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Bernhart JA, Turner-McGrievy GM, DuBois KE, Sentman C, Rudisill C, Okpara N, Wilcox S, Clemons BD. Community Health Worker Implementation and Cost Analysis of a Plant-Based Nutrition Program. J Nutr Educ Behav 2024; 56:256-264. [PMID: 38310498 PMCID: PMC10999348 DOI: 10.1016/j.jneb.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVE This study describes program implementation through a research-restaurant partnership and assesses participant satisfaction, program costs, and percent body weight changes. METHODS Participants (n = 60) in a virtual synchronous (n = 43) or virtual asynchronous (n = 17) 12-week plant-based nutrition program received restaurant vouchers. Class satisfaction data were collected weekly. Assessments were completed at baseline, 3 months, and 9 months, along with interviews (n = 13) between 3 and 9 months. The costing approach estimated costs per participant. Interviews were coded using a content analysis and constant comparative method. RESULTS Participants rated the intervention favorably. Program costs were $198.63/participant, and participants' willingness to pay postintervention was $101.50 ± $63.90. Participants shared satisfaction with course content, the restaurant partnership, and suggestions for future delivery. No changes in participants' percent body weight were observed between 3 and 9 months (P = 0.98), indicating maintenance of 3-month weight loss. CONCLUSIONS AND IMPLICATIONS A research-restaurant partnership successfully implemented a nutrition program and generated positive feedback. With the lifting of coronavirus disease 2019 pandemic restrictions, future research can now test alternative implementation methods (in person vs online) in other restaurants.
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Affiliation(s)
- John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Kelli E DuBois
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Claudia Sentman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Nkechi Okpara
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
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Day KR, Bernhart JA, Wilcox S. Barriers and Facilitators to 24-Month Maintenance of the Faith, Activity, and Nutrition Program in the U.S. J Relig Health 2024:10.1007/s10943-024-02012-9. [PMID: 38528275 DOI: 10.1007/s10943-024-02012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 03/27/2024]
Abstract
Little is known about the barriers and facilitators to organizational maintenance of faith-based health promotion programs. This study used qualitative data (collected from 2016-2019) from pastors (n = 81) and program coordinators (n = 103) to identify barriers and facilitators to 24-month maintenance of a faith-based physical activity (PA) and healthy eating (HE) intervention in South Carolina. Barriers differed for PA versus HE: resistance to change impeded HE while church characteristics tended to impede PA. Similar themes emerged for PA and HE facilitators: healthy opportunities, church communication, and consistency. Future research should build upon this study to tailor faith-based health promotion programs for long-term sustainability.
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Affiliation(s)
- Kelsey R Day
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Fowler LA, Quiñones-Cordero MM, Sidani JE, Bernhart JA, Mendoza-Vasconez AS, Bannon SM, Unni EJ. The urgency of restructuring the landscape of behavioral medicine: Commentary from early-career diversity institute scholars. Transl Behav Med 2024; 14:149-155. [PMID: 37897410 PMCID: PMC10890817 DOI: 10.1093/tbm/ibad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2023] Open
Abstract
Structural and systemic barriers entrenched in academia have sustained for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for women and underrepresented racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. Increasing opposition to diversity, equity, and inclusion (DEI) efforts in higher education via legislation, policies, and general anti-DEI sentiment contextualizes the importance of prioritizing DEI. The goal of this commentary is to open discussion among academic institutions regarding changes in DEI culture that will facilitate the growth of diverse early-career faculty (ECF). We use an adapted framework which incorporates DEI into a faculty competency model to (i) guide our discussion of the rationale for restructuring academic systems to promote DEI and (ii) recommend strategies for institutional progress for ECF that can translate across academic institutions. Implementing policies and practices that seek to recruit, retain, and support historically underrepresented ECF are needed, and may involve faculty mentorship programs, establishing equitable funding mechanisms, reforming faculty evaluation practices, and examining and correcting inequities in faculty workloads. The onus is on institutions to recognize and replace the exclusionary practices and biases that have existed within their walls, and continuously promote and monitor their DEI efforts and initiatives to ensure their efficacy. Inclusive academic cultures that demonstrate their value of diversity and commitment to equity promotion at all levels of the organization, including among ECF, are necessary for ensuring excellence in scholarship in academia.
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Affiliation(s)
- Lauren A Fowler
- Sexuality, Health, and Gender Center, Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Maria M Quiñones-Cordero
- Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
| | - Jaime E Sidani
- Department of Behavioral & Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Sarah M Bannon
- Brain Injury Research Center, Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elizabeth J Unni
- Department of Social, Behavioral, and Administrative Sciences, Touro University College of Pharmacy, New York, NY, USA
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Bernhart JA, Quattlebaum M, Eustis S, Okpara N, Wilson MJ, Sentman C, Turner-McGrievy GM. "It's Gonna Be Okay"-A Qualitative Exploration of the COVID-19 Pandemic's Effects on African American Participants During a Dietary Intervention Study. J Acad Nutr Diet 2023; 123:1763-1771. [PMID: 37437808 PMCID: PMC10789910 DOI: 10.1016/j.jand.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 06/20/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND African American adults are at increased risk for chronic diseases. Limited research exists regarding how the COVID-19 pandemic affected African American adults in behavioral interventions. OBJECTIVE This study assessed how the early months of the COVID-19 pandemic, before vaccine availability and widespread testing, affected stress, nutrition, and exercise behaviors of African American adults participating in a dietary intervention study. DESIGN This was a qualitative interview study conducted with participants from both diet groups as part of the ongoing Nutritious Eating with Soul (NEW Soul) study. NEW Soul is a 2-year, randomized dietary intervention study with participants randomized to follow a vegan (intervention) or low-fat omnivorous diet (control), with both diets focused on soul food. PARTICIPANTS/SETTING Participants (n = 20) came from 2 cohorts of the larger intervention study in South Carolina and were purposefully recruited based on high and low attendance at intervention sessions. Participants in the first cohort were near the end of the intervention, and participants in the second cohort were near the mid-point. The interviews were conducted from June to July 2020. MAIN OUTCOME MEASURES Outcomes included participants' experiences related to stress, nutrition, and exercise behaviors during the early months of the COVID-19 pandemic. ANALYSIS Interviews were recorded and transcribed verbatim. Interview transcripts were coded by two coders using NVivo software. Interviews were coded through content analysis using a constant comparative method. RESULTS Participants discussed the following 3 themes in relation to health behaviors: increased stress, change in routines, and advice to follow health goals. CONCLUSIONS Findings provide perspectives for designing interventions for African American adults establishing new routines to overcome setbacks and changes in routines created by the COVID-19 pandemic.
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Affiliation(s)
- John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Mary Quattlebaum
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Sarah Eustis
- Tufts University School of Medicine, Boston, Massachusetts
| | - Nkechi Okpara
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mary J Wilson
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Claudia Sentman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Bernhart JA, Fellers AW, Wilson MJ, Hutto B, Bailey S, Turner-McGrievy GM. COVID-19 Pandemic Associations on Mental and Physical Health in African Americans Participating in a Behavioral Intervention. J Racial Ethn Health Disparities 2023; 10:3070-3076. [PMID: 36469289 PMCID: PMC9734885 DOI: 10.1007/s40615-022-01481-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic has had disproportionate effects on communities of color, with higher death rates among African Americans (AA). The purpose of this study was to assess associations in African Americans' mental and physical health with the COVID-19 pandemic. Data for this study came from a larger nutrition intervention of AAs in the Southeastern United States, the Nutritious Eating with Soul study. Data collected before and after March 15, 2020 (the day when local South Carolina schools and businesses closed), were analyzed to assess the association of the pandemic on participants' stress, control of healthy eating, physical activity, and body mass index. Repeated measures analysis of covariance using full maximum likelihood estimation to handle missing data was used. At the onset of the COVID-19 pandemic, 150 participants were enrolled in the study (48.2 ± 10.6 years old, 79% female, 75% with college degree or higher). Participants' reporting of stress did not show statistically significant change over time. Cognitive control increased 1.43 points (F = 20.60, p < 0.0001) and body mass index increased 0.72 kg/m2 (F = 10.68, p = 0.001). Future longitudinal studies should investigate how the COVID-19 pandemic continues to present challenges to understanding and improving health among African Americans. The study is registered at www.clinicaltrials.gov NCT03354377.
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Affiliation(s)
- J A Bernhart
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Room 536, 915 Greene Street, SC, 29208, Columbia, USA.
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA.
| | - A W Fellers
- University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC, 29209, USA
| | - M J Wilson
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - B Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - S Bailey
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - G M Turner-McGrievy
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Room 536, 915 Greene Street, SC, 29208, Columbia, USA
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Bernhart JA, Turner-McGrievy GM, Wilson MJ, Sentman C, Wilcox S, Rudisill C. NEW Soul in the neighborhood-reach and effectiveness of a dissemination and implementation feasibility study. Transl Behav Med 2023; 13:123-131. [PMID: 36689305 PMCID: PMC10068901 DOI: 10.1093/tbm/ibac080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Dissemination and implementation (D&I) studies of dietary interventions for African Americans are limited. Restaurants may be an innovative setting to deliver dietary interventions. Purpose: Assess weight loss, self-efficacy for healthy eating, diet quality, and quality of life in African Americans in two groups: virtual synchronous and virtual asynchronous. Guided by RE-AIM, the Nutritious Eating with Soul @ Rare Variety Café Feasibility study included nutrition education, accountability partners for support, and cooking demonstrations led by a community health worker and was delivered across two cohorts in a non-randomized design. The intervention was conducted over 12 consecutive weekly classes. Due to the COVID-19 pandemic, intervention delivery was online. African Americans between 18-65 years old with overweight/obesity, not currently following a plant-based diet or taking medications to control diabetes, and living in a southeastern city were recruited. Participants completed in-person weight assessments and online surveys at baseline and post-intervention. Linear mixed models analyzed changes in outcomes and differences in 3-month outcomes between groups. All models controlled for age and sex. Regarding Reach, 199 participants expressed interest, and 60 enrolled. Among the full sample, participants decreased body weight -2.6 ± 0.5 kg (p < .0001) and increased self-efficacy 1.6 ± 0.7 points (p = .03). No differences in 3-month outcomes between groups were observed. This D&I feasibility study successfully recruited participants during the COVID-19 pandemic and produced significant results. The successful online intervention delivery compared to in-person suggests the potential for greater D&I in vegan soul food restaurants. As restrictions are loosened, future studies will test in-person delivery.
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Affiliation(s)
- John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Mary J Wilson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Claudia Sentman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
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Wilcox S, Saunders RP, Stucker J, Kaczynski AT, Day KR, Kinnard D, Decker L, Bernhart JA. A process for converting an in-person training to increase church capacity to implement physical activity and healthy eating practices and policies to an online format. Transl Behav Med 2023; 13:226-235. [PMID: 36688468 PMCID: PMC10105879 DOI: 10.1093/tbm/ibac102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The implementation of evidence-based public health programs into practice is critical for improving health, but trainings for organizational change agents are often not scalable. To describe the process of converting a training that targets faith-based organizational capacity development from an in-person to an online format. We engaged in an iterative process to convert the training delivery mode from in-person to online that included assessing stakeholder support, consulting the literature on best practices, seeking a design team, consolidating content, designing engaging lessons, and building an online site. Feedback from end-users and other audiences was incorporated throughout. Pilot participants with characteristics like intended training users were then recruited via community and faith-based partner networks. They rated their agreement with statements about the effectiveness as well as design and functionality of each lesson and the overall training (1 = strongly disagree, 5 = strongly agree) and participated in a structured follow-up interview. Nine pilot participants (representing 9 churches in 7 states; 6 African American, 5 with health ministries) rated the online lessons favorably (all ratings ≥ 4.5). Most (90.4%) perceived the lesson duration to be "just right" and spent 52.5 ± 9.9 minutes/lesson. Participants evaluated the overall training positively (all ratings ≥ 4.7). Lesson content, resources, multimedia, and program ideas were most-liked aspects of lessons, while content, staff responsiveness, discussion board, and pace were most-liked aspects of the overall training in open-ended and interview responses. This paper shares a replicable process for converting training modalities from in-person to online with the goal of increased scalability.
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Affiliation(s)
| | - Ruth P Saunders
- 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
| | - Jessica Stucker
- Prevention Research Center, 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
| | - Kelsey R Day
- 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
| | - Deborah Kinnard
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Lindsay Decker
- 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
| | - John A Bernhart
- 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
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Turner-McGrievy GM, Wilcox S, Frongillo EA, Murphy EA, Hutto B, Wilson M, Davey M, Bernhart JA, Okpara N, Bailey S, Hu E. Effect of a Plant-Based vs Omnivorous Soul Food Diet on Weight and Lipid Levels Among African American Adults: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2250626. [PMID: 36633848 PMCID: PMC9857469 DOI: 10.1001/jamanetworkopen.2022.50626] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE More African American individuals die from cardiovascular disease (CVD) than any other chronic disease condition. Despite this disparity, African American individuals are underrepresented in nutrition and CVD interventions. OBJECTIVE To compare the effects of an entirely plant-based (vegan) or low-fat omnivorous (omni) diet on change in body weight and lipids during a 2-year intervention. DESIGN, SETTING, AND PARTICIPANTS The Nutritious Eating With Soul (NEW Soul) study was a 2-year, randomized clinical trial conducted in 2 cohorts (2018-2020 and 2019-2021) that took place in a university teaching kitchen in Columbia, South Carolina (before March 2020), and via online videoconference sessions (after March 2020). Participants included African American adults aged 18 to 65 years with overweight or obesity (body mass index of 25.0-49.9) and without type 2 diabetes, uncontrolled thyroid disease, recent weight loss, or pregnancy. Data assessors and statisticians were blinded to study condition. Data analysis was performed from March to June 2022. INTERVENTIONS The intervention included weekly nutrition classes for 6 months biweekly classes for 6 months, and monthly classes for 12 months. Dietary interventions either emphasized no animal product intake (vegan) or a low-fat omnivorous diet (omni). Both dietary patterns emphasized soul food cuisine (traditional African American southern foodways). MAIN OUTCOMES AND MEASURES Primary outcomes included change in body weight and lipid measures at 12 months. RESULTS There were 568 participants who completed an online screening questionnaire; 409 were excluded and 159 were randomized (77 to the vegan group and 82 to the omni group). Of the 159 participants (mean [SD] age, 48.4 [10.6] years; 126 female [79%]) who began the study, the main outcome of body weight was obtained for 121 participants (76%) at 12 months. There were no differences in outcomes between groups, including 12-month changes in weight (mean, -2.39 kg [95% CI, -3.48 to -1.30 kg] for the vegan group vs -2.03 kg [95% CI, -3.07 to -1.00 kg] for the omni group; P = .64), total cholesterol (-1.05 mg/dL [95% CI, -9.60 to 7.50 mg/dL] for the vegan group vs 1.66 mg/dL [95% CI, -7.20 to 10.50 mg/dL] for the omni group; P = .67), or low-density lipoprotein cholesterol (mean, -2.56 mg/dL [95% CI, -9.52 to 4.40 mg/dL] for the vegan group vs -0.79 mg/dL [95% CI, -7.98 to 6.40 mg/dL] for the omni group; P = .73). Weight loss at 12 months among cohort 1, whose weight was assessed in 2019 before the COVID-19 pandemic, was significantly greater than that for cohort 2, whose weight was assessed summer 2020 during COVID-19 (-3.45 kg [95% CI, -4.67 to -2.22 kg] vs -1.24 kg [95% CI, -2.24 to -0.25 kg]; P = .01). CONCLUSIONS AND RELEVANCE In this randomized clinical trial examining weight loss and CVD risk factor reduction among African American adults, there were no differences between the groups, and the magnitude of changes overall was small. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03354377.
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Affiliation(s)
- Gabrielle M. Turner-McGrievy
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Edward A. Frongillo
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
| | | | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia
| | - Mary Wilson
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia
| | - Marty Davey
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia
| | - John A. Bernhart
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia
| | - Nkechi Okpara
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
| | - Shiba Bailey
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, Columbia
| | - Emily Hu
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia
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Bernhart JA, Dunn CG, Wilcox S, Stucker J, Kinnard D. The FAN program plan: Creating a healthy church environment for physical activity and healthy eating. Dialogues Health 2022; 1:100019. [PMID: 38515914 PMCID: PMC10953865 DOI: 10.1016/j.dialog.2022.100019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 03/23/2024]
Abstract
Background Faith, Activity, & Nutrition (FAN) helps churches create a healthier environment for physical activity (PA) and healthy eating (HE) through policy, systems, and environmental changes. Objective The purpose of this paper is to describe the implementation, evaluation, and revision of the FAN Program Plan across a two-phase study to help churches create guidelines and policies for PA and HE. Methods In Phase 1, church committees attended trainings led by Community Health Advisors (CHA) where they assessed current practices to PA and HE. Committees used the FAN Program Plan to outline an implementation plan to increase opportunities, programs, messages, pastor support, and guidelines/practices for PA and HE. FAN Program Plans were submitted to the research team for review. Findings from Phase 1 plans directed revisions in program materials for Phase 2, where the submission and review processes were repeated. Results Review of Phase 1 FAN Program Plans (53/54 churches submitted a Program Plan) revealed that church committees confused guidelines/practices with programs and had trouble differentiating programs for PA and HE from providing opportunities (i.e., building PA/HE into existing events). The CHA training, FAN church committee training, FAN Program Plan, and other documents were revised to use the term "guidelines (policies)" instead of "guidelines/practices." In addition, CHAs facilitated a training section on guidelines (policies) to committees, and a guidelines (policies) section was added in the FAN Program Plan and other program documents. These changes in Phase 2 were helpful for differentiating policies from programs and programs from opportunities in FAN Program Plans (53/115 churches submitted a Program Plan), although some confusion remained. Conclusions This study underscored challenges churches may have in setting policies for PA and HE and discusses strategies to address these challenges in future faith-based initiatives.
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Affiliation(s)
- John A. Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Caroline G. Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Jessica Stucker
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Deborah Kinnard
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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Bernhart JA, Fellers AW, Turner-McGrievy G, Wilson MJ, Hutto B. Socially Distanced Data Collection: Lessons Learned Using Electronic Bluetooth Scales to Assess Weight. Health Educ Behav 2022; 49:10901981221104723. [PMID: 35971569 DOI: 10.1177/10901981221104723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction. Electronic Bluetooth scales (e-scales) may be useful for remote weight assessment. This study analyzed predictors of engagement with e-scales and feasibility for remote weight assessment. Method. Due to COVID-19 restrictions, participants (n = 150, 100% African American, 79% female, average age 48.2 ± 10.6 years) in an ongoing trial were invited to receive an e-scale. Participants had 1 month to complete a weigh-in. Email, text, and phone call reminders were sent. Data were analyzed using descriptive approaches and logistic regression. Results. Seventy-five participants (50% of sample) elected to receive an e-scale. Older participants (t = -2.01, p = .05) and a greater proportion of females (χ2 = 7.8, p < .01) signed up to receive an e-scale. An average of 2.6 ± 1.3 reminders was required. Most participants who received an e-scale completed a weigh-in (n = 70). Discussion. Half the sample elected to receive an e-scale. Strategies to increase willingness among men and younger adults to sign up to receive an e-scale are needed.
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Affiliation(s)
| | - Ashley W Fellers
- University of South Carolina School of Medicine, Columbia, SC, USA
| | | | | | - Brent Hutto
- University of South Carolina, Columbia, SC, USA
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Wilcox S, Day KR, Saunders RP, Jake-Schoffman DE, Kaczynski AT, Stucker J, Dunn CG, Bernhart JA. The Faith, Activity, and Nutrition (FAN) dissemination and implementation study: changes in and maintenance of organizational practices over 24 months in a statewide initiative. Int J Behav Nutr Phys Act 2022; 19:23. [PMID: 35236373 PMCID: PMC8889739 DOI: 10.1186/s12966-022-01253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have examined the impact of ecological health promotion interventions on organizational practices over time, especially in faith-based settings. This statewide dissemination and implementation study examined change in organizational practices and their predictors across a 24-month period, as well as maintenance of change. METHODS Using a pre-post quasi-experimental design, church coordinators from 92 United Methodist Churches in South Carolina (42% predominantly African American congregations) completed surveys at baseline, and immediate, 12-, and 24-months post-training regarding physical activity (PA) and healthy eating (HE) organizational practices consistent with the Faith, Activity, and Nutrition (FAN) program (opportunities, policies, pastor support, messages) and possible predictors. The study was guided by the RE-AIM framework and the Consolidated Framework for Implementation Research (CFIR). Mixed model repeated measures analyses examined change in organizational practices over time. Regression models examined CFIR predictors of 24-month PA and HE organizational practices, controlling for baseline practices. Churches were also classified as maintainers (implemented at 12 and 24 months), non-sustained implementers (implemented at 12 but not 24 months), delayed implementers (implemented at 24 but not 12 months), and low implementers (implemented at neither 12 nor 24 months) for each FAN component. RESULTS PA and HE organizational practices increased over time (p < .0001). CFIR domains (and constructs within) of intervention characteristics (adaptability, relative advantage, cost/time), inner setting (relative priority, organizational rewards, readiness, congregant needs), characteristics of the implementer (self-efficacy, perceived benefits), and implementation process (engaging opinion leaders, engaging champions) were important predictors of 24-month PA and HE organizational practices. Over half of churches implementing PA policies, PA messages, HE policies, and HE opportunities at 12 months were maintainers at 24 months, and one-third were maintainers for PA opportunities, HE messages, and PA and HE pastor support. Furthermore, 16% of 12-month non-implementers were delayed implementers at 24 months for PA policies and 31% were delayed implementers for HE policies. CONCLUSIONS This study makes important contributions to the faith-based health promotion literature by including a large sample of churches, testing an ecological intervention approach, and assessing organizational practices over a 24-month period. Study findings can guide technical assistance and program adaptations over time. TRIAL REGISTRATION This study was registered in clinicaltrials.gov NCT02868866 on August 16, 2016.
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Affiliation(s)
- Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. .,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Kelsey R Day
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ruth P Saunders
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Danielle E Jake-Schoffman
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jessica Stucker
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Caroline G Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Bernhart JA, Wilcox S, McKeever BW, Ehlers DK, O’Neill JR. A Self-Determination Theory Application to Physical Activity in Charity Sports Events. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221077204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Charity sports events, specifically 5K events, reach large numbers of people and may help promote physical activity (PA). Few studies exist applying Self-Determination Theory (SDT) to participation in these events. This study examined changes in SDT constructs of Autonomy, Competence, and Relatedness satisfaction in participants (n = 207) of charity 5K events and (2) examined relationships among post-event SDT constructs, PA, and intention to complete future events. Participants completed online surveys before and after a charity 5K event using the Psychological Needs Satisfaction in Exercise Scale, Behavioral Regulation in Exercise Questionnaire-2, and International Physical Activity Questionnaire-Short Form. Repeated measures analysis of covariance analyzed the first purpose and regression the second. Competence satisfaction increased ( P = .04) and relatedness satisfaction decreased ( P = .04). Higher post-event relatedness satisfaction was associated with intention to complete future charity 5K events (OR = 1.05, 95% CI: 1.00, 1.11). Higher post-event autonomy, competence, and relatedness satisfaction and intrinsic motivation were associated with greater post-event MET-minutes of PA (all P < .05).Findings may be useful for promoting PA and helping organizations increase participation. Specifically, events facilitating relatedness among participants may lead to repeat participation as these events have opportunities to fulfill SDT outcomes and increase post-event PA.
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Affiliation(s)
- John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Brooke W. McKeever
- School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, USA
| | - Diane K. Ehlers
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jennifer R. O’Neill
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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13
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Bernhart JA, Turner-McGrievy GM, Wirth MD, Shivappa N, Hébert JR. The IMAGINE Intervention: Impacting Physical Activity, Body Fat, Body Mass Index, and Dietary Inflammatory Index. Transl J Am Coll Sports Med 2022; 7:e000181. [PMID: 35832660 PMCID: PMC9272997 DOI: 10.1249/tjx.0000000000000181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Many behavior-change interventions focused on nutrition and physical activity (PA) have been implemented to prevent disease and promote optimal health. Purpose This study examined changes in PA with Energy-adjusted Dietary Inflammatory Index (E-DII™) and chronic disease risk factors in participants of a multicomponent intervention. Methods Data from the Inflammation Management Intervention (IMAGINE) were used. Participants self-selected into the intervention or control group. At baseline and 12 weeks (post-intervention), participants completed three unannounced 24-hour dietary recalls (24HR), anthropometric measures (height, weight), and a dual x-ray absorptiometry scan. PA was measured using Sensewear® armbands. E-DII scores were calculated from the 24HR. Descriptive statistics and t-tests summarized variables and multiple regression assessed relationships between PA and body mass index (BMI), total body fat percent, and E-DII scores. Results Intervention participants increased moderate-to-vigorous PA (MVPA) and lowered BMI, total body fat, and E-DII scores compared to controls. Every 10-minute increase in post-intervention MVPA was associated with 1.6 kg/m2 lower BMI (p<0.01) and 2.4% lower body fat percent (p<0.01) among control participants, after adjusting for covariates. Every 10-minute increase in post-intervention MVPA was associated with 0.3 lower (i.e., less inflammatory) post-intervention E-DII (p=0.01) scores among intervention participants, after adjusting for covariates. Conclusion Participants who changed dietary intake changed PA. While changes were in expected directions, this intervention's emphasis on dietary behaviors compared to PA may have attenuated the relationship between PA and study outcomes.
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Affiliation(s)
- John A. Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Gabrielle M. Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Michael D. Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC USA,College of Nursing, University of South Carolina, Columbia, SC USA,Connecting Health Innovations LLC, Columbia, SC USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC USA,Connecting Health Innovations LLC, Columbia, SC USA
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA,Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC USA,Connecting Health Innovations LLC, Columbia, SC USA
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14
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Bernhart JA, Turner-McGrievy GM, Eustis S, Wilson MJ, Hutto B, Wilcox S. Physical activity assessment in African Americans participating in a dietary weight-loss trial focused on soul food. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Hutto B, Saunders RP, Wilcox S, Jake-Schoffman DE, Bernhart JA, Dunn CG, Kaczynski AT, James KL. Pathways of influences leading to adoption of the Faith, Activity and Nutrition (FAN) program in a statewide initiative. Eval Program Plann 2021; 87:101941. [PMID: 33773182 DOI: 10.1016/j.evalprogplan.2021.101941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/15/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
RE-AIM (Reach, effectiveness, Adoption, Implementation, Maintenance) and CFIR (Consolidated Framework for Implementation Research) are complementary frameworks guiding research on dissemination and implementation of evidence-based interventions and factors influencing this process. Faith, Activity, and Nutrition (FAN) is an evidence-based program that increased physical activity and fruit and vegetable intake in faith-based settings. The aims of this adoption study were to quantify state-wide church level adoption rates and congregant reach of FAN in accordance with RE-AIM guidelines, and to explore the association of CFIR-derived constructs of the church inner setting and pastor characteristics with FAN adoption. Church recruitment was documented, and data were collected via telephone-administered surveys from 93 pastors in adopting churches and 60 pastors in non-adopting churches. Qualitative Comparative Analysis (QCA) identified combinations of CFIR-derived church and pastor characteristics sufficient for FAN adoption. As defined by RE-AIM, church-level FAN adoption was 11.7 % and congregant-level reach was 20.0 %. Fourteen pathways to adoption were identified; seven of these featured the presence of a culture of concern for congregant health along with openness to new ideas. Results suggest early assessment of these two CFIR-derived inner setting constructs may help identify faith-based organizations predisposed to undertake a comprehensive, environmental intervention to promote congregant health.
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Affiliation(s)
- Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Ruth P Saunders
- 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
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA
| | - John A Bernhart
- 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
| | - Caroline G Dunn
- Department of Health Policy Management, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 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
| | - Katherine L James
- South Carolina Conference of the United Methodist Church, Columbia, SC, 29203, USA
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Turner-McGrievy GM, Wilson MJ, Bailey S, Bernhart JA, Wilcox S, Frongillo EA, Murphy EA, Hutto B. Effective recruitment strategies for African-American men and women: the Nutritious Eating with Soul study. Health Educ Res 2021; 36:206-211. [PMID: 33582788 PMCID: PMC8041456 DOI: 10.1093/her/cyab003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Previous studies have found it challenging to recruit African-American (AA) participants into health education research studies. The goal of this article is to describe the recruitment methods used for the Nutritious Eating with Soul (NEW Soul) study, a 2-year randomized behavioral health education intervention, conducted in two cohorts, with emphasis on methods used for reaching men. Participants indicated how they learned about the study on an online screening questionnaire from a list of the recruitment strategies we employed. Due to limited recruitment of men in Cohort 1, recruitment strategies for Cohort 2 focused on reaching men. Across the two cohorts, a total of 568 (23% men) participants completed the online screener and 159 (21% men) completed all baseline assessments and enrolled in the study. The most effective methods for completing screening questionnaires were radio ads, referrals from friends and family, TV interviews, social media posts and community events. Men were primarily recruited via radio ads, whereas women were more often recruited through TV and social media. Radio was an effective way to recruit AA adults into nutrition interventions, particularly men. In addition, low-cost methods, such as personal referrals, social media posts and community events were also effective strategies.
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Affiliation(s)
- Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Mary J Wilson
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Shiba Bailey
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - E Angela Murphy
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, 6439 Garners Ferry Rd, Columbia, SC 29209, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
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Turner-McGrievy G, Hutto B, Bernhart JA, Wilson MJ. Comparison of the Diet ID Platform to the Automated Self-administered 24-hour (ASA24) Dietary Assessment Tool for Assessment of Dietary Intake. J Am Coll Nutr 2021; 41:360-382. [PMID: 33705267 PMCID: PMC8634522 DOI: 10.1080/07315724.2021.1887775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Collecting multiple 24-hour recalls (24HR) can be burdensome, necessitating alternative methods to assess dietary intake in the research setting. METHOD This cross-sectional study compared the use of the Diet ID™ online platform with three unannounced 24HR assessed via the Automated Self-Administered 24-Hour recall (ASA24) among participants in the Nutritious Eating with Soul (NEW Soul) study. NEW Soul participants (n = 68; 100% African American, 79% female, mean age 50.7 ± 9.6 years) were randomized to follow one of two healthy soul food diets: vegan or omnivorous. For the present study, data from both groups were combined. Energy intake, dietary quality (Healthy Eating Index), and macro-/micronutrient densities per 1000 kcals, as assessed by either the averaged values of the three 24HR or the Diet ID. Descriptive statistics (means, standard deviations, and Spearman rank correlations) summarized each nutrient as measured by the Diet ID and ASA24. Bland-Altman plots were used as the main method to assess agreement between the two measures. RESULTS Nutrients from the Diet ID were generally higher than the 24HR except for the Healthy Eating Index (HEI) score (69.6 ± 12.2 ASA24 vs 51.1 ± 34.5 Diet ID). Diet ID reported 950 kcals higher energy intake than ASA24, with the difference being most pronounced at lower ASA24-reported energy intake. There were significant correlations among measures for HEI score, protein, carbohydrates, cholesterol, potassium, copper, thiamin, and vitamins B12 and E. There was higher reporting of nutrients using Diet ID compared to the 24HR. Diet ID is a rapid way to assess dietary intake. CONCLUSIONS Future studies should consider comparing these two methods with objective assessments of energy and nutrient intake and using multiple instruments to ensure that the strengths of all methods are included.
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Affiliation(s)
- Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Mary J Wilson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Bernhart JA, Turner‐McGrievy GM, Eustis S, Wilson MJ, Hutto B, Wilcox S, Frongillo EA, Murphy EA. Sensor‐measured physical activity is associated with decreased cardiovascular disease risk in African Americans. Lifestyle Medicine 2020. [DOI: 10.1002/lim2.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- John A. Bernhart
- Department of Health Promotion Education, and Behavior Arnold School of Public Health University of South Carolina Columbia South Carolina
- Prevention Research Center Arnold School of Public Health University of South Carolina Columbia South Carolina
| | - Gabrielle M. Turner‐McGrievy
- Department of Health Promotion Education, and Behavior Arnold School of Public Health University of South Carolina Columbia South Carolina
| | - Sarah Eustis
- Department of Health Promotion Education, and Behavior Arnold School of Public Health University of South Carolina Columbia South Carolina
| | - Mary J. Wilson
- Prevention Research Center 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
| | - Sara Wilcox
- Prevention Research Center Arnold School of Public Health University of South Carolina Columbia South Carolina
| | - Edward A. Frongillo
- Department of Health Promotion Education, and Behavior Arnold School of Public Health University of South Carolina Columbia South Carolina
| | - E. Angela Murphy
- Department of Pathology, Microbiology, and Immunology, School of Medicine University of South Carolina Columbia South Carolina
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Bernhart JA, Wilcox S, Decker L, Ehlers DK, McKeever BW, O'Neill JR. "It's having something that you've done it for": Applying Self-Determination Theory to participants' motivations in a for-cause physical activity event. J Health Psychol 2020; 27:119-134. [PMID: 32757667 DOI: 10.1177/1359105320947811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
For-cause physical activity events reach many people. Little research has applied Self-Determination Theory to participants' experiences in for-cause physical activity events. This qualitative study explored participants' (n = 18) experiences in 5K for-cause physical activity events and intention to complete future events. Interviews were recorded and transcribed verbatim. Emergent coding assessed responses for themes. Constructs of competence and relatedness were most prevalent and an altruistic desire to support the cause. Participants highlighted feelings of community supporting their intention to complete future events. Overall, experiences aligned with Self-Determination Theory. Future studies may include altruism to understand leveraging opportunities for promoting physical activity.
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Affiliation(s)
| | | | | | - Diane K Ehlers
- University of South Carolina, USA.,University of Nebraska Medical Center, USA
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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. J Relig 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] [What about the content of this article? (0)] [Affiliation(s)] [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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22
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Dunn CG, Wilcox S, Bernhart JA, Blake CE, Kaczynski AT, Turner-McGrievy GM. Church Leaders' Views of Obesity Prevention Efforts for Children and Youth. J Nutr Educ Behav 2020; 52:259-269. [PMID: 31677941 PMCID: PMC7064414 DOI: 10.1016/j.jneb.2019.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To examine church leaders' views on the role of faith-based organizations in promoting healthy eating and physical activity in children. DESIGN Qualitative research using semi-structured in-depth interviews. SETTING South Carolina. PARTICIPANTS Leaders (n = 26) from United Methodist churches (n = 20). PHENOMENON OF INTEREST Perceptions of health promotion efforts for children in faith-based settings, including primary health concerns, perceived opportunities, partnerships, and the relationship of these efforts to the overall church mission. ANALYSIS Interviews were transcribed verbatim and coded using a constant comparative method. RESULTS Five themes emerged related to (1) multiple concerns about health issues facing children; (2) existing church structures influencing health behaviors; (3) potential partnerships to address children's health; (4) importance of role models; and (5) the need for a tailored approach. CONCLUSIONS AND IMPLICATIONS Church leaders viewed childhood health behaviors as an important area of concern for the church and identified links between physical and spiritual health. They identified multiple existing and potential organizational and community structures as important in improving healthy eating and physical activity. Faith-based organizations can play an important role in developing and delivering health programming for children but desired assistance through partnerships with subject matter experts.
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Affiliation(s)
- Caroline Glagola Dunn
- Department of Health Policy Management, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Sara Wilcox
- Prevention Research Center, University of South Carolina Arnold School of Public Health, Columbia, SC; Department of Exercise Science, University of South Carolina Arnold School of Public Health, Columbia, SC
| | - John A Bernhart
- Prevention Research Center, University of South Carolina Arnold School of Public Health, Columbia, SC; Department of Exercise Science, University of South Carolina Arnold School of Public Health, Columbia, SC
| | - Christine E Blake
- Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC
| | - Andrew T Kaczynski
- Prevention Research Center, University of South Carolina Arnold School of Public Health, Columbia, SC; Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, SC
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Bernhart JA, O'Neill JR. Walking and running to benefit breast cancer: descriptive characteristics of participants in the 2017 Walk for Life events. Perspect Public Health 2019; 139:303-307. [PMID: 31070509 DOI: 10.1177/1757913919833717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The prevalence of charities and other non-profit organisations sponsoring for-cause physical activity (PA) events has continued to rise. Few studies have examined for-cause events through a public health perspective to determine the reach and potential for public health and PA promotion. This study described participants in a for-cause event supporting breast cancer to determine the reach of the event and identified possible leverage points of for-cause events for public health promotion. METHODS Participants registered online for the Walk for Life events in Columbia, SC (Half marathon, 10k, 5k, and Walk-a-thon), were included in this study. Data were analyzed using Microsoft Excel. RESULTS Over 6,000 people participated in the event and 4,942 registered online. Of online registrants, most participants were women (n = 3,800, 78.95%) and most participants, completed the walk-a-thon (n = 3,539), followed by the 5k (n = 829), half-marathon (n = 236), and 10k (n = 209). The average age of participants was 39.79 years (SD = 1.35). CONCLUSIONS For-cause PA events often recruit high numbers of participants, particularly high-priority populations in PA interventions. Therefore, these events bear innovative implications for PA researchers and practitioners to leverage these events to promote health and PA while simultaneously supporting charity and non-profit organisations.
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Affiliation(s)
- J A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Public Health Research Center, 1st Floor, 921 Assembly Street, Columbia, SC 29208, USA.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - J R O'Neill
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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24
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Bernhart JA, Dunn CG, Wilcox S, Saunders RP, Sharpe PA, Stucker J. Church leaders' barriers and facilitators before and after implementing a physical activity and nutrition intervention. Health Educ Res 2019; 34:188-199. [PMID: 30601982 DOI: 10.1093/her/cyy051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
Faith-based health promotion programs have been effective in increasing healthy eating (HE) and physical activity (PA). Very few reports exist regarding church leaders' anticipated and experienced barriers and facilitators to program implementation. Pastors (n = 38, 70%) and program coordinators (n = 54, 100%) from churches (N = 54) who attended a program training answered open-ended questions about anticipated barriers and facilitators to implementing the HE and PA parts of the Faith, Activity, and Nutrition (FAN) program. Twelve months later, pastors (n = 49, 92%) and coordinators (n = 53, 98%) answered analogous questions about their experienced barriers and facilitators to implementing the HE and PA parts of the FAN program. Responses were coded using thematic analysis. Similar themes appeared at baseline and follow-up for anticipated and experienced barriers and facilitators. The most common barriers were no anticipated barriers, resistance to change, church characteristics, and lack of participation/motivation. The most common facilitators were internal support, leadership, and communication. Few differences were found between anticipated and experienced barriers and facilitators. Understanding these perspectives, particularly overcoming resistance to change and church characteristics through strong leadership and internal support from church leaders, will improve future program development, resources, and technical assistance in faith-based and non-faith-based communities alike.
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Affiliation(s)
- J A Bernhart
- Prevention Research Center, University of South Carolina
- Department of Exercise Science
| | - C G Dunn
- Prevention Research Center, University of South Carolina
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, USA
| | - S Wilcox
- Prevention Research Center, University of South Carolina
- Department of Exercise Science
| | - R P Saunders
- Prevention Research Center, University of South Carolina
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, USA
| | - P A Sharpe
- Prevention Research Center, University of South Carolina
| | - J Stucker
- Prevention Research Center, University of South Carolina
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Bernhart JA, Ylitalo KR, Umstattd Meyer MR, Doyle EI, Wilkinson LR, Stone KW. Leveraging Household Structure for Increasing Adult Physical Activity in a Low-Income, African American Community. Health Promot Pract 2018; 21:582-590. [PMID: 30486674 DOI: 10.1177/1524839918814731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health behavior changes often require focusing on factors beyond the individual, particularly in low-income and underresourced areas. The purpose of this article was to assess associations between household structure and adult physical activity levels. Data were collected using Community Assessment for Public Health Emergency Response methodology to administer a household survey (n = 100). Household structure was calculated from summing the number of adults (⩾18 years) and children (<18 years) reported living in the house. Physical activity was measured using the International Physical Activity Questionnaire-Short Form. Adults living in households with two or more adults reported more MET (metabolic equivalent of task) minutes of physical activity per week than adults from households with only one adult. Adults living in households with two or more adults were twice as likely to meet aerobic guidelines for physical activity compared to adults living in households with only adult. Findings suggest the need for developing ecologic approaches in low-income communities to increase social support for physical activity in adults.
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Affiliation(s)
- John A Bernhart
- Baylor University, Waco, TX, USA.,University of South Carolina, Columbia, SC, USA
| | | | | | | | | | - Kahler W Stone
- Texas A&M University, College Station, TX, USA.,Waco-McLennan County Public Health District, Waco, TX, USA
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