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Ware KS, Lee ASD, Rodriguez M, Williams CH. Perceptions to Overcoming Barriers to Prenatal Care in African American Women. Nurs Clin North Am 2024; 59:121-129. [PMID: 38272578 DOI: 10.1016/j.cnur.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Pregnancy-related deaths affect African American women at a rate four to five times higher than White women. These deaths occur during pregnancy or up to 1 year after childbirth. Inadequate or delayed prenatal care is a factor associated with poor maternal health outcomes in African American women. Identifying factors that pose as facilitators and barriers to prenatal care is essential in developing interventions aimed at improving maternal health outcomes.
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Affiliation(s)
- Katilya S Ware
- Auburn University College of Nursing, 710 South Donahue Drive, Auburn, AL 36849, USA.
| | - Amy S D Lee
- Capstone College of Nursing 3006, Box 870358, Tuscaloosa, AL 35487, USA
| | - Mayra Rodriguez
- Edward Via College of Osteopathic Medicine Auburn, 910 South Donahue Drive, Auburn, AL 36832, USA
| | - Courtney H Williams
- Auburn University College of Nursing, 710 South Donahue Drive, Auburn, AL 36832, USA
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Tadese K, Jenkins S, Aycock D, Jones C, Hayes SN, Burke LE, Cooper LA, Patten CA, Brewer LC. Factors Facilitating Academic-Community Research Partnerships With African American Churches: Recruitment Process for a Community-Based, Cluster Randomized Controlled Trial During the COVID-19 Pandemic. Health Promot Pract 2024; 25:8-12. [PMID: 36189723 DOI: 10.1177/15248399221118394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
African American (AA) churches are valuable partners in implementing health promotion programming (HPP) to combat health disparities. The study purpose was to evaluate AA church characteristics associated with enrollment into the FAITH! (Fostering African American Improvement in Total Health) Trial, a community-based, cluster randomized controlled trial (RCT) of a mobile health intervention for cardiovascular health promotion among AA churches. Churches located in Minneapolis-St. Paul and Rochester, Minnesota were invited to complete an electronic screening survey and follow-up telephone interview including the PREACH (Predicting Readiness to Engage African American Churches in Health) tool to assess church characteristics and infrastructure for HPP. The primary outcome was church enrollment in the FAITH! Trial. Key predictors included overall PREACH scores and its subscales (Personnel, Physical Structure, Faith-based Approach, Funding), congregation size, and mean congregation member age. Of the 26 churches screened, 16 (61.5%) enrolled in the trial. The enrolled churches had higher overall mean PREACH scores (36.1 vs. 30.2) and subscales for Personnel (8.8 vs. 5.6), Faith-based Approach (11.0 vs. 9.6), and Funding (7.3 vs. 4.8) compared with non-enrolled churches; all differences were not statistically significant due to small sample size. Twelve (75.0%) of the enrolled churches had >75 members versus six (60.0%) of the non-enrolled churches. Twelve (80.0%) of the enrolled churches had an average congregation member age ≤54 years versus six (67.0%) of the non-enrolled churches. AA churches enrolling into a community-based RCT reported greater infrastructure for HPP, larger congregations, and members of younger age. These characteristics may be helpful to consider among researchers partnering with AA churches for HPP studies.
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Affiliation(s)
| | - Sarah Jenkins
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | | | - Lisa A Cooper
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
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3
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Gandara E, Harvey IS, McKyer L, Luo W, Burdine J. Qualitative Inquiry of African American Female Church Leaders on Facilitators and Barriers of Conducting Adult Health Programs Within African American Churches: A Pilot Study Using a Socioecological Perspective Within the United States. JOURNAL OF RELIGION AND HEALTH 2023; 62:3430-3452. [PMID: 37314599 DOI: 10.1007/s10943-023-01852-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 06/15/2023]
Abstract
Despite the success of health programs conducted within African American (AA) churches, research has been limited in understanding the facilitators and barriers of conducting adult health programs in churches led by female AA pastors/leaders. In addition, research has yet to analyze the effect of policy on these church-based health programs. Thus, this pilot study's objective is to use the socio-ecological model (SEM) as a framework to explore female AA pastors' and church leaders' perspectives, in the U.S., on facilitators and barriers that exist when conducting adult health programs within their congregations. Using snowball sampling to recruit AA female church leaders and pastors (n = 6), semi-structured interviews were conducted with study participants. Data were then transcribed and analyzed using First and Second Cycle coding to identify themes. Nine themes emerged from the data, and after stratifying the themes according to the SEM, this study found that facilitators and barriers exist at the intrapersonal, organizational, community, and policy levels of the SEM. It is important for these factors to be considered to ensure that health programs led by AA women pastors/leaders are successful within AA churches. Study limitations and the need for further research are also noted.
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Affiliation(s)
- Eduardo Gandara
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA.
| | | | - Lisako McKyer
- Alice L. Walton School of Medicine, Bentonville, AR, USA
| | - Wen Luo
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Jim Burdine
- Department of Health Behavior, Texas A&M School of Public Health, College Station, TX, USA
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Torres VN, Fulton BR, Wong EC, Derose KP. Prevalence and Predictors of Substance Use Support Programming Among U.S. Religious Congregations. JOURNAL OF DRUG ISSUES 2023; 53:581-601. [PMID: 37799348 PMCID: PMC10552553 DOI: 10.1177/00220426221138479] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
We conducted a cross-sectional secondary analysis of data from the 2012 National Congregation Study, a nationally representative survey of religious congregations in the United States ( N = 1,331). Multivariate logistic regression was used to identify congregational characteristics associated with providing substance use support programing. Nearly one-third (38%) of U.S. congregations indicated that they provided substance use support programming; approximately half (52%) of all congregational attendees were in a congregation that provided some type of substance use support. The internal factors associated with a congregation providing substance use programming include having members who are unemployed and younger, being conservative Protestant, engaging in the practice of speaking in tongues, and having the resources to support social services. The analysis also identifies external factors (i.e., assessing community needs and hosting social service speakers) as being associated with a congregation’s likelihood of providing substance use programming. Findings identify factors associated with congregations providing substance use support.
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Affiliation(s)
- Vanessa N Torres
- RAND Corporation, Santa Monica, CA, USA
- Department of Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Brad R Fulton
- O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | | | - Kathryn P Derose
- RAND Corporation, Santa Monica, CA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
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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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Gandara E, Harvey IS, Foster M, Luo W, McKyer L, Burdine J, Martinez D. Facilitators and Barriers When Conducting Adult Health Programs Within the African American Church: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2022:10.1007/s10943-022-01532-6. [PMID: 35303242 DOI: 10.1007/s10943-022-01532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
Despite the success of health programs conducted within African American (AA) churches, research has been limited in understanding facilitators and barriers that exist when conducting adult health programs within AA churches. Thus, the objective of this study was to systematically review the literature to identify these facilitators and barriers. A comprehensive literature search was conducted and studies that met the eligibility criteria were divided based on their focus: disease topic or behavior, health promotion activities, or church readiness. Facilitators and barriers were also stratified using the socioecological model. Out of 288 articles initially identified, only 29 were included. Facilitators and barriers were predominantly found at the intrapersonal and organizational level for disease topic or behavior studies, and at the organizational level for studies focused on health promotion activities and church readiness. None of the articles identified facilitators and barriers at the policy level.
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Affiliation(s)
- Eduardo Gandara
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA.
- Psychiatry, Texas A&M University, College Station, TX, USA.
| | | | - Margaret Foster
- University Libraries, Texas A&M University, College Station, TX, USA
| | - Wen Luo
- Department of Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Lisako McKyer
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
| | - Jim Burdine
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
| | - Denise Martinez
- Center for Community Health Development, Texas A&M School of Public Health, College Station, TX, USA
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Vincent-Doe A, Sneed R, Jordan T, Key K, Bailey RS, Jefferson BB, Sanders RPE, Brewer A, Scott JB, Calvin K, Summers M, Farmer B, Johnson-Lawrence V. Exploring the Readiness of African-American Churches to Engage in a Community-Engaged Blood Pressure Reduction Research Study: Lessons Learned from the Church Challenge. JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP 2022; 14:10. [PMID: 35734421 PMCID: PMC9207767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction The Transtheoretical Model (TTM) has been used to assess individual readiness for health behavior change. We describe our use of the TTM to assess organizational readiness of African-American churches to participate in the Church Challenge (CC) in Flint, Michigan; the processes of change that moved churches toward readiness for change; and lessons learned. Methods The CC was a faith-based, multilevel intervention to reduce chronic disease risk. A community-based participatory approach was used to engage and recruit churches. We used the TTM to capture church readiness for change and track church progress through the five stages. Results We engaged with 70 churches: 35 remained in Stage 1 (precontemplation), 10 remained in Stage 2 (contemplation), 3 remained in Stage 3 (preparation), 5 made it to Stage 4 (action), and 17 finished within Stage 5 (maintenance). Churches engaged in several processes of change as they moved through the various stages of change. Lessons Learned Utilizing processes of change, establishing rapport, and having previous participants share success stories helped move churches from stage-to-stage. However, certain barriers prevented progression, such as burnout/trauma from the Flint Water Crisis and scheduling conflicts. Discussion Faith-based organizational readiness greatly impacted participation in the CC. Researchers should utilize established social capital, build rapport, and remain flexible when working with African-American churches. Conclusion Although traditionally used at the individual level, the TTM works well at the organizational level to assess and monitor church readiness to participate in community-engaged research and health programming to improve health in an African-American faith community.
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Affiliation(s)
| | - Rodlescia Sneed
- Division of Public Health, Michigan State University, Flint, MI
| | - Tamara Jordan
- Division of Public Health, Michigan State University, Flint, MI
| | - Kent Key
- Division of Public Health, Michigan State University, Flint, MI,Community Based Organization Partners, Flint, MI
| | - Rev. Sarah Bailey
- Bridges to the Future, Flint, MI,Community Based Organization Partners, Flint, MI
| | | | | | - Allysoon Brewer
- Division of Public Health, Michigan State University, Flint, MI
| | - Jamil B. Scott
- Division of Public Health, Michigan State University, Flint, MI,National Human Genome Research Institute, National Institute of Health
| | - Kahlil Calvin
- Division of Public Health, Michigan State University, Flint, MI
| | - Monicia Summers
- Division of Public Health, Michigan State University, Flint, MI
| | - Bridget Farmer
- Division of Public Health, Michigan State University, Flint, MI
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Maxwell AE, Vargas C, Santifer R, Chang LC, Crespi CM, Lucas-Wright A. Facilitators and Challenges to Health Promotion in Black and Latino Churches. J Racial Ethn Health Disparities 2022; 9:59-67. [PMID: 33230738 PMCID: PMC8141063 DOI: 10.1007/s40615-020-00929-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Churches are important assets for the African American and Latino communities. They can play a critical role in health promotion, especially in areas that are under-resourced and in which residents have limited access to health care. A better understanding of health promotion in churches is needed to support and maintain church collaborations and health initiatives that are integrated, data-driven, and culturally appropriate. The purpose of this study is to identify churches' facilitators and challenges to health promotion and to contrast and compare Black and Latino churches of different sizes (< 200 members versus > 200 members). METHODS We interviewed leaders of 100 Black and 42 Latino churches in South Los Angeles to assess their history of wellness activities, resources, facilitators, and challenges to conduct health promotion activities. RESULTS Eighty-three percent of African American and 86% of Latino church leaders reported at least one health activity in the last 12 months. Black and Latino churches of different sizes have similar interests in implementing specific health promotion strategies and face similar challenges. However, we found significant differences in the composition of their congregations, number of paid staff, and the proportions of churches that have a health or wellness ministry and that implement specific wellness strategies. Fifty-seven percent of African American and 43% of Latino church leaders stated that they needed both financial support and professional expertise for health promotion. DISCUSSION Our findings highlight the importance of conducting a readiness assessment for identifying intervention content and strategies that fit the intervention context of a church.
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Affiliation(s)
- Annette E Maxwell
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Claudia Vargas
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Rhonda Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - L Cindy Chang
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Catherine M Crespi
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Allen JD, Shelton RC, Kephart L, Jandorf L, Folta SC, Knott CL. Organizational characteristics conducive to the implementation of health programs among Latino churches. Implement Sci Commun 2020; 1:62. [PMID: 32885217 PMCID: PMC7427941 DOI: 10.1186/s43058-020-00052-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/18/2020] [Indexed: 01/16/2023] Open
Abstract
Background Faith-based organizations (FBOs) can be effective partners in the implementation of health interventions to reach underserved audiences. However, little is known about the capacity they have or need to engage in these efforts. We examined inner-setting organizational characteristics hypothesized to be important for program implementation by the Consolidated Framework for Implementation Research (CFIR). Methods This cross-sectional study involved 34 churches with predominantly Latino congregations in Massachusetts. FBO leaders completed a survey assessing inner-setting CFIR organizational characteristics, including organizational readiness, implementation climate, organizational culture, and innovation “fit” with organizational mission. Results There was limited variability in CFIR organizational characteristics, with scores on a scale from 1 to 5 skewed toward higher values, ranging from 3.27 (SD 0.94) for implementation climate to 4.58 (SD 0.54). Twenty-one percent of the FBOs had offered health programs in the prior year. Conclusions FBOs had high scores on most of the organizational factors hypothesized to be important for the implementation of health programs, although relatively few FBOs offered them. While this suggests that FBOs have favorable characteristics for health programming, prospective studies are needed to understand relative salience of inner-setting organizational characteristics versus factors external to the organization (e.g., policies, incentives), as well as the potential direction of relationships between internal organizational characteristics and health program offerings. Trial registration Clinical trials identifier number NCT01740219 (clinicaltrials.gov)
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Affiliation(s)
- Jennifer D Allen
- Department of Community Health, Tufts University, 574 Boston Avenue, Medford, MA 02155 USA
| | - Rachel C Shelton
- Department of Socio-medical Sciences, Columbia University Mailman School of Public Health, New York, NY 10032 USA
| | - Lindsay Kephart
- Massachusetts Department of Public Health, 250 Washington Street, Boston, MA 02108 USA
| | - Lina Jandorf
- Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029 USA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave., Boston, MA 02111 USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 1234 W SPH Building, College Park, MD 20742 USA
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