Faith-based leaders' perceptions on the implementation of programs to promote healthy lifestyles in churches in Barbados-a mixed-methods analysis

Background

There is a high burden of chronic diseases such as hypertension and diabetes in small island developing states (SIDS). SIDS governments have committed to a range of public health, healthcare, and fiscal measures to reduce this burden including community-based health education in collaboration with civil society organizations. We sought to explore perceived acceptability, appropriateness, and feasibility of implementing self-management health programs in 20 faith-based organizations in the small island developing state of Barbados.

Methods

This was a concurrent mixed methods study - a quantitative online survey and a qualitative inquiry using semi-structured interviews. Acceptability, appropriateness and feasibility of the intervention were assessed using the following quantitative assessment tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM). Thirteen in-depth interviews were conducted virtually, recorded and transcribed verbatim. Transcripts were analyzed using thematic analysis based on deductive codes from Proctor's implementation outcomes definitions.

Results

From the 52 respondents of the survey, the median and interquartile ranges for the AIM, IAM and FIM scales were 16 (15-20), 16 (16-20) and 16 (15-17) (out of 20), respectively. We found high levels of acceptability, 82% (95% CI (69%, 95%)) of leaders indicating that health programs in churches met with their approval; and high levels of appropriateness-90% (95% CI (80%, 100%)) indicating health programs in churches were "fitting" and "a good match". Feasibility scores were lower, with 60% (95% CI (44%, 76%)) indicating that health programs in churches would be easy to use. In interviews, leaders expressed acceptance of healthy lifestyle programs in churches and described their appropriateness through alignment with church doctrines stating, "the body is the temple of God". They felt that economic impacts from COVID-19 were likely to be a barrier to the success of programs. Leaders expressed the need for support from healthcare providers who are sensitive and respectful of church culture.

Conclusion

We found that health-based programs in churches align well with church doctrines, but the success of these programs will depend on establishing trust through the engagement of church-based champions, tailoring programming to include a biblical perspective and engaging entire households.

Perceived Health Needs of Church Leaders and Members: A Secondary Data Analysis of the Mid-South Congregational Health Survey

Needs assessments have been successful in helping communities and congregations focus their health ministry efforts; however, most have used leader perceptions of congregational health needs. The purpose of this study was to examine and compare the self-reported needs of both church leaders and members to be addressed by their congregation. Church leaders (n = 369) and members (n = 459) from 92 congregations completed the 2019 Mid-South Congregational Health Survey. Frequencies and generalized linear mixed models (GLMM) were performed to examine the top 10 self-reported needs and associations by church role, respectively. Of the top 10 congregational needs, anxiety or depression, high blood pressure, stress, and healthy foods were ranked identically regardless of church role. Church leaders perceived obesity and diabetes to be important congregational health needs, whereas members perceived affordable health care and heart disease to be important congregational health needs. GLMM, controlling for within-church clustering and covariates, revealed church leaders were more likely than members to report obesity (odds ratio [OR]: 1.93, 95% confidence interval [CI] = [1.39, 2.67], p < .0001) and diabetes (OR: 1.73, 95% CI = [1.24, 2.41], p = .001) as congregational needs. Findings display similarities and differences in needs reported by church role. Including many perspectives when conducting congregational health needs assessments will assist the development of effective faith-based health promotion programs.

Qualitative Assessment of Key Implementation Factors in a Faith-Based Response to Intimate Partner Violence

BACKGROUND

Faith-based organizations (FBOs) have a scant history in the literature of implementing intimate partner violence (IPV) initiatives, though many members of faith communities consider it an important issue. Furthermore, the limited studies on this topic have not explored organizational factors that are important in the implementation of such efforts.

PURPOSE

To investigate factors that influence the implementation of IPV prevention and response by one Catholic organization at both diocesan and parish levels.

METHODS

We conducted sixteen semi-structured interviews with members of Archdiocese of Chicago Domestic Violence Outreach (ACDVO) leadership. Using deductive content analysis, we drew on all 14 constructs and sub-constructs from the inner setting domain of the Consolidated Framework for Implementation Research (CFIR) for coding transcripts and characterizing factors influencing implementation success.

RESULTS

Seven CFIR constructs were useful in identifying factors that influenced implementation success of ACDVO. At the diocesan level, the organization's leadership structure, their driven culture, and in-kind available resources propelled their work. At the level of parish ministries, successful implementation was facilitated by networking and communication among parishes. At the diocesan-level, access to knowledge and information through ACDVO's Parish Support Committee, compatibility with parish values, leadership engagement, and available resources from parishes supported implementation.

CONCLUSIONS

We identified modifiable and reproducible inner setting factors that influence implementation of a Catholic IPV initiative at the diocesan-level and support parish ministries in their local activities. Future work should validate these findings in other dioceses and examine non-Catholic FBO settings.

Engaging Faith-Based Organizations for Promoting the Uptake of COVID-19 Vaccine in India: A Case Study of a Multi-Faith Society

Mass vaccination, currently the most promising solution to contain communicable diseases, including COVID-19 requires collaboration between a variety of partners to improve the supply and demand and alleviate vaccine inequity. Vaccine hesitancy features in WHO's list of top 10 threats to global health, and there is plethora of disinformation instigating conflict between COVID-19 vaccination drive and religious sentiments. Negotiating public health partnerships with FBOs (Faith Based Organizations) has always been challenging. A handful of faith leaders have always shown resistance to ideas such as child immunization, and family planning. Many others have been supportive on other fronts like helping people with food, shelter, and medical aid in the times of public health crisis. Religion is an important part of life for the majority of the Indian population. People confide in faith-based leaders in the times of difficulty. This article presents experiences from the strategic engagement with FBOs (entities dedicated to specific religious identities, often including a social or moral component) to promote uptake of COVID-19 vaccination, especially among the vulnerable and marginalized communities. The project team collaborated with 18 FBOs and more than 400 religious institutions to promote COVID-19 vaccination and build confidence for the vaccination program. As a result, a sustainable network of sensitized FBOs from diverse faiths was created. The FBOs mobilized and facilitated vaccination of 0.41 million beneficiaries under the project.

Safeguarding in Church: Children and Young People's Perceptions of Safety in Religious and Other Faith-Based Settings

Organizations that interact with children and young people have a duty of care to ensure the safety of those children and young people from any manner of abuse, particularly from child sexual abuse. Faith-based ("religious") organizations are of particular interest due to the number of victims/survivors speaking out about their experiences of grooming, child sexual abuse, and other forms of harm in religious organizations. Focusing on addressing the risks and improving safeguarding efforts, prevention activities benefit from giving children agency and a voice. We conducted a study using two focus groups with children and young people involved with two different Christian denominations. We conducted activities and led discussions regarding their views about safety in the context of the faith-based organization with which they engage. Children and young people described different potentially unsafe situations, their likely frequency, and the level of impact such situations would have from their own point of view. They also described how they thought adults in their faith-based organization would see them. Thematic analysis of the data supported four themes related to young people's sense of safety: concerning behavior of adults and other young people, fear of judgment by others (adults and peers), sense of or lack of empowerment due to power dynamics, and the importance of a sense of "familiarity." Visual comparisons of the data on scatterplots suggested differences not only in the level of impact and frequency of potentially unsafe situations between young people and adults but also between the two denominations. Children and young people can provide a wealth of information regarding their safety concerns when involved in programs and services at faith-based organizations. Clergy and other faith-based organizational leaders should consider how the context in which young people are involved (including interdenominational and interfaith difference, as well as the diverse types of activities young people are involved with) can affect their safety concerns.

outpatient clinics

Background

Minority and low socioeconomic communities may face practical barriers to vaccination, including decreased access to health care and less trust in healthcare organizations; however, few studies have focused on these barriers as the cause of differential vaccine uptake. We worked with community partners to implement and evaluate two community-driven approaches to COVID-19 vaccination distribution-through faith-based organizations (FBOs) and outpatient clinics-with a focus on understanding the differences between the populations who accessed each distribution method.

Methodology

Participants who came to the vaccination locations were approached and asked to complete a survey during their 15 min post-vaccination observation period. Differences between distribution locations were examined using Chi-square tests.

Results

The survey rendered 1,476 valid responses, with a total of 927 participants recruited at clinical locations and 519 at FBOs during vaccination events. There were significant differences by race/ethnicity, with distribution methods at FBOs reaching a higher proportion of Hispanic/Latino and Marshallese participants. The proportion of uninsured participants who had lower health literacy and had lower educational attainment was higher with the FBO distribution method. FBO participants were more likely to report "completely" trusting the COVID-19 vaccine. There was no significant difference between FBO and clinic participants with regard to the level of vaccine hesitancy. There were no statistically significant differences with regard to access.

Conclusion

A higher proportion of Hispanic/Latino and Marshallese participants utilized FBOs for vaccination, suggesting collaborations with FBOs can potentially increase vaccination uptake among minority communities and help mitigate vaccination disparities.

Veiling Religion: The Public Face of Czech Re-Entry Faith-Based Organizations

Due to the lack of sufficient non-governmental prisoner re-entry services in the Czech Republic, many post-release activities are provided by faith-based organizations (FBOs). However, the Czech Republic is considered to be one of the most atheistic countries in the world. Most of the Czech population is at least apathetic toward organized religion. This study examines how re-entry FBOs present Christianity to the public in the religiously indifferent Czech Republic. The primary focus is on how the organizations present themselves to the public. We employ qualitative content analysis examining names, logos, mission statements, and other documents of 14 re-entry FBOs. The analysis reveals four general themes within the organizations' public presentations: Ambiguity when expressing religious topics, Christianity as an offer, Christianity as a form of social movement (self-legitimization), and Christianity as a pro-social lifestyle.

Pastoral Leaders Perceptions of Mental Health and Relational Concerns within Faith Based Organizations

The purpose of this study was to explore the attitudes, beliefs, and perspectives of pastoral leaders regarding mental health and relational concerns within Faith-Based Organizations (FBO). As a follow-up to a previous study (Moore et al., 2016), the authors intended to gain insight regarding how pastoral leaders view their role within their organizations related to promoting sound mental health and relational health. Utilizing a qualitative description, authors disseminated a survey to 12 pastoral leaders to complete. Three themes emerged from their responses, which included: (1) Defining mental health; (2) The role of pastoral leaders in mental health; and (3) Mental health needs in pastoral leadership. In the study, investigators discuss clinical implications and provide recommendations regarding how pastoral leaders and Faith- Based Organizations may address the topic of mental health and relational health among its constituents. We believe this research is relevant to the readers of this journal as it contributes to a discussion about pastoral leaders and mental health, as well as how pastoral leaders' perception of mental health may impact how they discuss this topic within their own organizations. Furthermore, for readers who are clinicians, this study contributes to the body of knowledge about what pastoral leaders and constituents may need, as one considers opportunities for collaboration.

Exploring How Public Health Partnerships with Community-Based Organizations (CBOs) can be Leveraged for Health Promotion and Community Health

The Academic Public Health Corps (APHC) works to support local public health in Massachusetts through varying models of collaboration. In the setting of the COVID-19 pandemic, one initiative of the APHC has been to partner with community-based organizations (CBOs) to address vaccine hesitancy and improve overall community health. The purpose of this article is to share how the APHC partnered with CBOs in Massachusetts to address COVID-19 concerns within their respective communities, and present strategies to empower communities, share resources, and increase health promotion. The APHC partnered with 2 CBOs who received the Massachusetts COVID-19 Community Grants distributed by Health Resources in Action (HRiA). These CBOs include the Association of Islamic Charitable Projects Massachusetts (AICP) and the Somali Parents Advocacy Center for Education (SPACE). Culturally relevant educational and promotional materials were created and tailored toward the communities of interest within the CBOs. Additionally, in response to the community's desire for more informational events, the APHC hosted a virtual COVID-19 Q&A panel with Muslim health care professionals that included live Arabic translation. The model of outreach that the APHC has employed illustrates an intentional way of addressing key public health issues within local communities. The success of these partnerships highlights the importance of including CBOs in conversations about public health and health equity.

Religion and Food Insecurity in the Time of COVID-19: Food Sovereignty for a Healthier Future

The COVID-19 pandemic has exposed and amplified food insecurity in marginalized communities of color, revealing systemic health and socioeconomic inequalities. Given the role that religious organizations play in building social capital, disseminating information to local communities, and facilitating the distribution of basic necessities such as food, they are integrally involved in short- and long-term solutions to food insecurity. Yet, literature on the role of religious institutions for mitigating food insecurity is limited. The literature related to methods and means by which religious organizations engage community efforts to mitigate food security as well as studies in food sovereignty will be reviewed.

Community-Based Participatory Research partnership with faith-based organizations to address obesity and glucose control

OBJECTIVES

To explore the lived (narrative) experience of obesity and/or diabetes mellitus within focus groups consisting of individuals and community support persons residing in Genesee County, Michigan.

DESIGN

Qualitative study, using Community-Based Participatory Research (CBPR) methodology to design and conduct focus group interviews.

SAMPLE

Nineteen participants from faith-based organizations (FBOs) in Genesee County (74.5% Caucasian, 3.0% Hispanic American).

MEASUREMENTS

Semi-structured narrative focus group interviews, using thematic coding and qualitative analysis software (Otter.com).

RESULTS

Participants from diverse FBOs revealed barriers that prevent them from reaching their weight goals and preventing or controlling diabetes. A shared theme included the concern that providers do not actively inquire about patient concerns at appointments, and they fail to offer practical strategies beyond pharmaceutical interventions.

CONCLUSION

Focus group interviews with community residents revealed issues and barriers patients and their support persons face in health care experiences. Utilizing CBPR (methodology) is an opportunity for advanced practice nurses (health care professionals) to co-create strategies and interventions with the community that can assist them in successfully reaching their weight loss and diabetes prevention goals.

Overcoming Historical Barriers: Enhancing Positive Perceptions of Medical Research Among African Americans Through a Conference-Based Workshop

BACKGROUND

African Americans (AAs) and other racial/ethnic minority groups continue to be underrepresented in medical research and clinical trials. Failure to create more racially diverse research cohorts can exacerbate existing health disparities among these groups.

OBJECTIVE

To investigate best practices and strategies for enhancing participation of AAs in medical research among attendees of a preconference Institute at a faith-based public health conference.

DESIGN

Qualitative study using semi-structured interviews.

PARTICIPANTS

A total of 21 out of 29 attendees (90% AA) of the Institute (72% response rate).

APPROACH

A culturally tailored preconference Institute was held at the 2017 Healthy Churches 2020 National Conference. The Institute was led by AA researchers focused on underrepresentation of AAs in medical research. Semi-structured interviews were conducted 1-year post-Institute (n=21) and were audio-recorded, transcribed verbatim, and reviewed using thematic analysis.

KEY RESULTS

The majority of attendees reported that they were more likely to participate in medical research after attending the Institute (75%). Salient learning points reported by attendees demonstrated attainment of the Institute objectives. Key themes emerged describing barriers preventing AAs from participating in medical research including fear/lack of trust, lack of information on research projects, and not being approached to participate. Key themes regarding facilitators for participation in medical research by AAs were clear communication of study objectives and research benefits along with trust in researchers.

CONCLUSIONS

Attendees' perceptions of participation in medical research were largely positive following their attendance at a conference-based Institute aimed to address the underrepresentation of AAs in medical research. Our culturally tailored approach to disseminating knowledge of the research process could extend to other national conferences prioritizing AAs and other racial/ethnic minority populations to improve research participation.

Assisting Faith-Based Organizations Increase Sense of Belonging during the Covid-19 Pandemic

The Covid-19 pandemic has negatively affected the three basic needs of individuals. Faith-based organization leaders are carrying the additional weight of stewardship of members during these challenging times. Many Faith-based organization leaders feel a sense of responsibility to create environments where members feel a sense of belonging. Five considerations for Faith-based organization leaders hoping to increase belonging are discussed below. Specifically, low-cost options are presented that could be implemented in small-to-large Faith-based organizations.

A road map for the future: An exploration of attitudes, perceptions, and beliefs among African Americans to tailor health promotion of cancer-related genetic counseling and testing

African Americans (AA), the second largest racial/ethnic minority group in the United States (US), carry the largest mortality burden of cancer compared with other racial/ethnic groups (Cancer Facts & Figures for African Americans, 2019-2021, American Cancer Society).One solution to address this disparity is through cancer-related genetic counseling and testing (CGT). Although CGT is utilized among the general population, it remains underutilized among AA populations. Community-engaged and community-driven health promotion programs within faith-based organizations (FBOs) have been successfully implemented and delivered among AA populations (Israel et al., American Journal of Public Health, 100, 2010, 2094). FBOs are well positioned for cancer-related health promotion and equipped as conduits of health education and information distribution for cancer prevention. In the present pilot study, a community-based participatory approach (CBPR) was used to collect exploratory data on attitudes, perceptions, and beliefs toward CGT and uptake among an AA sample in the Midwest. Focus groups were conducted in two churches where respondents (N=34) answered a pre-focus group survey prior to a discussion. Respondents were largely unaware of CGT and thought of testing as primarily for ancestral discovery and not for an inheritable disease. Themes identified through qualitative analysis included emotional experiences with cancer; perception of cancer risk; different pictures of genetic testing; other things to worry about; trust in the healthcare system/faith in God and the healthcare system; and ideas and insights regarding promotion of CGT. These primary themes showed participants' perceptions of CGT were shaped by their experiences with cancer, faith, faith communities/FBOs, and cost and access to CGT. Overall, participants within these organizations had positive perceptions about the church as a conduit of genetic testing information but had mixed opinions about the rationale for completing CGT. These findings have implications for genetic counselors, medical providers, and health promotion personnel as to how AA faith populations view CGT and the utility of FBOs as promoters of CGT information.

Foods served at faith community events for children - Is there room for improvements in this unexplored child nutrition site?

OBJECTIVE

To describe food and beverage provisions by Faith Communities from one denomination in association with events for children.

DESIGN, SAMPLE AND MEASURES

Foods and beverages provided at 32 child-focused activities were documented using direct observation methodology and analyzed for contribution to food groups and per serving energy, fat, saturated fat, sugar, and sodium contents.

RESULTS

Main dishes were mostly (71%) convenience/casserole-type foods, and averaged 962 mg sodium and 436 kcal, with 36% of energy from fat and 14% as saturated fat. Cheese was the main source of dairy products. Grain-based side dishes, provided at 29% of meals, included white rice, pasta, and bread. Non-starchy vegetables were provided at three (29%) meals. Fruits were served at six events. Desserts, served at 75% of events, contained 41% of energy from fat, with 17% as saturated fat, and 22 g of added sugar. Snack chips, provided at 31% of events, contributed 165 kcal mostly from fat and 243 mg of sodium. Sugar-sweetened beverages, served at 71% of events, contributed 28 g of added sugar.

CONCLUSIONS

This pilot investigation identified areas for improvements in the nutritional quality of foods/beverages served at faith community child-focused events and aligns with expanding public health efforts to improve child nutrition beyond traditional settings.

Safeguarding Health at the Workplace: A Study of Work Engagement, Authenticity and Subjective Wellbeing among Religious Workers

Research in work and organizational psychology has paid little attention to religious workers, something certainly surprising as faith-based organizations play a key role in the welfare state of many countries. This research shows that religious workers in a Catholic order present a high degree of subjective wellbeing, both in terms of flourishing and satisfaction with life in general, and a positive balance of positive and negative feelings. More specifically, this study examines the relationship between authenticity and wellbeing amongst religious workers. Survey responses from 142 religious workers in Spain were analyzed using partial least squares path modelling. The results reveal that subjective wellbeing at work is positively related to authenticity. In addition, this relationship is mediated by their level of work engagement.

Feasibility and acceptability of a mobile messaging program within a church-based healthy living intervention for African Americans and Latinos

Church-based programs can act on multiple levels to improve dietary and physical activity behaviors among African Americans and Latinos. However, the effectiveness of these interventions may be limited due to challenges in reaching all congregants or influencing behavior outside of the church setting. To increase intervention impact, we sent mobile messages (text and email) in English or Spanish to congregants (n = 131) from predominantly African American or Latino churches participating in a multi-level, church-based program. To assess feasibility and acceptability, we collected feedback throughout the 4-month messaging intervention and conducted a process evaluation using the messaging platform. We found that the intervention was feasible to implement and acceptable to a racially ethnically diverse study sample with high obesity and overweight rates. While the process evaluation had some limitations (e.g. low response rate), we conclude that mobile messaging is a promising, feasible addition to church-based programs aiming to improve dietary and physical activity behaviors.

Work Engagement and Flourishing at Work Among Nuns: The Moderating Role of Human Values

Faith-based organizations are a key player in major sectors of activity for maintaining the welfare state, including health, education, and social services. This paper uses a multivariate regression model in an attempt to identify the factors that affect the relationship between work engagement and flourishing. The paper also discusses the empirical research gap that has been identified in the literature about the moderated effect of human values on this relationship. This study is based on a sample of 142 nuns of a congregation belonging to a religious organization with an international scope and a Catholic inspiration. The case of religious women who have chosen to live a life consistent with the charism of the congregation constitutes a paradigmatic and unique environment to investigate the potential alignment of personal values with professional activity. This work unveils two main findings. First, the more engaged nuns are in their work (social action to serve the poorest and most disadvantaged people), the more they flourish in their working environment and in their personal lives. Second, Schwartz's values reinforce the relationship between the professional role (work engagement) and the personal role (flourishing at work). In conclusion, flourishing at work could be improved through work engagement and this relationship is moderated by human values. These results add insights to better know the relationship among life and work domains.

Effectiveness of a Faith-placed Cardiovascular Health Promotion Intervention for Rural Adults

INTRODUCTION

Cardiovascular disease (CVD) is the leading cause of mortality in the US. Further, rural US adults experience disproportionately high CVD prevalence and mortality compared to non-rural. Cardiovascular risk-reduction interventions for rural adults have shown short-term effectiveness, but long-term maintenance of outcomes remains a challenge. Faith organizations offer promise as collaborative partners for translating evidence-based interventions to reduce CVD.

METHODS

We adapted and implemented a collaborative, faith-placed, CVD risk-reduction intervention in rural Illinois. We used a quasi-experimental, pre-post design to compare changes in dietary and physical activity among participants. Intervention components included Heart Smart for Women (HSFW), an evidence-based program implemented weekly for 12 weeks followed by Heart Smart Maintenance (HSM), implemented monthly for two years. Participants engaged in HSFW only, HSM only, or both. We used regression and generalized estimating equations models to examine changes in outcomes after one year.

RESULTS

Among participants who completed both baseline and one-year surveys (n = 131), HSFW+HSM participants had significantly higher vegetable consumption (p = .007) and combined fruit/vegetable consumption (p = .01) compared to the HSM-only group at one year. We found no differences in physical activity.

CONCLUSION

Improving and maintaining CVD-risk behaviors is a persistent challenge in rural populations. Advancing research to improve our understanding of effective translation of CVD risk-reduction interventions in rural populations is critical.

Facilitating Partnerships With Community- and Faith-Based Organizations for Disaster Preparedness and Response: Results of a National Survey of Public Health Departments

OBJECTIVE

We identify characteristics of local health departments, which enhance collaborations with community- and faith-based organizations (CFBOs) for emergency preparedness and response.

METHODS

Online survey data were collected from a sample of 273 disaster preparedness coordinators working at local health departments across the United States between August and December 2011.

RESULTS

Using multiple linear regression models, we found that perceptions of CFBO trust were associated with more successful partnership planning (β=0.63; P=0.02) and capacity building (β=0.61; P=0.01). Employee layoffs in the past 3 years (β=0.41; P=0.001) and urban location (β=0.41; P=0.005) were positively associated with higher ratings of resource sharing between health agencies and CFBOs. Having 1-3 full-time employees increased the ratings of success in communication and outreach activities compared with health departments having less than 1 full-time employee (β=0.33; P=0.05). Positive attitudes toward CFBOs also enhanced communication and outreach (β=0.16; P=0.03).

CONCLUSIONS

Staff-capacity factors are important for quick dissemination of information and resources needed to address emerging threats. Building the trust of CFBOs can help address large-scale disasters by improving the success of more involved activities that integrate the CFBO into emergency plans and operations of the health department and that better align with federal-funding performance measures. (Disaster Med Public Health Preparedness. 2018;12:57-66).

Mass-Fatality Incident Preparedness Among Faith-Based Organizations

Introduction Members of faith-based organizations (FBOs) are in a unique position to provide support and services to their local communities during disasters. Because of their close community ties and well-established trust, they can play an especially critical role in helping communities heal in the aftermath of a mass-fatality incident (MFI). Faith-based organizations are considered an important disaster resource and partner under the National Response Plan (NRP) and National Response Framework; however, their level of preparedness and response capabilities with respect to MFIs has never been evaluated. The purpose of this study was threefold: (1) to develop appropriate measures of preparedness for this sector; (2) to assess MFI preparedness among United States FBOs; and (3) to identify key factors associated with MFI preparedness. Problem New metrics for MFI preparedness, comprised of three domains (organizational capabilities, operational capabilities, and resource sharing partnerships), were developed and tested in a national convenience sample of FBO members.

METHODS

Data were collected using an online anonymous survey that was distributed through two major, national faith-based associations and social media during a 6-week period in 2014. Descriptive, bivariate, and correlational analyses were conducted.

RESULTS

One hundred twenty-four respondents completed the online survey. More than one-half of the FBOs had responded to MFIs in the previous five years. Only 20% of respondents thought that roughly three-quarters of FBO clergy would be able to respond to MFIs, with or without hazardous contamination. A higher proportion (45%) thought that most FBO clergy would be willing to respond, but only 37% thought they would be willing if hazardous contamination was involved. Almost all respondents reported that their FBO was capable of providing emotional care and grief counseling in response to MFIs. Resource sharing partnerships were typically in place with other voluntary organizations (73%) and less likely with local death care sector organizations (27%) or Departments of Health (DOHs; 32%).

CONCLUSIONS

The study suggests improvements are needed in terms of staff training in general, and specifically, drills with planning partners are needed. Greater cooperation and inclusion of FBOs in national planning and training will likely benefit overall MFI preparedness in the US. Zhi Q , Merrill JA , Gershon RR . Mass-fatality incident preparedness among faith-based organizations. Prehosp Disaster Med. 2017;32(6):596-603.

Comparison of Government and Non-Government Alcohol and Other Drug (AOD) Treatment Service Delivery for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community

BACKGROUND

Lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to misuse alcohol and other drugs (AOD), compared to the general population. However, LGBT engagement with AOD treatment is often precluded by insensitivity and misunderstanding of LGBT issues. These treatment barriers may be a consequence of either worker attitudes, organizational factors or a combination of both. Few studies have compared service context as an impediment to AOD treatment.

OBJECTIVES

This pilot study sought to examine and compare staff attitudes, knowledge and awareness of LGBT issues in two state-wide AOD services within Australia. One organization was a government service, whilst the other was faith based.

METHODS

A cross-sectional study of a convenience sample (N = 130) of workers employed in a state-wide government AOD service (n = 65), and a state-wide non-government service (n = 65) was conducted. Participants self-completed a questionnaire comprising tools previously used to assess staff attitudes, knowledge and awareness of LGBT issues.

RESULTS

Few significant differences in attitudes and awareness of LGBT issues between government and non-government respondents were found. Nearly all respondents were supportive of LGBT persons irrespective of organizational context, with a small number of negative views. Although most respondents demonstrated awareness of organizational policies and practices relating to LGBT clients, many were "unsure" or "neutral" of what these might be.

CONCLUSION

It is confirming that the majority of staff report supportive attitudes towards LGBT clients. Findings suggest that organizations need to continue to take leadership to strengthen organizational training and capacity to deliver LGBT friendly AOD treatment practices.

Accessing Faith-Based Organizations Using Public Transportation: A Qualitative and GIS Study

Nondriving aging adults are at risk of experiencing mobility barriers that inhibit access to important community resources for managing health and wellbeing. This multimethod study explores bus transportation experiences of older adults who live in extended stay hotels and use faith-based organizations to access resources. Interviews from 17 nondriving older adults were analyzed for perspectives about using faith-based organizations and residents' experiences navigating to faith-based organizations through available bus transportation in their communities. Residents described both favorable and unfavorable experiences when reaching out for help from faith-based organizations. Although they report reliance on faith-based organizations for a variety of resources, residents were challenged by an ineffective bus system that interfered with resource accessibility. Suggestions for improving bus transit systems and providing alternative, aging-friendly transportation options are discussed.

Reducing Low Birth Weight among African Americans in the Midwest: A Look at How Faith-Based Organizations Are Poised to Inform and Influence Health Communication on the Developmental Origins of Health and Disease (DOHaD)

Low birth weight (LBW) rates remain the highest among African Americans despite public health efforts to address these disparities; with some of the highest racial disparities in the Midwest (Kansas). The Developmental Origins of Health and Disease (DOHaD) perspective offers an explanation for how LBW contributes to racial health disparities among African Americans and informs a community directed health communication framework for creating sustainable programs to address these disparities. Trusted community organizations such as faith-based organizations are well situated to explain health communication gaps that may occur over the life course. These entities are underutilized in core health promotion programming targeting underserved populations and can prove essential for addressing developmental origins of LBW among African Americans. Extrapolating from focus group data collected from African American church populations as part of a social marketing health promotion project on cancer prevention, we theoretically consider how a similar communication framework and approach may apply to address LBW disparities. Stratified focus groups (n = 9) were used to discover emergent themes about disease prevention, and subsequently applied to explore how faith-based organizations (FBOs) inform strategic health care (media) advocacy and health promotion that potentially apply to address LBW among African Americans. We argue that FBOs are poised to meet health promotion and health communication needs among African American women who face social barriers in health.

A Mid-South Perspective: African American Faith-based Organizations, HIV, and Stigma

Shelby County, Tennessee has the fastest growing rate of HIV infection in the state, and the majority of new infections are in African Americans. In 2011, a Centers for Disease Control and Prevention report stated that Memphis (the largest city in Shelby County) ranked seventh highest in new HIV infections. Little research has addressed HIV-related themes in African American culture that could hinder HIV prevention measures. Our qualitative study engaged African American, faith-based leaders in areas with high rates of HIV in meaningful conversations regarding their attitudes toward HIV and those who are infected. Although faith-based leaders felt they had a role in HIV prevention, only 4% in our study had participated in HIV prevention activities, but they were open to HIV prevention programs. We found that faith-based leaders had limited knowledge of health disparities and ongoing stigma concerning HIV, which served as a major barrier to HIV prevention.

Exploring the Role of Faith-Based Organizations in Addressing Adolescent Relationship Abuse

Adolescent relationship abuse (ARA) is prevalent with significant health and social consequences. Faith-based organizations could play an important role in ARA prevention and intervention. Studies on the role of faith-based organizations in interpersonal violence have focused on adult survivor perspectives rather than adolescents. Focus groups and interviews were conducted with faith-based organization leaders, parents, and youth. Findings highlight that church leaders, parents, and youth all expect that faith-based organizations can play a role in educating teens about healthy relationships. Divergent perspectives about how faith-based organizations should address adolescent sexuality and privacy need to be addressed.

Recruiting and Surveying Catholic Parishes for Cancer Control Initiatives: Lessons Learned From the CRUZA Implementation Study

BACKGROUND

We describe activities undertaken to conduct organizational surveys among faith-based organizations in Massachusetts as part of a larger study designed to promote parish-based cancer control programs for Latinos.

METHOD

Catholic parishes located in Massachusetts that provided Spanish-language mass were eligible for study participation. Parishes were identified through diocesan records and online directories. Prior to parish recruitment, we implemented a variety of activities to gain support from Catholic leaders at the diocesan level. We then recruited individual parishes to complete a four-part organizational survey, which assessed (A) parish leadership, (B) financial resources, (C) involvement in Hispanic Ministry, and (D) health and social service offerings. Our goal was to administer each survey component to a parish representatives who could best provide an organizational perspective on the content of each component (e.g., A = pastors, B = business managers, C = Hispanic Ministry leaders, and D = parish nurse or health ministry leader). Here, we present descriptive statistics on recruitment and survey administration processes.

RESULTS

Seventy-five percent of eligible parishes responded to the survey and of these, 92% completed all four components. Completed four-part surveys required an average of 16.6 contact attempts. There were an average of 2.1 respondents per site. Pastoral staff were the most frequent respondents (79%), but they also required the most contact attempts (M = 9.3, range = 1-27). While most interviews were completed by phone (71%), one quarter were completed during in-person site visits.

CONCLUSIONS

We achieved a high survey completion rate among organizational representatives. Our lessons learned may inform efforts to engage and survey faith-based organizations for public health efforts.

Correlates of HIV testing among African American and Latino church congregants: the role of HIV stigmatizing attitudes and discussions about HIV

Faith-based organizations can be key settings in which to reach African Americans and Latinos for HIV prevention, but little is known regarding factors that predict congregants' HIV testing behaviors. We examined the extent to which sociodemographic factors, HIV-related cues to action (e.g., knowing someone who is HIV-positive), and the social climate surrounding HIV (stigma toward a hypothetical HIV-positive congregant, HIV-related discussions at church about abstinence, condoms, and testing) were associated with willingness to be tested in church and with ever having been tested among 1211 African American and Latino congregants. Multivariate analyses indicated that congregants were more open to church-based testing if they were younger and had discussed condoms at church. They were less open if they expressed stigmatizing attitudes toward a hypothetical congregant. Foreign-born Latinos with low English proficiency were more willing to be tested at church than were African Americans. Congregants were more likely to have ever been tested if they were younger, African American, female, or married; if they knew someone who was HIV-positive; and if they had discussed testing and condoms at church. They were less likely if they had discussed abstinence. Open dialogue around HIV may activate congregants to be more receptive to church-based prevention.

Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji

Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.

Perceptions and activities of religious leaders on the prevention of HIV/AIDS and care of people living with the HIV infection in Ibadan, Nigeria

Introduction

The epidemic of human immunodeficiency virus (HIV) continues in Nigeria despite efforts to control it. Meaningful efforts aimed at combating this disease must be multisectoral. However, despite the major influence religious leaders have in this society, their role has not been well studied. The aim of the study was to assess the perceptions and activities of religious leaders on prevention of HIV/acquired immunodeficiency syndrome (AIDS) and care of people living with the virus in Ibadan, Nigeria.

Materials and methods

In a cross-sectional study, 336 leaders from eight religious denominations in Ibadan were surveyed utilizing a self-administered, semi-structured questionnaire. Respondents were selected by cluster sampling technique. Data was analyzed using the Statistical Package for Social Sciences software version 15.

Results

The mean age of respondents was 37.9 (± 13.5) years. The majority (97.6%) were aware of the HIV/AIDS scourge, and most had good knowledge of routes of transmission and modes of prevention (85.7%). Attitudes to people living with HIV/AIDS were positive in 84.2% respondents, and many practiced preventive measures (94.9%). One hundred and ninety (56.5%) respondents had ever preached about HIV/AIDS transmission and treatment to their congregations, while 257 (76.5%) used their position as a medium of educating their congregation about the dangers of HIV/AIDS and how to prevent it. Further analysis showed that respondents who were Christians (P = 0.026), had ever been married (P = 0.004), and were males (P = 0.002) were more likely to have ever preached about health issues to their congregations (individual role).

Conclusion

The study concluded that the religious leaders are well informed about HIV/AIDS and have adequate knowledge and positive attitudes towards people living with AIDS. However, they need encouragement and training to enable them to more effectively harness their position for HIV prevention and to control programs and activities among their congregation to thereby play a crucial role in the war against HIV/AIDS in Nigeria.

Perspectives of community- and faith-based organizations about partnering with local health departments for disasters

Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way "push" model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

Shaking and rattling: developing a child obesity prevention program using a faith-based community approach

This article describes the creation of a faith-based, community action research intervention aimed at reducing childhood obesity among a vulnerable population. Of particular concern to the community was the prevalence of obesity among its minority children. Engaging parents in a childhood obesity initiative through faith-based organizations (churches, community organizations with a common religious focus) was a method to provide a research intervention. It is important for researchers to be culturally competent, employ community-based participatory research methods, carefully plan interventions that have clear outcome criteria, and build evaluation of the process into every step of the research.