1
|
Kwarteng JL, White K, Nevels D, Brown S, Stolley MR. Equipping Faith-Based Communities for Cancer Support Ministry: A Pilot Study of Cancer Support Training for Members of African-American Churches in the USA. JOURNAL OF RELIGION AND HEALTH 2024; 63:1523-1537. [PMID: 38453721 DOI: 10.1007/s10943-024-02013-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/09/2024]
Abstract
Church-academic partnerships focused on cancer, generally target cancer screening and prevention, with few focusing explicitly on cancer survivors. With the population of cancer survivors steadily increasing, highlighting the value of faith-based cancer support ministry is paramount. However, many churches may not have the resources to integrate relevant cancer support ministry and may need to identify ways to reach cancer survivors. We piloted cancer support training to help church members to start a cancer support ministry with African-American churches in Milwaukee, WI. We sought to measure the feasibility of a two-day training workshop to build the capacity of churches through recruiting and training church members on how to foster social support and to disseminate cancer information and resources throughout their churches. Our study was guided by the social networks and social support framework, which we applied to cancer survivorship. Our study supports the feasibility of engaging churches in a virtual training to support the development of cancer support ministries to address the needs of African-American cancer survivors. Based on our recruitment success, workshop attendance, evaluation and retention, our results suggest that a two-day workshop was successful in facilitating the initiation of cancer support ministries within African-American churches.
Collapse
Affiliation(s)
- Jamila L Kwarteng
- Division of Community Health, Institute for Health and Equity, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
- Cancer Center, Medical College of Wisconsin, Milwaukee, USA.
| | - Karen White
- Breast Cancer Support Ministry, United4theCause, San Bernardino, USA
| | - Debra Nevels
- Cancer Center, Medical College of Wisconsin, Milwaukee, USA
| | - Sharon Brown
- Cancer Center, Medical College of Wisconsin, Milwaukee, USA
| | - Melinda R Stolley
- Cancer Center, Medical College of Wisconsin, Milwaukee, USA
- Department of Medicine, Division of Hematology and Oncology, Milwaukee, USA
| |
Collapse
|
2
|
Luquis RR, Rodriguez-Colon SM, Ramirez SI, Lengerich EJ. Assessing the Feasibility of a Faith-Based Colorectal Cancer Education and Screening Intervention for Latino Men in Pennsylvania. HISPANIC HEALTH CARE INTERNATIONAL 2023:15404153231214714. [PMID: 37964548 DOI: 10.1177/15404153231214714] [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: 11/16/2023]
Abstract
Introduction: Limited health knowledge, literacy, engagement in preventive health services, participation in health promotion behaviors, and cultural factors place Latino men at high risk for colorectal cancer (CRC). This pilot study aimed to determine the feasibility and acceptability of a faith-based cancer education intervention focusing on Latino men between 45 and 74 years old. Methods: This pilot study used a single group pre- and post-intervention research design to compare changes in knowledge, perceived benefit of screening, perceived susceptibility and severity of CRC, and the completion of CRC screening after the intervention. Results: In this study, Latino men were willing to participate in a CRC educational intervention supported by a faith-based institution. The participants had limited knowledge about CRC, yet most recognized that screening is beneficial and that getting CRC is serious. Sixty percent of the participants completed the fecal immunochemical screening test, which showed that the intervention impacted the screening uptake among this group. Conclusion: The findings of this study support the further development of faith-based interventions focusing on Latino men.
Collapse
Affiliation(s)
- Raffy R Luquis
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, PA, USA
| | | | - Sarah Ines Ramirez
- Department of Family and Community Medicine, College of Medicine, Penn State University, Hershey, PA, USA
| | - Eugene J Lengerich
- Penn State Cancer Institute, Penn State University, Hershey, PA, USA
- Department of Family and Community Medicine, College of Medicine, Penn State University, Hershey, PA, USA
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| |
Collapse
|
3
|
Knott CL, Miech EJ, Woodard N, Huq M. The role of organizational capacity in intervention efficacy in a church-based cancer education program: A configurational analysis. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2023; 3:284-294. [PMID: 38107832 PMCID: PMC10723821 DOI: 10.1007/s43477-023-00089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/29/2023] [Indexed: 12/19/2023]
Abstract
It is well-established in the field of implementation science that the context in which an intervention is delivered can play a crucial role in how well it is implemented. However, less is known about how organizational context or capacity relates to efficacy outcomes, particularly with health promotion interventions delivered outside of healthcare settings. The present study examined whether organizational capacity indicators were linked to key efficacy outcomes in an evidence-based cancer control intervention delivered in 13 African American churches in Maryland. Outcomes included increases in colorectal cancer knowledge and self-report colonoscopy screening behavior from baseline to follow-up. We used Coincidence Analysis to identify features of organizational capacity that uniquely distinguished churches with varying levels of cancer knowledge and screening. Indicators of organizational capacity (e.g., congregation size, prior health promotion experience) were from an existing measure of church organizational capacity for health promotion. A single solution pathway accounted for greater increases in colorectal cancer knowledge over 12 months, a combination of two conditions: conducting 3 or more health promotion activities in the prior 2 years together with not receiving any technical assistance from outside partners in the prior 2 years. A single condition accounted for greater increases in colonoscopy screening over 24 months: churches that had conducted health promotion activities in 1-4 different topical areas in the prior 2 years. Findings highlight aspects of organizational capacity (e.g., prior experience in health promotion) that may facilitate intervention efficacy and can help practitioners identify organizational settings most promising for intervention impact.
Collapse
Affiliation(s)
- Cheryl L. Knott
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| | - Edward J. Miech
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Nathaniel Woodard
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| | - Maisha Huq
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| |
Collapse
|
4
|
Julian McFarlane S, Occa A, Peng W, Awonuga O, Morgan SE. Community-Based Participatory Research (CBPR) to Enhance Participation of Racial/Ethnic Minorities in Clinical Trials: A 10-Year Systematic Review. HEALTH COMMUNICATION 2022; 37:1075-1092. [PMID: 34420460 DOI: 10.1080/10410236.2021.1943978] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There has not been a significant improvement in the rate of clinical trial accrual in more than 20 years. Worse, the challenge of inadequate representation among racial and ethnic minorities also persists, deepening disparities in health. Community-Based Participatory Research (CBPR) is a participatory communication method that centers on effective dialogue between researchers and community stakeholders with the goal of creating an equitable partnership for health and social change. The objective of the current study was to provide an update since a systematic review in 2012, on the current status of the empirical research, with a particular focus on the elements of CBPR methods used to improve the rate of accrual of members of racial and ethnic minority communities for clinical trials. Our systematic review found a large increase in the number of CBPR related studies and studies related to racial and ethnic representation in research. More than 85% of studies employing CBPR methods saw statistically positive outcomes. Specifically, the elements of CBPR that are associated with these positive outcomes include community partner participation in (1) a study advisory committee, (2) data collection, (3) the development of interventions, and (4) participant recruitment. However, the results of our study indicate that researchers need to be more transparent about the extent of community participation as well as more thoroughly and accurately describe the nature of the partnership with members of minority communities in order to build upon the scientific literature on community-engaged methods.
Collapse
Affiliation(s)
| | - Aurora Occa
- Department of Communication, University of Kentucky
| | - Wei Peng
- Murrow College of Communication, Washington State University
| | | | | |
Collapse
|
5
|
Knott CL, Miech EJ, Slade J, Woodard N, Robinson-Shaneman BJ, Huq M. Evaluation of organizational capacity in the implementation of a church-based cancer education program. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:22-33. [PMID: 35392361 PMCID: PMC8983006 DOI: 10.1007/s43477-021-00033-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Implementation evaluations have increasingly taken into account how features of local context help determine implementation outcomes. The purpose of this study was to determine which contextual features of organizational capacity led directly to the RE-AIM Framework implementation outcomes of intervention reach and number of days taken to implement, in an implementation trial of a series of cancer education workshops conducted across 13 African American churches in Maryland. We used a configurational approach with Coincidence Analysis to identify specific features of organizational capacity that uniquely distinguished churches with implementation success from those that were less successful. Aspects of organizational capacity (e.g., congregation size, staffing/volunteers, health ministry experience) were drawn from an existing measure of church organizational capacity for health promotion. Solution pathways leading to higher intervention reach included: having a health ministry in place for 1-4 years; or having fewer than 100 members; or mid-size churches that had conducted health promotion activities in 1-4 different topics in the past 2 years. Solution pathways to implementing the intervention in fewer number of days included: having conducted 1-2 health promotion activities in the past 2 years; or having 1-5 part-time staff and a pastor without additional outside employment; or churches with a doctorally prepared pastor and a weekly attendance of 101-249 members. Study findings can inform future theory, research, and practice in implementation of evidence-based health promotion interventions delivered in faith-based and other limited-resource community settings. Findings support the important role of organizational capacity in implementation outcomes in these settings.
Collapse
Affiliation(s)
- Cheryl L. Knott
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA.,Corresponding author: Cheryl L. Knott, PhD, University of Maryland School of Public Health, 1234W School of Public Health Building, College Park, MD 20742. Phone: 301-405-6659; Fax: 301-314-9167; ; Twitter: ChampUMD; Tumblr: champlabumd
| | - Edward J. Miech
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Jimmie Slade
- Community Ministry of Prince George’s County, PO Box 250, Upper Marlboro, MD 20773, USA
| | - Nathaniel Woodard
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| | | | - Maisha Huq
- University of Maryland School of Public Health, Department of Behavioral and Community Health, 1234 School of Public Health Building, College Park, MD, 20742, USA
| |
Collapse
|
6
|
Measuring capacity to use evidence-based interventions in community-based organizations: A comprehensive, scoping review. J Clin Transl Sci 2022; 6:e92. [PMID: 36003212 PMCID: PMC9389281 DOI: 10.1017/cts.2022.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction: Community-based organizations (CBOs) are well-positioned to incorporate research evidence, local expertise, and contextual factors to address health inequities. However, insufficient capacity limits use of evidence-based interventions (EBIs) in these settings. Capacity-building implementation strategies are popular, but a lack of standard models and validated measures hinders progress in the field. To advance the literature, we conducted a comprehensive scoping review. Methods: With a reference librarian, we executed a comprehensive search strategy of PubMed/Medline, Web of Science Core Collection, and EBSCO Global Health. We included articles that addressed implementation science, capacity-building, and CBOs. Of 5527 articles, 99 met our inclusion criteria, and we extracted data using a double-coding process Results: Of the 99 articles, 47% defined capacity explicitly, 31% defined it indirectly, and 21% did not define it. Common concepts in definitions were skills, knowledge/expertise, and resources. Of the 57 articles with quantitative analysis, 48 (82%) measured capacity, and 11 (23%) offered psychometric data for the capacity measures. Of the 99 studies, 40% focused exclusively on populations experiencing inequities and 22% included those populations to some extent. The bulk of the studies came from high-income countries. Conclusions: Implementation scientists should 1) be explicit about models and definitions of capacity and strategies for building capacity, 2) specify expected multi-level implementation outcomes, 3) develop and use validated measures for quantitative work, and 4) integrate equity considerations into the conceptualization and measurement of capacity-building efforts. With these refinements, we can ensure that the necessary supports reach CBO practitioners and critical partners for addressing health inequities.
Collapse
|
7
|
Allen JD, Shelton RC, Kephart L, Tom LS, Leyva B, Ospino H, Cuevas AG. Examining the external validity of the CRUZA study, a randomized trial to promote implementation of evidence-based cancer control programs by faith-based organizations. Transl Behav Med 2021; 10:213-222. [PMID: 30496532 DOI: 10.1093/tbm/iby099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
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.
Collapse
Affiliation(s)
| | | | | | - Laura S Tom
- Community Health, Tufts University, Medford, MA
| | - Bryan Leyva
- Community Health, Tufts University, Medford, MA
| | | | | |
Collapse
|
8
|
Woodard N, Williams RM, Fryer CS, Wang MQ, Zhang J, Knott CL. Correlates of Health Promotion in a Community Sample of African American Churches. J Community Health 2021; 45:828-835. [PMID: 32107711 DOI: 10.1007/s10900-020-00799-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Though many African American churches offer health promotion activities to their members, less is known about organizational factors that predict the availability of this programming. This study examines organizational capacity as a predictor of the amount and type of health programming offered by a convenience sample of 119 African American churches. Leaders completed a survey of health promotion activities provided in the previous 12 months and a measure of organizational capacity. Churches offered an average of 6.08 (SD = 2.15) different health programs targeting 4.66 (SD = 3.63) topics. Allocation of space and having a health ministry were positively associated with both the number of health programs and health topics addressed. When seeking to initiate health programming in an African American church setting, it is recommended that stakeholders partner with churches that have existing structures to support health promotion such as a health ministry, or help them build this capacity.
Collapse
Affiliation(s)
- Nathaniel Woodard
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA.
| | - Randi M Williams
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Craig S Fryer
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Jing Zhang
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2242 Valley Dr, College Park, MD, 20742, USA
| |
Collapse
|
9
|
Understanding Health Priorities, Behaviors, and Service Utilization Among Brazilian Immigrant Women: Implications for Designing Community-Based Interventions. J Racial Ethn Health Disparities 2021; 9:135-145. [PMID: 33403650 PMCID: PMC7785287 DOI: 10.1007/s40615-020-00936-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 12/28/2022]
Abstract
Brazilians represent a growing proportion of immigrants in the USA. Little is known about their health or healthcare utilization after their arrival. This study aimed to gather formative data to understand the needs of Brazilian immigrant women to guide public health interventions. We conducted five focus groups with Brazilian women born in Brazil (n = 47) and 13 key informant interviews with representatives from Brazilian-serving organizations. Participants were recruited from churches and social service organizations in the Greater Boston area. Findings revealed that mental health was the most pressing health priority; many attributed high levels of anxiety and depression to worries about undocumented status, separation from social networks, and strenuous work schedules. Occupational health issues were frequently mentioned, including musculoskeletal complaints, skin rashes, and respiratory problems. Domestic violence was also a concern, and many women feared reporting to police due to undocumented status. Most reported good access to medical care and described the quality of healthcare services as superior to that available in Brazil. However, many reported challenges with interpersonal communication with providers, dissatisfaction with a perceived unwillingness from providers to order medical tests or prescribe treatment, and limited access to mental health services. There was agreement that effective intervention strategies should use social media, radio, and group education in churches.
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
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)
Collapse
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
| |
Collapse
|
12
|
Ramanadhan S, Aronstein D, Martinez-Dominguez V, Xuan Z, Viswanath K. Designing Capacity-Building Supports to Promote Evidence-Based Programs in Community-Based Organizations Working with Underserved Populations. Prog Community Health Partnersh 2020; 14:149-160. [PMID: 33416638 PMCID: PMC11017196 DOI: 10.1353/cpr.2020.0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND It is critical to build capacity to use evidence-based health promotion programs in community-based organizations (CBOs), particularly those working with underserved populations. Packages of ongoing capacity-building supports seem to be critical, but it is not clear how best to design and deploy them. OBJECTIVES PLANET MassCONECT was a participatory research project to increase capacity for the use of evidence-based programs (EBPs) among CBO staff members in three Massachusetts communities experiencing health disparities. We assessed the impact of trainee engagement with capacity-building supports on the use of a systematic approach to program planning. METHODS Trainees were enrolled from 2010 to 2012 and engaged until 2014. The intervention started with a workshop and included ongoing capacity-building supports (a customized web portal and resources, networking events, minigrants, and technical assistance). Logistic regression was used to examine the relationship between trainee engagement with capacity-building supports offered after the workshop and key outcomes at year 1. RESULTS Of the capacity-building supports offered after the workshop, the web portal was the most popular. Higher use of systematic program planning approaches in the first year was predicted by web portal use (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.04-8.67; p = 0.04), and participation in the minigrant process (OR, 5.40; 95% CI, 1.09-28.69; p = 0.04). Separately, high intention to use systematic approaches for program planning was predicted by web portal use (OR, 3.47; 95% CI, 1.27-9.52; p = 0.02). CONCLUSIONS Ongoing capacity-building supports may promote EBP planning in CBOs, but institutional constraints may limit practitioners' ability to engage with such supports.
Collapse
Affiliation(s)
- Shoba Ramanadhan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | | | - Ziming Xuan
- . Department of Community Health Sciences, Boston University School of Public Health, Boston, MA USA
| | - Kasisomayajula Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| |
Collapse
|
13
|
Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach. Transl Behav Med 2018; 7:517-528. [PMID: 28733726 DOI: 10.1007/s13142-017-0513-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.
Collapse
|
14
|
Kwon SC, Patel S, Choy C, Zanowiak J, Rideout C, Yi S, Wyatt L, Taher MD, Garcia-Dia MJ, Kim SS, Denholm TK, Kavathe R, Islam NS. Implementing health promotion activities using community-engaged approaches in Asian American faith-based organizations in New York City and New Jersey. Transl Behav Med 2018; 7:444-466. [PMID: 28547738 DOI: 10.1007/s13142-017-0506-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Faith-based organizations (FBOs) (e.g., churches, mosques, and gurdwaras) can play a vital role in health promotion. The Racial and Ethnic Approaches to Community Health for Asian Americans (REACH FAR) Project is implementing a multi-level and evidence-based health promotion and hypertension (HTN) control program in faith-based organizations serving Asian American (AA) communities (Bangladeshi, Filipino, Korean, Asian Indian) across multiple denominations (Christian, Muslim, and Sikh) in New York/New Jersey (NY/NJ). This paper presents baseline results and describes the cultural adaptation and implementation process of the REACH FAR program across diverse FBOs and religious denominations serving AA subgroups. Working with 12 FBOs, informed by implementation research and guided by a cultural adaptation framework and community-engaged approaches, REACH FAR strategies included (1) implementing healthy food policies for communal meals and (2) delivering a culturally-linguistically adapted HTN management coaching program. Using the Ecological Validity Model (EVM), the program was culturally adapted across congregation and faith settings. Baseline measures include (i) Congregant surveys assessing social norms and diet (n = 946), (ii) HTN participant program surveys (n = 725), (iii) FBO environmental strategy checklists (n = 13), and (iv) community partner in-depth interviews assessing project feasibility (n = 5). We describe the adaptation process and baseline assessments of FBOs. In year 1, we reached 3790 (nutritional strategies) and 725 (HTN program) via AA FBO sites. Most AA FBOs lack nutrition policies and present prime opportunities for evidence-based multi-level interventions. REACH FAR presents a promising health promotion implementation program that may result in significant community reach.
Collapse
Affiliation(s)
- S C Kwon
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | - S Patel
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA.
| | - C Choy
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | - J Zanowiak
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | - C Rideout
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | - S Yi
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | - L Wyatt
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | - M D Taher
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| | | | - S S Kim
- Korean Community Services of Metropolitan NY, Inc., New York, NY, USA
| | - T K Denholm
- Korean Community Services of Metropolitan NY, Inc., New York, NY, USA
| | | | - N S Islam
- Department of Population Health, NYU School of Medicine, 550 First Avenue, VZN, 8th Floor, New York, NY, USA
| |
Collapse
|