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Syed U, Kapera O, Chandrasekhar A, Baylor BT, Hassan A, Magalhães M, Meidany F, Schenker I, Messiah SE, Bhatti A. The Role of Faith-Based Organizations in Improving Vaccination Confidence & Addressing Vaccination Disparities to Help Improve Vaccine Uptake: A Systematic Review. Vaccines (Basel) 2023; 11:vaccines11020449. [PMID: 36851325 PMCID: PMC9966262 DOI: 10.3390/vaccines11020449] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023] Open
Abstract
The COVID-19 pandemic underscored the importance of vaccination to support individual health across the life-course, with vaccination playing a central strategy role in mitigating transmission and disease. This required unprecedented mobilization and coordination across all sectors to meet people where they are, enable equitable access, and build vaccination confidence. A literature search was conducted with combinations of the keywords and variations of vaccination and faith-based organizations (FBOs). Search inclusion criteria were: (1) FBO programs that supported public health emergency efforts, including vaccination efforts as the primary outcome; and (2) articles written in English language. A total of 37 articles met inclusion criteria (n = 26 focused on general public health campaigns, n = 11 focused on vaccination efforts). The findings related to public health campaigns fell into four themes: FBO's ability to (1) tailor public health campaigns; (2) mitigate barriers; (3) establish trust; and (4) disseminate and sustain efforts. The findings related to vaccine uptake efforts fell into three themes: (1) pre-pandemic influenza and HPV vaccination efforts, (2) addressing vaccine disparities in minority communities, and (3) enabling COVID-19 vaccination. This review demonstrated that FBOs have a vital role in both public health campaigns and vaccination initiatives to support high vaccine uptake and confidence.
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Affiliation(s)
- Uzma Syed
- South Shore Infectious Diseases and Travel Medicine Consultants, Bayshore, NY 11706, USA
| | - Olivia Kapera
- School of Public Health, University of Texas Health Science Center, Austin Campus, Austin, TX 78712, USA
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX 75027, USA
| | - Aparajita Chandrasekhar
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX 75027, USA
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX 75207, USA
| | - Barbara T. Baylor
- Caucus on Public Health and the Faith Community, Atlanta, GA 30331, USA
| | - Adebola Hassan
- Illinois Department of Public Health, Chicago, IL 60612, USA
| | - Marina Magalhães
- School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Farshid Meidany
- Black Pearl Consulting & Research, Leesburg, VA 20175-3012, USA
| | | | - Sarah E. Messiah
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX 75027, USA
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX 75207, USA
| | - Alexandra Bhatti
- Merck & Co., Inc., Rahway, NJ 07065, USA
- Correspondence: ; Tel.: +1-602-814-7519
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Bernhart JA, Wende ME, Kaczynski AT, Wilcox S, Dunn CG, Hutto B. Assessing the Walkability Environments of Churches in a Rural Southeastern County of the United States. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:E170-E177. [PMID: 31688738 PMCID: PMC7190400 DOI: 10.1097/phh.0000000000001076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT Churches can serve as important health promotion partners, especially in rural areas. However, little is known about the built environment surrounding churches in rural areas, including how these environments may impact opportunities for physical activity (PA) and may differ by neighborhood income levels. OBJECTIVE This study described walkability around churches in a rural county and examined differences in church walkability between high-, medium-, and low-income neighborhoods. DESIGN As part of the Faith, Activity, and Nutrition study, trained data collectors conducted a windshield survey of adjacent street segments within a half-mile of churches. SETTING Churches (N = 54) in a rural southeastern county in the United States. MAIN OUTCOME MEASURE A summary walkability score (eg, presence of sidewalks, safety features, low traffic volume) was created with a possible range from 0 to 7. Analysis of variance was used to assess differences in walkability of churches by neighborhood income levels. RESULTS Walkability scores ranged from 0 to 6 (M = 2.31, SD = 1.23). Few churches had sidewalks, shoulders or buffers, or amenities nearby. In contrast, most churches had low traffic volume and no environmental incivilities. While not statistically significant, churches in low-income neighborhoods scored higher for walkability than churches in medium- and high-income neighborhoods. CONCLUSIONS This study used low-cost environmental audits to analyze walkability in a sample of churches in a rural area and examined differences by neighborhood income. While churches may improve reach of people living in underserved and rural communities, a lack of environmental supports may limit effective PA promotion activities. Partnerships focused on improving existing areas or providing alternative PA opportunities for church and community members may be needed, especially in African American communities.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center (Messrs Bernhart and Hutto, Ms Wende, and Drs Kaczynski, Wilcox, and Dunn), Department of Exercise Science (Mr Bernhart and Dr Wilcox), and Department of Health Promotion, Education, and Behavior (Ms Wende and Drs Kaczynski and Dunn), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Bernhart JA, Wilcox S, Saunders RP, Hutto B, Stucker J. Program Implementation and Church Members' Health Behaviors in a Countywide Study of the Faith, Activity, and Nutrition Program. Prev Chronic Dis 2021; 18:E05. [PMID: 33444524 PMCID: PMC7845546 DOI: 10.5888/pcd18.200224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Implementation research of health programs in faith-based organizations is lacking. The Faith, Activity, and Nutrition (FAN) program helps churches improve physical activity and fruit and vegetable behaviors of members. This study examined associations between implementation of FAN intervention components and church members' physical activity, fruit and vegetable behaviors, and self-efficacy for improving these behaviors. FAN was implemented in 35 churches in a southeastern US county. After attending in-person training, led by community health advisors, church committees received 12 months of telephone-delivered technical assistance to implement FAN according to 4 components: increasing opportunities, increasing guidelines and policies, increasing pastor support, and increasing messages for physical activity and healthy eating in their church. In this correlational study, FAN coordinators (n = 35) for each church reported baseline practices in 2015 and 12-month follow-up implementation of the 4 components for physical activity and healthy eating in 2016. Church members (n = 893) reported perceived implementation, physical activity and fruit and vegetable behaviors, and self-efficacy at 12-month follow-up in 2016. Independent variables were coordinator-reported baseline practices, baseline-adjusted 12-month implementation, and member-perceived 12-month implementation. Multilevel modeling examined associations between independent variables and member-reported 12-month physical activity and fruit and vegetable behaviors and self-efficacy. Coordinator-reported 12-month implementation of fruit and vegetable opportunities was associated with member fruit and vegetable consumption. Member perceptions at 12 months of church physical activity opportunities, pastor support, and messages were associated with higher self-efficacy for physical activity; pastor support and messages were positively associated with physical activity. Member perceptions at 12 months of fruit and vegetable opportunities, pastor support, and messages were associated with higher fruit and vegetable consumption and self-efficacy. Member-perceived implementation was more strongly associated with member behaviors than coordinator-reported implementation. Providing opportunities for healthy eating during already scheduled events may be an effective strategy for improving fruit and vegetable behavior.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Public Health Research Center, 1st Fl, 921 Assembly St, Columbia, SC 29208. E-mail:
| | - Ruth P Saunders
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Jessica Stucker
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Objective Church Environment Audits and Attendee Perceptions of Healthy Eating and Physical Activity Supports within the Church Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103598. [PMID: 32443819 PMCID: PMC7277806 DOI: 10.3390/ijerph17103598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/13/2020] [Accepted: 05/16/2020] [Indexed: 11/17/2022]
Abstract
Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees' perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was used to analyze associations between the church environment and outcomes. Physical elements of churches were positively related to attendees' perceptions of church environment supports for PA (B = 0.03, 95% CI = 0.01, 0.05) and HE (B = 0.05, 95% CI = 0.01, 0.09) and there was a significant interaction between perceptions of HE supports and HE church environment. Self-efficacy and behaviors for PA and HE did not show an association with the church environment. Future research should establish a temporal relationship between the church environment and these important constructs for improving health. Future faith-based interventions should apply infrastructure changes to the church environment to influence important mediating constructs to health behavior.
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Bernhart JA, La Valley EA, Kaczynski AT, Wilcox S, Jake-Schoffman DE, Peters N, Dunn CG, Hutto B. Investigating Socioeconomic Disparities in the Potential Healthy Eating and Physical Activity Environments of Churches. JOURNAL OF RELIGION AND HEALTH 2020; 59:1065-1079. [PMID: 30132179 PMCID: PMC6384145 DOI: 10.1007/s10943-018-0687-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Faith-based settings have the potential to improve health in underresourced communities, but little research has quantified and compared health-promoting elements in church environments. This study examines the number of potential indoor and outdoor physical activity opportunities, healthy eating opportunities, healthy living media, and total environmental resources present in churches (n = 54) in a rural, southeastern US county and the relationship between these resources and neighborhood income. In our sample, most churches offered potential indoor and outdoor opportunities for physical activity and healthy eating opportunities, with more variability in the number of healthy living media items on display compared to other environmental components. Common potential opportunities present in churches for physical activity included a fellowship hall and green/open space, while potential opportunities for healthy eating frequently included a refrigerator and sink. Compared to those in medium- and high-income neighborhoods, churches in low-income neighborhoods scored higher on measures of potential outdoor physical activity opportunities and lower on measures of total potential environment resources, healthy eating opportunities, healthy living media, and indoor physical activity opportunities, though only indoor physical activity opportunities reached statistical significance. Potential opportunities for using existing resources in and around churches for health promotion should be investigated further, particularly in rural areas.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Elizabeth A La Valley
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Nathan Peters
- School of Human Movement, Sport and Leisure Studies, Bowling Green University, Bowling Green, OH, USA
| | - Caroline G Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Saunders RP, Wilcox S, Jake-Schoffman DE, Kinnard D, Hutto B, Forthofer M, Kaczynski AT. The Faith, Activity, and Nutrition (FAN) Dissemination and Implementation Study, Phase 1: Implementation Monitoring Methods and Results. HEALTH EDUCATION & BEHAVIOR 2018; 46:388-397. [PMID: 30577714 DOI: 10.1177/1090198118818235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Faith-based settings offer opportunities for reaching populations at risk for chronic conditions and are optimal settings for dissemination and implementation (D&I) research. Faith, Activity, and Nutrition (FAN) is an evidence-based program designed to promote physical activity (PA) and healthy eating (HE) through church policy, systems, and environmental change. We report implementation fidelity for Phase 1 of the FAN D&I project, a countywide effort. The group randomized study included pre- and postintervention assessments of core PA and HE components. We compared implementation in early intervention ( n = 35) versus delayed intervention (control, n = 19) churches; assessed individual church implementation; and examined the effects of level of implementation on church member outcomes. Implementation assessments were conducted with the FAN coordinator via telephone survey. Study outcomes were assessed with church members 8 to 12 months following baseline assessment via self-administered surveys. We found significantly higher levels of implementation for PA opportunities, PA and HE guidelines, PA and HE messages, and PA and HE pastor support in intervention versus control churches and showed church-level variation in PA and HE implementation. PA self-efficacy varied by level of implementation; high and low implementers did not differ in proportion of church members physically inactive, although low implementers had fewer members inactive than controls. The high level of implementation in intervention churches shows promise for broader dissemination of FAN.
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Affiliation(s)
| | - Sara Wilcox
- 1 University of South Carolina, Columbia, SC, USA
| | | | | | - Brent Hutto
- 1 University of South Carolina, Columbia, SC, USA
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