that three priority areas received the most votes, specifically community outreach and education, providing affordable health care and engaging in complementary care practice. Stakeholders also agreed it is critical to ‘include youth in the conversation’ when planning for cancer support and educational programmes for caregivers, friends and family members.

Conclusion

Storytelling as a patient engagement approach can build trust in the patient‐research partnership, ensure that patients are meaningfully engaged throughout the process and capture the diversity of patient experiences and perspectives.

Role of religion, spirituality, and faith in assisted reproduction

Purpose: The purpose of this study is to evaluate the impact of the patient's faith, religion, and spirituality on the outcomes of intracytoplasmic sperm injection (ICSI) cycles. Materials and methods: Eight hundred and seventy-seven patients received a questionnaire containing information on faith, religiosity, and spirituality and the results of the questionnaires were correlated with ICSI outcomes. Patients stated to be Catholic (n = 476), spiritists (n = 93), Evangelical (n = 118), and other religion (n = 32), and 78 did not identify with any religious group. Results: A significant increase in fertilization, high-quality embryos, and pregnancy rate was found among Spiritists and Evangelicals. Patients who included the infertility diagnosis and treatment in their prayers showed an increased pregnancy rate, and those who reported their faith to be affected by the infertility diagnosis presented a decreased high-quality embryos rate. The high-quality embryos rate was increased among patients who answered that their faith contributed to their decision to undergo infertility treatment. The cycle's cancelation was negatively correlated with the frequency of religious meetings, and the frequency of prayers was positively correlated with the response to ovarian stimulation. Finally, belief in treatment success positively influenced the embryo quality. Conclusion: The findings suggest that spirituality plays a role in adjusting the psychological aspects of an infertile patient.

The religion variable in community health promotion and illness prevention

Religion is a source of beliefs and practices, which can in turn influence health behaviors. Therefore, religious communities represent potential public health partners to improve well-being across economic and ethnic diversity. This issue of the Journal of Prevention & Intervention in the Community presents six empirical studies with a breadth of methodologies, and a range of subjects. The associations of religion with cancer fatalism, prenatal substance abuse, bereavement, suicide prevention, clergy mental health and attitudes toward the Affordable Care Act are reported here. These research findings support the key importance of community. Like community, religion is complex. This issue's studies demonstrate the need to include ethnicity in analyses as well as the necessity to measure both religious belief and practice. Consistently, religious community participation predicted more positive outcomes than one's level of belief.

An Examination of Denomination-Level Efforts in Congregation Health Programming

Large denominational faith-based organizations (FBOs, e.g., conferences, dioceses) have potential to impact population health, though current activities are largely unknown. This study examined how large denominational FBOs approach health promotion programming and relevant barriers and issues related to capacity. A self-report survey via email and mail collected responses from representatives of FBOs about their health programming. The sample (n = 154) was diverse and included Catholic, Presbyterian, and Lutheran traditions. The most common activities were inclusion of health-related topics at organizational events and the provision of educational resources. Working with FBOs at a macro-level has potential implications for population-level health improvements.

An on-site health home for homeless men in addiction recovery

Patients with comorbid substance abuse, mental health disorders, and chronic health conditions face difficult challenges when attempting to access health care. A large gospel rescue mission developed an onsite wellness center, based on an integrated, embedded practice health home model, to promote health care access among homeless men in addiction recovery. The center model integrated primary care with behavioral health, specialty care referrals, and wellness services to address the multifaceted needs of the population. Standardized health care performance measures and resident and staff feedback support the effectiveness of the model in promoting improved health care access and treatment adherence. Future directions for program expansion include infrastructure development, expanded community outreach, and evaluation of effectiveness of the onsite health home through systematic program evaluation and research.

What Is Faith-Based Health Promotion? A Working Definition

Faith-based health promotion (FBHP) is a concept utilized across multiple disciplines, including nursing, public health, government, social work, and medicine. This article presents a hybrid concept analysis of FBHP and construction of a working definition for further investigative study. Defining FBHP is especially valuable for faith community nurses (FCNs), public health nurses, and other healthcare professionals who seek to study and offer FBHP. The relationship and application of FBHP to FCN practice is explored.

Religion and Health: exploration of attitudes and health perceptions of faith healing users in urban Ghana

BACKGROUND

The main aim of the study was to explore the attitudes and health perceptions of faith healing users in Kumasi Metropolis, Ghana. This has become necessary because faith healing practice is an important area but remains neglected in the health care literature. In an age when biowestern medicine is touted as the cure for most diseases, understanding how and why individuals seek alternative treatment, specifically faith healing modalities may help to develop more effective health care interventions.

METHODS

We employed exploratory study design of purely qualitative research approach involving 40 conveniently selected participants from four different purposively selected faith healing centres to get a maximum variation of experiences and opinions on the time of consultation, perceived effectiveness and challenges of faith healing practices in Ghana. In-depth interviews were conducted from 10th June to 30th July, 2017. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.

RESULTS

The main findings were that faith healers served as the first port of call for disease curing and prevention for most users. Consumers of faith healing perceived their health status to be good due to the perceived effectiveness of faith healing for curing of health problems. However, users faced challenges such as stigmatisation and victimisation in seeking health care.

CONCLUSION

This study has provided the first baseline evidence in this important area of inquiry that has been neglected in the scholarly discourse in Ghana. By implication, users' positive attitudes and perceptions toward faith healing call for integration policies that allow formal medical services to have open idea to faith healing practices in Ghana.

The discourse on faith and medicine: a tale of two literatures

Research and writing at the intersection of faith and medicine by now include thousands of published studies, review articles, books, chapters, and essays. Yet this emerging field has been described, from within, as disheveled on account of imprecision and lack of careful attention to conceptual and theoretical concerns. An important source of confusion is the fact that scholarship in this field constitutes two distinct literatures, or rather meta-literatures, which can be termed (a) faith as a problematic for medicine and (b) medicine as a problematic for faith. These categories represent distinct theoretical lenses for viewing the intersection of faith and medicine. Observations about these two approaches are offered, along with insights about why the discourse on faith and medicine should become better integrated into discussions of religion and science.

Religious Communities and Human Flourishing

Participation in religious services is associated with numerous aspects of human flourishing, including happiness and life satisfaction, mental and physical health, meaning and purpose, character and virtue, and close social relationships. Evidence for the effects of religious communities on these flourishing outcomes now comes from rigorous longitudinal study designs with extensive confounding control. The associations with flourishing are much stronger for communal religious participation than for spiritual-religious identity or for private practices. While the social support is an important mechanism relating religion to health, this only explains a small portion of the associations. Numerous other mechanisms appear to be operative as well. It may be the confluence of the religious values and practices, reinforced by social ties and norms, that give religious communities their powerful effects on so many aspects of human flourishing.

Faith-Based Institutions as Venues for Obesity Prevention

PURPOSE OF REVIEW

The aim of this current narrative review is to critique the scope and value of recent studies with a focus on obesity-related health promotion in faith organizations.

RECENT FINDINGS

Electronic database searches, scanning of the reference lists of identified articles, and hand searching of journals for articles written in English and published in 2013-2016 revealed 16 studies. Half of the studies involved African-Americans, in churches and with predominantly female participants. Research among other ethnic groups was more likely to be exploratory. All of the 11 studies reporting the impact of programmes on weight-related measures showed favourable outcomes. However, due to study limitations (small sample size, short duration, attrition), significant unbiased effects cannot yet be concluded for most of the interventions reviewed. Study strengths included application of theory in community engagement and detailed description of cultural tailoring. Faith organizations show promise as settings for obesity prevention among high-risk groups, particularly African-Americans. Support for progressing formative work to adequately powered, randomized controlled trials is vital. Wider involvement of diverse faith settings and targeting obesity in men and childhood would be valuable developments.

"For They Knew Not What It Was": Rethinking the Tacit Narrative History of Religion and Health Research

Over the past couple of decades, research on religion and health has grown into a thriving field. Misperceptions about the history and scope of this field, however, continue to exist, especially among new investigators and commentators on this research. Contrary to the tacit narrative, published research and writing date to the nineteenth century, programmatic research to the 1950s, and NIH funding to 1990; elite medical journals have embraced this topic for over 100 years; study populations are religiously and sociodemographically diverse; and published findings are mostly positive, consistent with psychosocial theories of health and confirmed by comprehensive reviews and expert panels.