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Yeary KHCK, Allen JD, Arredondo E, Atemnkeng J, Buzcu-Guven B, Day KR, Dicarlo E, Formagini T, Kwon SC, McElfish P, McNeill LH, Newton RL, Park CL, Wilcox S, Williams LB, Yusuf Y, Zoellner J. Cancer interventions with faith-based organizations: a scoping review. Cancer Causes Control 2025:10.1007/s10552-025-01977-6. [PMID: 40038170 DOI: 10.1007/s10552-025-01977-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 02/17/2025] [Indexed: 03/06/2025]
Abstract
PURPOSE Faith-based organizations (FBOs) have been recognized as a critical partner to reach underserved, marginalized populations in the U.S. for disease prevention and health promotion. FBOs have been successfully engaged to lower risk for leading causes of death, including cancer, but despite the proliferation of FBO cancer intervention research, a comprehensive review is lacking. METHODS We conducted a PRISMA Scoping Review to ascertain the impact of FBO cancer interventions. Seven bibliographical databases were used to search for articles evaluating cancer interventions reporting quantitative outcomes in which places of worship in the U.S. served as the research location. Study characteristics and results data were extracted by two independent extractors. RESULTS Thirty-six studies were included. All FBOs were Christian churches with healthy populations. Breast (25%), prostate (22%), and colorectal (17%) were the primary cancers targeted and cancer screening was the primary outcome of 75% of studies. Sixty-nine percent (k = 25) reported significant results in cancer-related outcomes from baseline to post-intervention follow-up, with 100% of studies in Korean American communities (k = 7) reporting significant results. CONCLUSION FBO interventions can successfully increase preventative screening across numerous cancer types in diverse communities, particularly in Korean Americans. Additional FBO cancer interventions that aim to reduce inequities in other cancers (e.g., lung) that disproportionately affect Korean Americans and have not been targeted are warranted. Expanding current investigations of FBO collaborations with other faiths (besides Christian) to include cancer prevention and control would further realize FBOs' untapped potential.
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Affiliation(s)
| | - Jennifer D Allen
- Tufts University (School of Arts and Sciences), Medford, MA, USA
| | | | | | | | - Kelsey R Day
- University of Virginia, Charlottesville, VA, USA
| | - Elizabeth Dicarlo
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Taynara Formagini
- University of California San Diego, San Diego State University, La JollaSan Diego, CACA, USA
| | | | - Pearl McElfish
- University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Sara Wilcox
- University of South Carolina, Columbia, SC, USA
| | | | - Yousra Yusuf
- NYU Grossman School of Medicine, New York, NY, USA
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Iltis AS, Baker LL, Baldwin K, Cruz L, Yaeger LH, DuBois JM. Approaches to engaging faith communities in public health efforts regarding vaccination, genetics, and colorectal cancer: a systematic review. BMC Public Health 2025; 25:703. [PMID: 39979841 PMCID: PMC11841242 DOI: 10.1186/s12889-025-21903-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 02/11/2025] [Indexed: 02/22/2025] Open
Abstract
BACKGROUND Public health professionals regularly engage faith communities to improve public health. This systematic review characterizes approaches that public health professionals have used to engage faith communities and evaluates them using the Theory of Planned Behavior. It examines engagement regarding vaccination and genetic and genomic healthcare, which have generated significant controversy within religious groups and, for comparison, colorectal cancer screening, which has not. METHODS This systematic review followed PRISMA reporting guidelines. We searched 8 online databases (e.g., Medline, Embase, Scopus). Publications in English that reported engaging a faith community on genetics, vaccination, or colorectal cancer screening were included. We screened 13,117 articles and extracted information from 121 articles reporting on 96 distinct projects. RESULTS This review includes 121 articles reporting on 96 distinct projects. 67% of projects took place in the United States. Of these, 73% reported engaging racial or ethnic minorities; only 5% of projects reported engaging primarily White, Christian communities. Only 35% of projects reported addressing religious values that might inform attitudes and beliefs. The majority of publications (n = 74; 77.1%) reported primarily engaging faith communities for reasons unrelated to faith. CONCLUSION Because the Theory of Planned Behavior is widely used and our focus was on faith communities, we expected to see engagement with faith values and beliefs that might inform attitudes toward behaviors or social pressures community members perceive. Fewer than half of the projects reported addressing values or attitudes. There are missed opportunities to engage faith communities on religiously controversial public health initiatives in ways that are most likely to affect health behaviors. Evaluation of the outcomes of such engagement is needed. TRIAL REGISTRATION The protocol is registered on Open Science Framework (OSF) at osf.io/r2c9n.
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Affiliation(s)
- Ana S Iltis
- Center for Bioethics, Health and Society, Wake Forest University, 1834 Wake Forest Rd., Winston-Salem, NC, 27106, USA.
| | - Lauren L Baker
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, 425 S. Euclid Ave., 8 Barnard, St. Louis, MO, 63110, USA
| | - Kari Baldwin
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, 425 S. Euclid Ave., 8 Barnard, St. Louis, MO, 63110, USA
| | - Lucas Cruz
- Washington University in St. Louis, St. Louis, MO, USA
| | - Lauren H Yaeger
- Bernard Becker Medical Library, Washington University School of Medicine, Campus, 660 S. Euclid Ave, Box 8132, St. Louis, MO, 63110, USA
| | - James M DuBois
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, 425 S. Euclid Ave., 8 Barnard, St. Louis, MO, 63110, USA
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Wilmoth SR, Carrillo-McCracken LL, Wilhite B, Pan M, Parra-Medina D, Sosa ET, Reyes R, He M. Impacts of Diabetes Self-Management Education and Support Programs in Hispanic Church Settings: A Cluster-Randomized Trial Comparing Faith-Based and Faith-Placed Approaches. Nutrients 2024; 17:69. [PMID: 39796503 PMCID: PMC11722868 DOI: 10.3390/nu17010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 12/17/2024] [Accepted: 12/26/2024] [Indexed: 01/13/2025] Open
Abstract
Background/Objectives: This study aimed to adapt evidence-based diabetes self-management education and support (DSMES) into a faith-based (FB) context for Hispanic communities and compare its effectiveness to a faith-placed (FP) approach using the church as a venue for DSMES delivery. Methods: A cluster-randomized trial was conducted among adults with type 2 diabetes from predominantly Hispanic churches. The churches were assigned to either the FB Group (nine churches, n = 146) or the FP Group (seven churches, n = 125). The FB Group, led by trained lay health leaders, received a health sermon, a six-session DSMES program, and a seven-session Healthy Bible Study. The FP Group, led by outside health professionals, received the same six-session DSMES and a seven-session partial attention control curriculum. Key outcomes, including hemoglobin A1c (HbA1c), waist circumference (WC), diabetes distress, self-care activities, and self-efficacy, were assessed at baseline, 6, 9, and 12 months. Results: The FB Group had lower HbA1c levels than the FP Group at 6 months (-0.3%, p < 0.01), with no within-group differences post-intervention. No significant between-group differences were found for other outcomes. Within-group comparisons from baseline showed that both groups reduced WC at 9 and 12 months. Both groups showed reductions in diabetes distress and increased self-efficacy at all time points post-intervention (p < 0.05). The FB Group increased self-care scores at all time points post-intervention, while the FP Group increased at 9 and 12 months. Conclusions: DSMES can be effectively delivered in church settings by trained lay leaders or health professionals in Hispanic communities. Adding a spiritual dimension to DSMES may enhance outcomes.
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Affiliation(s)
- Summer R. Wilmoth
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX 78249, USA; (S.R.W.); (E.T.S.)
| | - Leah L. Carrillo-McCracken
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX 78249, USA; (S.R.W.); (E.T.S.)
| | - Bradley Wilhite
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX 78249, USA; (S.R.W.); (E.T.S.)
| | - Meixia Pan
- Barshop Institute, UT Health Science Center (UT Health) San Antonio, San Antonio, TX 78229, USA;
| | - Deborah Parra-Medina
- Center for Health Equity, Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Erica T. Sosa
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX 78249, USA; (S.R.W.); (E.T.S.)
| | - Ramon Reyes
- Bandera Family Health Care Research, San Antonio, TX 78249, USA;
| | - Meizi He
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX 78249, USA; (S.R.W.); (E.T.S.)
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Obeng-Nyarko CN, Ralston PA, Wickrama KKAS, Lemacks JL, Ilich JZ. Health for Hearts United Longitudinal Trial: Improving Perceived Stress and Allostatic Load Outcomes of Mid-Life and Older African American Women. HEALTH EDUCATION & BEHAVIOR 2024; 51:843-852. [PMID: 39051464 DOI: 10.1177/10901981241263027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in the United States, with African Americans experiencing higher age-adjusted mortality compared to Whites. African American women in particular carry a high CVD burden due to more exposure to adverse personal and socioenvironmental challenges. Church-based interventions can improve health behaviors and health status of African Americans, yet few have addressed stress-related health. The purpose of this study was to determine the effectiveness of the 18-month Health for Hearts United intervention in relation to stress-related outcomes (perceived stress, allostatic load) of mid-life and older African American women (≥45 years of age; n = 152 overall sample, n = 65 clinical subsample). The results of the repeated measures analysis of variance (ANOVA) analyses showed overall significant decreases in perceived stress and allostatic load for both treatment and comparison groups over the measurement occasions (baseline and 18 months) with educational level remaining as a significant correlate over time. There was no significant interaction between treatment and time, yet there were trends in improvements for the treatment group compared to the comparison group. The findings demonstrate the potential of church-based interventions in reducing both self-reported stress and allostatic load in African American women, and highlight the need for further investigation of educational level and other possible factors influencing stress management in these settings.
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Wilmoth S, Wilhite B, Highwood K, Palacios C, Carrillo-McCracken L, Parra-Medina D, Sosa E, He M. Participants' Perspectives on Diabetes Self-Management Programming at Church: Faith-Placed Versus Faith-Based Approach. Sci Diabetes Self Manag Care 2024; 50:469-483. [PMID: 39425574 PMCID: PMC11600661 DOI: 10.1177/26350106241288787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2024]
Abstract
PURPOSE The purpose of the study was to explore Hispanic adults' experiences participating in the Building a Healthy Temple diabetes self-management education and support (DSMES) cluster randomized trial and collect their insights on intervention approach, delivery, content, impact, and suggested improvements for future DSMES programs delivered at church. METHODS Focus groups were conducted with participants from both intervention arms, that is, faith-based (FB) group and faith-placed group. Participating churches were predominantly Hispanic and located in San Antonio, Texas. Focus groups were audiotaped and transcribed verbatim. Inductive content analysis was performed with the assistance of NVivo software to code and categorize emerging themes. RESULTS A total of 138 adult participants took part in the current study. Participants in both groups highly valued the church setting for its convenient location and support system and reported positive changes in diabetes-related beliefs, knowledge, skills, behaviors, and health outcomes. FB participants appreciated the incorporation of spiritual teachings and facilitation by lay leaders, which created a sense of empowerment and improved outlook on living with diabetes. CONCLUSIONS Church holds promise as a setting for DSMES program delivery in Hispanic communities. Church-based DSMES programs using a FB approach may further facilitate program adoption and sustainability.
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Affiliation(s)
- Summer Wilmoth
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
| | - Bradley Wilhite
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
| | - Kimberly Highwood
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
| | - Christine Palacios
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
| | - Leah Carrillo-McCracken
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
| | - Deborah Parra-Medina
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, School of Medicine, Center for Health Equity, Aurora, Colorado
| | - Erica Sosa
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
| | - Meizi He
- Department of Public Health, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, Texas
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Gebretsadik LA, Mamo A, Abera M, Haji Bediru K, Bulcha G, Koricha ZB, Morankar S. The Involvement of Religious Leaders in Supporting Institutional Childbirth in Rural Jimma Zone, Oromia, Southwest Ethiopia: An exploratory Qualitative Study. JOURNAL OF RELIGION AND HEALTH 2024; 63:4623-4640. [PMID: 39377889 DOI: 10.1007/s10943-024-02151-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2024] [Indexed: 10/09/2024]
Abstract
This exploratory qualitative study examined the involvement of religious leaders in maternal health practices with a focus on promoting institutional childbirth in the rural Jimma Zone, Oromia, Ethiopia. In-depth interviews with 24 male religious leaders revealed five key themes: awareness of childbirth practices, religious beliefs, experiences of childbirth preparedness, experiences at health institutions, and challenges with using institutional childbirth services. The findings indicate that, while religious leaders significantly influence community attitudes toward institutional childbirth, their impact is often limited by a lack of awareness and insufficient engagement with health services. This study underscores the need for culturally sensitive interventions incorporating religious beliefs into maternal health promotion. Enhanced collaboration between health care providers and religious leaders, along with targeted training, is essential for improving maternal health outcomes and increasing the use of institutional childbirth services in rural Ethiopia and other similar contexts.
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Affiliation(s)
- Lakew Abebe Gebretsadik
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, PO Box 378, Jimma, Oromia, Ethiopia.
| | - Abebe Mamo
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, PO Box 378, Jimma, Oromia, Ethiopia
| | - Muluemebet Abera
- Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Oromia, Ethiopia
| | | | | | - Zewdie Birhanu Koricha
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, PO Box 378, Jimma, Oromia, Ethiopia
| | - Sudhakar Morankar
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, PO Box 378, Jimma, Oromia, Ethiopia
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Williams LB, Abu Farsakh B, Karle ER, Almogheer ZS, Coughlin S, Kim Yeary KH. How effective are church-based weight-loss interventions among Black adults? A systematic review. Obesity (Silver Spring) 2024; 32:2060-2076. [PMID: 39199014 DOI: 10.1002/oby.24115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/18/2024] [Accepted: 06/10/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE Churches are frequently used to reach Black adults to effect weight loss. However, there has been no recent review, to our knowledge, inclusive of solely Black adults in church settings. We sought to comprehensively examine the methodological approaches and weight-loss outcomes of church-based weight-loss lifestyle interventions conducted among Black adults to provide insights on literature gaps and offer suggestions for future research. METHODS Google Scholar, PubMed, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for trials conducted in churches that reported weight outcomes at any time point. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guided manuscript development. RESULTS A total of 15 studies (N = 2285) from 2007 to 2023 met inclusion criteria, and 33% were high-quality randomized trials. The majority were pilot studies (60%) conducted in the Southern United States. Most reported significant postintervention weight loss. The follow-up time points varied from 2 to 12 months. Methodological approaches included the following: cultural adaptations (93%); theory-guided (93%); delivered by community health workers (80%); and delivered in person in a group format (100%). Only one study offered individual-level attention beyond texts/emails. Most participants were well-educated female individuals. CONCLUSIONS Weight-loss interventions among Black church settings effect statistically significant weight loss, albeit in a small way. Limitations include pilot studies and small samples. More rigorously designed studies are warranted.
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Affiliation(s)
| | | | - Erika R Karle
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | | | - Steven Coughlin
- College of Allied Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Karen H Kim Yeary
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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Morenz AM, Bender J, Hairston B, Starks H, Jackson S. "Advocates for Each Other": The creation and evaluation of a pragmatic peer navigation program for black patients in primary care with uncontrolled hypertension. PATIENT EDUCATION AND COUNSELING 2024; 125:108315. [PMID: 38723337 PMCID: PMC11146043 DOI: 10.1016/j.pec.2024.108315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Black individuals in the U.S. and in our primary care clinic experience worse control of blood pressure compared to White individuals. OBJECTIVE To address this inequity, our objectives were to (1) elicit from patients and community members their ideas for barriers and facilitators to blood pressure control; and (2) use their input to design and pilot a navigator program for Black patients in our clinic to improve blood pressure management. PATIENT INVOLVEMENT We conducted three focus groups with 27 individuals and identified two main areas of need that informed the peer navigator program: (1) community-based services and (2) skill development for hypertension self-management. METHODS Peer navigators from the Black community called participants at least monthly for 6-12 months and connected them with medical and social services. Available blood pressure data was used as the primary outcome to measure change pre- to post-peer navigation program. RESULTS Among 499 eligible patients in the clinic, 53 (10.6%) enrolled in the peer navigation program. For those with baseline and follow-up blood pressure data, mean systolic blood pressure decreased from 155.9 to 142.4 mmHg after the program (change of -13.6, 95% CI -24.7 to -2.4) for the enrolled patients (N = 17) and from 139.1 to 137.1 mmHg (change of -2.5, -4.8 to 1.9) for unenrolled, comparison patients (N = 183). DISCUSSION This community-informed peer navigation program to support Black patients with uncontrolled hypertension led to a 11.1 mmHg greater decrease in average systolic blood pressure for enrolled patients compared to the comparison group. However, the enrolled group started with a significantly higher systolic blood pressure at baseline with more room for improvement. While this study was conducted during the pandemic years, low uptake of this program needs to be addressed in expansion efforts. PRACTICAL VALUE Clinic-based peer navigation for hypertension improved blood pressure control and was highly regarded by the subset of enrolled patients. Increasing uptake and sustainable funding for non-billable clinic roles remain areas of need. FUNDING Grant from the Pacific Hospital Preservation & Development Authority.
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Affiliation(s)
- Anna M Morenz
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
| | - Jessica Bender
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Helene Starks
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA
| | - Sara Jackson
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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Wright RL, Kara D, Buchanan KC, Adler C, Pulley A. The Impact of Rural Environments on Reproductive Autonomy Among Women in Appalachia: A Qualitative Analysis. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:273-286. [PMID: 39148922 PMCID: PMC11323869 DOI: 10.1080/19317611.2024.2360730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 08/17/2024]
Abstract
Reproductive autonomy encompasses one's ability to make decisions around contraceptive use, pregnancy, and childbirth. An individual's geographic location affects access to a wide range of information and care related to reproductive choice. Individuals in rural areas face additional barriers to reproductive health and decision-making than those in urban areas. This phenomenological qualitative study examined the experiences with and perceptions of reproductive decision-making among women in rural Appalachian communities in the United States. Four themes emerged from the data: autonomy tied to choice, role of religion and church on autonomy and decision-making, navigating limited access to care, and shame. Women should be supported in making reproductive health decisions, and efforts are needed to increase autonomy within reproductive health care and decisions. Sexual health programming within school and other community settings should address shame that often occurs around reproductive health topics, particularly among religious communities.
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Affiliation(s)
- Rachel L. Wright
- Department of Social Work, Appalachian State University, Boone, NC, USA
| | - Danyelle Kara
- Department of Social Work, Appalachian State University, Boone, NC, USA
| | - K. C. Buchanan
- Department of Social Work, Appalachian State University, Boone, NC, USA
| | - Cassie Adler
- Department of Social Work, Appalachian State University, Boone, NC, USA
| | - Amanda Pulley
- Department of Social Work, Appalachian State University, Boone, NC, USA
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Wells A, McClave R, Cotter EW, Pruski T, Nix D, Snelling AM. Engaging Faith-Based Organizations to Promote Health Through Health Ministries in Washington, DC. JOURNAL OF RELIGION AND HEALTH 2024; 63:2011-2030. [PMID: 36085245 PMCID: PMC9463055 DOI: 10.1007/s10943-022-01651-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 05/11/2023]
Abstract
This article describes capacity building and formative assessments completed at five faith-based organizations (FBOs) in Washington, DC to inform sustainable health promotion programming led by certified health ministers. Five FBO partners were recruited with two congregation members from each FBO completing a health minister certificate program. A series of health assessments were conducted to assess each FBO's capacity to implement evidence-based lifestyle change programs that are responsive to congregation members' health needs. Results indicated a need for programming to support older adults in managing high blood pressure and arthritis. Health ministers represent a significant opportunity for building capacity within FBOs to deliver programming that can improve health outcomes.
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Affiliation(s)
- Ayanna Wells
- Department of Health Studies, College of Arts and Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA
| | - Robin McClave
- Department of Health Studies, College of Arts and Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA
| | - Elizabeth W Cotter
- Department of Health Studies, College of Arts and Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA.
| | - Tom Pruski
- Wesley Theological Seminary, Washington, DC, USA
| | - Deborah Nix
- Wesley Theological Seminary, Washington, DC, USA
| | - Anastasia M Snelling
- Department of Health Studies, College of Arts and Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA
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Muro A, Czajkowski S, Hall KL, Neta G, Weaver SJ, D'Angelo H. Climate Change Harm Perception Among U.S. Adults in the NCI Health Information National Trends Survey, 2022. Am J Health Promot 2024; 38:625-632. [PMID: 38233070 DOI: 10.1177/08901171241228339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE To examine associations between 1) sociodemographics and 2) trust in health information sources with climate change harm perception. METHODS Weighted adjusted logistic regression models examined correlates of climate change harm perception (harm vs no harm/don't know) among a nationally representative sample of U.S. adults (2022, n = 5585). RESULTS Sixty-four percent of U.S. adults believed climate change will harm their health. College education (vs high school or less) (AOR 1.7, 95% CI 1.3, 2.2) and having greater trust in doctors (AOR 1.4, 95% CI 1.2, 1.7), scientists (aOR 1.8, 95% CI 1.6, 2.0), and government health agencies (AOR 1.7, 95% CI 1.5, 1.9) for health information were associated with believing climate change harms health. Conversely, greater trust in religious organizations was associated with 16% lower odds of believing climate change harms health (95% CI .74, .94). CONCLUSIONS Climate change harm perception varied by sociodemographics and trust in health information source. Health communication delivered via alternative and diverse channels could expand the reach of climate and health messaging and ultimately increase public awareness and support for measures to mitigate the health impacts of climate change.
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Affiliation(s)
- Abigail Muro
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Susan Czajkowski
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kara L Hall
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Gila Neta
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Sallie J Weaver
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Heather D'Angelo
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Rasmussen JM, Johnson SL, Ochieng Y, Jaguga F, Green E, Puffer E. Congregation leader and member discussions in a church-based family strengthening, mental health promotion and HIV prevention trial: Intervention. Glob Ment Health (Camb) 2024; 11:e52. [PMID: 38721486 PMCID: PMC11076922 DOI: 10.1017/gmh.2024.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/13/2024] [Accepted: 03/26/2024] [Indexed: 10/29/2024] Open
Abstract
Collaboration with African religious congregations can promote psychosocial well-being with greater accessibility. Effective collaboration requires studying congregations as unique intervention contexts. This study explored how an intervention in western Kenya fit within and altered congregational discussion patterns. We conducted a cluster-randomized trial of a church-based intervention to improve family relationships, mental health and sexual health. For each intervention topic covered, we describe baseline and post-intervention changes in church leaders' beliefs and communication as well as discussion frequency between leaders and members and among members. Mixed-effects logistic regression assessed pre-post change in member-reported discussion frequency. At baseline, members and leaders reported already discussing family, parenting, and emotions frequently and sexuality and finances less frequently. Leaders generally felt they should discuss all topics but were less comfortable and knowledgeable about sexuality and finances than other topics. After the intervention, leader comfort and knowledge increased and discussion frequency increased for nearly all topics, especially those discussed less initially. Good fit between the desires and activities of church members and leaders suggests the potential for further collaboration, especially on mental health and family well-being. Increased discussion of sensitive topics underscores the potential of community-level interventions to affect social norms.
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Affiliation(s)
- Justin M. Rasmussen
- Department of Psychology & Neuroscience, Duke University, Durham, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Savannah L. Johnson
- Department of Psychology & Neuroscience, Duke University, Durham, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Yvonne Ochieng
- Department of Psychology & Neuroscience, Duke University, Durham, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Florence Jaguga
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Eric Green
- Department of Psychology & Neuroscience, Duke University, Durham, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Eve Puffer
- Department of Psychology & Neuroscience, Duke University, Durham, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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13
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Mui Y, Adam A, Santo R, Bassarab K, Wolfson JA, Palmer A. Characterizing Food Policy Councils' Network Partnerships and COVID-19 Responses. Nutrients 2024; 16:915. [PMID: 38612949 PMCID: PMC11013245 DOI: 10.3390/nu16070915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
The COVID-19 pandemic pushed millions of Americans into food insecurity. Food policy councils (FPCs) across the country played a vital role in organizing coordinated food responses across multiple sectors. We used a social network analysis (SNA) approach to investigate: (1) the network of partnering organizations and agencies within FPCs; (2) how the characteristics of FPCs' network partnerships (i.e., degree, coreness, and density) related to programmatic, policy, and advocacy actions in response to the pandemic; and (3) how FPCs' use of a racial or social equity framework shifted their network partnerships and responses. Local government agencies and food supply chain actors were core in FPCs' network partnerships, while public utilities, correctional facilities, social justice groups, and others were non-core partners. Network density was more likely to be associated with any action by FPCs, and it was especially pronounced for advocacy actions taken by FPCs; trends were similar among FPCs that reported using a racial or social equity framework. The findings begin to uncover core actors in FPCs' partnerships and opportunities to establish new partnerships, particularly with social justice groups. The results also suggest that network density (interconnectedness) may be more important than other network characteristics when responding to food-related needs.
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Affiliation(s)
- Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.A.); (J.A.W.)
| | - Atif Adam
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.A.); (J.A.W.)
| | - Raychel Santo
- Johns Hopkins Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.S.); (K.B.); (A.P.)
| | - Karen Bassarab
- Johns Hopkins Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.S.); (K.B.); (A.P.)
| | - Julia A. Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.A.); (J.A.W.)
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anne Palmer
- Johns Hopkins Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.S.); (K.B.); (A.P.)
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14
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Adinkrah EK, Bazargan S, Cobb S, Kibe LW, Vargas R, Waller J, Sanchez H, Bazargan M. Mobilizing faith-based COVID-19 health ambassadors to address COVID-19 health disparities among African American older adults in under-resourced communities: A hybrid, community-based participatory intervention. PLoS One 2024; 19:e0285963. [PMID: 38358995 PMCID: PMC10868749 DOI: 10.1371/journal.pone.0285963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 01/26/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic disproportionately affected older adults, particularly those with pre-existing chronic health conditions. To address the health disparity and challenges faced by under-resourced African American older adults in South Los Angeles during this period, we implemented a hybrid (virtual/in-person), pre-post, community-based participatory intervention research project utilizing a faith-based lay health advisor model (COVID-19 Health Ambassador Program (CHAP)). We recruited COVID-19 Health Ambassadors (CHAs) and African American older adults (participants) from faith-based organizations who partook in CHA-led meetings and follow-ups that educated and supported the participants. This paper seeks to evaluate this intervention's implementation using the Consolidated Framework for Implementation Research (CFIR) as a reporting tool with an emphasis on fidelity, challenges, and adaptations based on data collected via stakeholder interviews and surveys. RESULTS CHAP was delivered to 152 participants by 19 CHAs from 17 faith-based organizations. CHAs assisted with chronic disease management, resolved medication-related challenges, encouraged COVID-19 vaccination, reduced psychological stress and addressed healthcare avoidance behaviors such as COVID-19 vaccine hesitancy among the participants. Challenges encountered include ensuring participant engagement and retention in the virtual format and addressing technological barriers for CHAs and participants. Adaptations made to better suit the needs of participants included providing communication tools and additional training to CHAs to improve their proficiency in using virtual platforms in addition to adapting scientific/educational materials to suit our participants' diverse cultural and linguistic needs. CONCLUSION The community-centered hybrid approach in addition to our partnership with faith-based organizations and their respective COVID-19 health ambassadors proved to be essential in assisting underserved African American older adults manage chronic health conditions and address community-wide health disparities during the COVID-19 pandemic. Adaptability, cultural sensitivity, and teamwork are key to implementing health interventions especially in underserved populations.
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Affiliation(s)
- Edward K. Adinkrah
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
| | - Shahrzad Bazargan
- Departments of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, United States of America
| | - Sharon Cobb
- Mervyn M. Dymally College of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
| | - Lucy W. Kibe
- Physician Associate Program, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
| | - Roberto Vargas
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
| | - Joe Waller
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
| | - Humberto Sanchez
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America
- Department of Family Medicine, University of California Los Angeles, Los Angeles, California, United States of America
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15
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Ordaz OH, Croff RL, Robinson LD, Shea SA, Bowles NP. Belonging, endurance, and resistance: Black placemaking theory in primary care. Soc Sci Med 2024; 342:116509. [PMID: 38184964 PMCID: PMC10903339 DOI: 10.1016/j.socscimed.2023.116509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/04/2023] [Accepted: 12/10/2023] [Indexed: 01/09/2024]
Abstract
Black-Americans continue to experience pervasive health disparities. Factors contributing to increased disease risk include a general mistrust of biomedical institutions among Black Americans. The purpose of this focus group study was to identify, among Black patients who regularly seek care from a primary provider, salient themes regarding barriers to 1) receiving quality primary care; and 2) adhering to medical recommendations. We examined transcripts of eight focus groups held remotely with 29 Black patients (aged 30-60 years) who had established primary care providers. Using grounded theory and an inductive thematic analysis of the transcripts, we identified three themes (belonging, endurance, and resistance) consistent with Black placemaking theory. Our findings suggest that reducing health disparities for Black Americans will require clinical initiatives that emphasize: 1) attention to social influences on health behavior and to features of medical institutions that mark them as White spaces (belonging); 2) recognition of, as well as sensitivity to, community awareness of the systemic and interpersonal barriers to health and safety that many Black adults endure; and 3) reframing avoidant (resistant) behaviors as protective strategies among Black patients. Examining primary care in this way-through the lens of Black placemaking theory-reveals how culturally meaningful approaches to harnessing the specialized knowledge and resilience that clearly exists among many Black communities can improve health care delivery.
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Affiliation(s)
- Omar H Ordaz
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Raina L Croff
- School of Medicine Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - LaTroy D Robinson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Nicole P Bowles
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA.
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16
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Hong B, Scribner S, Downs D, Jackson-Beavers R, Wright T, Orson W, Rice B, Wilson K, Poirier R. The Saint Louis bridges program: A mental health network of more than one hundred churches and the mental health community. J Natl Med Assoc 2024; 116:16-23. [PMID: 38065783 DOI: 10.1016/j.jnma.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 10/10/2023] [Accepted: 11/20/2023] [Indexed: 02/27/2024]
Abstract
This article describes the history and development of a faith-based mental health network of over one hundred Black churches in North St Louis City and County. The Bridges to Care and Recovery (BCR) program is a joint effort of the Black faith community, three community hospitals, local universities, a school of medicine and funding from the city /state departments of mental health. The mission of BCR is to improve the fragmented mental health services to the Black community and to address the stigma of mental illness. This innovative program provides a blueprint for other metropolitan areas to emulate. The present paper is a detailed description of the key elements and services of the Bridges program.
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Affiliation(s)
- Barry Hong
- Washington University School of Medicine Department of Psychiatry, 660 South Euclid Avenue, St. Louis, Missouri, 63110-1010, USA.
| | - Susan Scribner
- Behavioral Health Network of Greater St. Louis, 2 Campbell Plaza, St. Louis, Missouri, 63139-1779, USA
| | - Dana Downs
- Washington University School of Medicine Department of Psychiatry, 660 South Euclid Avenue, St. Louis, Missouri, 63110-1010, USA
| | - Rose Jackson-Beavers
- Behavioral Health Network of Greater St. Louis, 2 Campbell Plaza, St. Louis, Missouri, 63139-1779, USA
| | - Tamela Wright
- Behavioral Health Network of Greater St. Louis, 2 Campbell Plaza, St. Louis, Missouri, 63139-1779, USA
| | - Wendy Orson
- Behavioral Health Network of Greater St. Louis, 2 Campbell Plaza, St. Louis, Missouri, 63139-1779, USA
| | - Booker Rice
- New Horizon Seventh Day Christian Church, 206 Emerling Drive, St. Louis, Missouri, 63121, USA
| | - Karl Wilson
- Behavioral Health Network of Greater St. Louis, 2 Campbell Plaza, St. Louis, Missouri, 63139-1779, USA
| | - Rob Poirier
- Washington University School of Medicine Department of Emergency Medicine, 660 South Euclid Avenue, St. Louis, Missouri, 63110-1010, USA
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Dinizulu SM, Velez GM, Morency M, Jacobson K, Moore K, Carter N, Frazier SL. Lift Every Voice: Engaging Black Adolescents in Social Justice Service-Learning to Promote Mental Health and Educational Equity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:68-84. [PMID: 37768423 PMCID: PMC10830586 DOI: 10.1007/s11121-023-01570-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 09/29/2023]
Abstract
This study reports on the feasibility and acceptability of a social justice infused service-learning (S-L) program to promote Black adolescent mental health and educational equity. We convened a community advisory board to help adapt and pilot test, via open trial mixed method design, an evidence-based service-learning program for Black middle school adolescents (n = 21) attending summer camp at a faith-based setting. We describe a S-L curriculum, with a focus on the achievement gap, and training for church staff and assess staff and youth reports of feasibility, acceptability, and promise to (a) improve/engage psychological engagement targets, and (b) improve academic motivation, and social-emotional and behavioral outcomes. Mixed method findings revealed high feasibility and acceptability of the S-L intervention as indicated by consistent attendance and enthusiastic engagement by staff and youth, high satisfaction, high completion rates of planned sessions, and emergent qualitative themes from staff interviews and adolescent focus groups highlighting that service-learning (1) facilitated skills (e.g., goal-setting, social-emotional and behavioral regulation, and problem-solving), (2) shaped perspectives and inspired openness, and (3) created a space for all to feel valued and included to address the inequities of education that directly impacted them. There was preliminary evidence for efficacy in that youth report of emotional symptoms, peer problems, and staff report of general internalizing symptoms decreased following the intervention, while youth report of prosocial behaviors increased. Implications suggest that S-L programming demonstrates promise to promote mental health outcomes, raise social awareness, and inspire critical consciousness and lift the voices of Black youth by providing tools for working toward systemic changes to reduce inequities in both education and mental health.
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Affiliation(s)
- Sonya Mathies Dinizulu
- Department of Psychiatry & Behavior Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Gabriel M Velez
- College of Education, Marquette University, Milwaukee, WI, USA
| | - Mirinda Morency
- Institute for Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Kristen Jacobson
- Department of Psychiatry & Behavior Neuroscience, University of Chicago, Chicago, IL, USA
| | - Kelsey Moore
- Community Strategies, Health Management Associates, Chicago, IL, USA
| | | | - Stacy L Frazier
- Department of Psychology, Florida International University, Miami, FL, USA
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Gul R, Khan I, Alam I, Almajwal A, Hussain I, Sohail N, Hussain M, Cena H, Shafiq S, Aftab A. Ramadan-specific nutrition education improves cardio-metabolic health and inflammation-a prospective nutrition intervention study from Pakistan. Front Nutr 2023; 10:1204883. [PMID: 38249603 PMCID: PMC10798056 DOI: 10.3389/fnut.2023.1204883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/26/2023] [Indexed: 01/23/2024] Open
Abstract
There are recent reports that Ramadan fasting (RF) results in weight gain instead of weight loss. In addition, the data on the efficacy of brief nutrition education on healthy eating practices in Ramadan for better health are scarce. Therefore, a study was conducted to investigate the effects of brief nutrition education before the start of RF on healthy eating practices during RF. For this purpose, a prospective observational study focused on "Dietary Education and Awareness for Ramadan (DEAR)" as an intervention was carried out. The participants (n = 74) were recruited and divided into two groups, i.e., intervention and control groups (n = 37 each). As an intervention, nutrition education lessons were given before and during RF month. The control group did not attend these nutrition education lessons. Data on anthropometrics, dietary intake, and other parameters were collected at three time points: before, in the end, and 4 weeks after RF. Weight was measured in kg; height, waist circumference (WC), and hip circumference (HC) were measured in cm; and body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was calculated by dividing the waist value by the hip value. Body composition analysis was performed by the body composition analyzer (BF-907). Blood pressure (BP) was measured using a validated automated blood pressure. A 3-5 ml of venous blood was collected, and plasma and serum were separated. Serum and plasma samples were processed for general blood chemistry (blood lipid profile, glucose, and CRP) within 2 h. CRP was determined by the immunoturbidimetry method using an auto-analyzer. An enzyme-linked immunosorbent assay (ELISA) was used to determine cytokine/chemokines. Adherence to nutrition education (intervention) was assessed. The results show that nutrition education has positive effects on overall nutrition. Significant improvement in dietary adherence to dietary advice in the intervention group was noted. Significant BW loss (mean loss: 1.21 kg) in the intervention group was observed. The majority (63.3%) had lost BW ≥ 1.0 kg. Other changes observed as a result of the intervention included improvements in blood glucose, cholesterol, CRP levels, and systolic and diastolic BP. There was a notable shift in pro- and anti-inflammatory cytokine concentrations: IL-7, IL-4, and TGF-α decreased, while IL-2, TNF-α and resistin, IL-1 RA, IL-17 A, and sCD40 increased. In conclusion, RF resulted in a loss in mean BW and an improvement in related blood chemistry and cytokine profiles. Furthermore, nutrition education before RF resulted in better nutrition practices during RF and a desirable healthy BW, blood lipid, and cytokine profiles.
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Affiliation(s)
- Rahmat Gul
- Department of Human Nutrition, Faculty of Nutrition Sciences, The University of Agriculture, Peshawar, Pakistan
- Department of Dietetics and Nutritional Science, Faculty of Pharmacy and Allied Health Sciences, University of Sialkot, Sialkot, Pakistan
| | - Imran Khan
- Department of Human Nutrition, Faculty of Nutrition Sciences, The University of Agriculture, Peshawar, Pakistan
| | - Iftikhar Alam
- Department of Human Nutrition and Dietetics, Bacha Khan University, Charsadda, Pakistan
| | - Ali Almajwal
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Imtiaz Hussain
- Department of Food Science and Technology, University of Poonch Rawalakot Azad Jammu and Kashmir, Poonch, Pakistan
| | - Namrah Sohail
- Department of Dietetics and Nutritional Science, Faculty of Pharmacy and Allied Health Sciences, University of Sialkot, Sialkot, Pakistan
| | - Muhammad Hussain
- Department of Human Nutrition, Faculty of Nutrition Sciences, The University of Agriculture, Peshawar, Pakistan
| | - Hellas Cena
- Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Sunara Shafiq
- Department of Dietetics and Nutritional Sciences, University of Sialkot, Sialkot, Pakistan
| | - Anam Aftab
- Department of Dietetics and Nutritional Sciences, University of Sialkot, Sialkot, Pakistan
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19
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Allouch F, Mills KT, Laurent J, Alvarado F, Gustat J, He H, He J, Ferdinand KC. Perceived Religious Influence on Health Is Associated with Beneficial Health Behaviors in Members of Predominantly Black Churches. Ethn Dis 2023; DECIPHeR:81-88. [PMID: 38846731 PMCID: PMC11895546 DOI: 10.18865/ed.decipher.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Background Cardiovascular disease is the leading cause of death in the United States, and Black populations are disproportionately affected. Black populations also have high rates of religiosity, which may be an important health motivator, but mechanisms are unclear. Objective We examined the relationship between perceived religious influence on health and cardiovascular health behaviors, risk factors, and confidence participating in medical care in Black church congregants. Methods We surveyed 302 members of 13 churches with predominantly Black congregations in New Orleans, Louisiana. Participants reported if religious beliefs had an influence on their health and if they avoided harmful behaviors because of religion. Fruit and vegetable intake, physical activity, smoking status, confidence asking questions to health care providers, understanding treatment plans and self-reported hypertension, hypercholesterolemia, and diabetes were assessed. Logistic regression was used adjusting for age, sex, and education. Results Survey respondents were 77% female with a median age of 66 years, and 72%, 56%, and 37% reported hypertension, hypercholesterolemia, and diabetes, respectively. Perceived religious influence on health was positively associated with fruit and vegetable intake, physical activity, and confidence asking questions to health care providers. Avoiding harmful behaviors because of religion was positively associated with physical activity. There was no association between perceived religious influence on health and smoking, hypertension, hypercholesterolemia, or diabetes. Conclusion Perceived religious influence on health was associated with beneficial cardiovascular health behaviors and confidence participating in medical care. These findings can inform the design and delivery of interventions to reduce cardiovascular disease among Black religious communities.
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Affiliation(s)
- Farah Allouch
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Katherine T. Mills
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Jodie Laurent
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Flor Alvarado
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
| | - Jeanette Gustat
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Hua He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Jiang He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
| | - Keith C. Ferdinand
- Translational Sciences Institute, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA
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20
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Ransome Y, Luan H, Song I, Duncan DT. Church Closings Were Associated with Higher COVID-19 Infection Rates: Implications for Community Health Equity. J Urban Health 2023; 100:1258-1263. [PMID: 37989815 PMCID: PMC10728374 DOI: 10.1007/s11524-023-00791-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 11/23/2023]
Abstract
This study investigates the changes in physical church closings years 2013 to 2019 in New York City (NYC), Philadelphia, and Baltimore and the association with COVID-19 infection rates. We applied Bayesian spatial binomial models to analyze confirmed cases of COVID-19 as of February 28, 2022, in each city at the zip code-level. A one unit increase in the number of churches closed corresponded to a 5% higher COVID-19 infection rate, in NYC (rate ratio = 1.05, 95% credible interval = 1.02-1.08%), where the association was significant. Church closings appears to be an important indicator of neighborhood social vulnerability. Church closings should be routinely monitored as a structural determinant of community health and to advance health equity.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH, New Haven, CT, 06511, USA.
| | - Hui Luan
- Department of Geography, University of Oregon, Eugene, OR, 97403, USA
| | - Insang Song
- Department of Geography, University of Oregon, Eugene, OR, 97403, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
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21
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Gamble C, Woodard TJ, Yakubu AI, Chapman-Davis E. An Intervention-Based Approach to Achieve Racial Equity in Gynecologic Oncology. Obstet Gynecol 2023; 142:957-966. [PMID: 37678907 PMCID: PMC10510810 DOI: 10.1097/aog.0000000000005348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 09/09/2023]
Abstract
Racial inequities within gynecologic oncology exist at every step of the cancer continuum. Although the disparities have been well described, there is a significant gap in the literature focused on eliminating inequities in gynecologic cancer outcomes. The goal of this narrative review is to highlight successful, evidence-based interventions from within and outside of gynecologic oncology that alleviate disparity, providing a call to action for further research and implementation efforts within the field. These solutions are organized in the socioecologic framework, where multiple levels of influence-societal, community, organizational, interpersonal, and individual-affect health outcomes.
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Affiliation(s)
- Charlotte Gamble
- Division of Gynecologic Oncology, MedStar Washington Hospital Center, and Georgetown University, Washington, DC; the Division of Gynecologic Oncology, Washington University School of Medicine in St. Louis, St. Louis, Missouri; the Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia; and the Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York
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22
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Torres VN, Fulton BR, Wong EC, Derose KP. Prevalence and Predictors of Substance Use Support Programming Among U.S. Religious Congregations. JOURNAL OF DRUG ISSUES 2023; 53:581-601. [PMID: 37799348 PMCID: PMC10552553 DOI: 10.1177/00220426221138479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
We conducted a cross-sectional secondary analysis of data from the 2012 National Congregation Study, a nationally representative survey of religious congregations in the United States ( N = 1,331). Multivariate logistic regression was used to identify congregational characteristics associated with providing substance use support programing. Nearly one-third (38%) of U.S. congregations indicated that they provided substance use support programming; approximately half (52%) of all congregational attendees were in a congregation that provided some type of substance use support. The internal factors associated with a congregation providing substance use programming include having members who are unemployed and younger, being conservative Protestant, engaging in the practice of speaking in tongues, and having the resources to support social services. The analysis also identifies external factors (i.e., assessing community needs and hosting social service speakers) as being associated with a congregation’s likelihood of providing substance use programming. Findings identify factors associated with congregations providing substance use support.
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Affiliation(s)
- Vanessa N Torres
- RAND Corporation, Santa Monica, CA, USA
- Department of Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Brad R Fulton
- O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | | | - Kathryn P Derose
- RAND Corporation, Santa Monica, CA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
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Eden TM, Smallwood SW, Matthews DD. Using a Measurement Model to Reconceptualize the Church Experiences of Black Men who have Sex with Men. JOURNAL OF RELIGION AND HEALTH 2023; 62:2213-2225. [PMID: 36260262 PMCID: PMC10113399 DOI: 10.1007/s10943-022-01671-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Religious spaces have proven to be effective sites of health intervention among Black Americans. Less is known about how religious environments impact the health of subgroups of Black Americans, specifically Black men who have sex with men (MSM). Using data from the Promoting Our Worth, Equality, and Resilience study, we explored the factor structure of a 10-item religious environment scale among Black MSM (N = 2,482). Exploratory factor analysis revealed three distinct factors: (1) visibility of MSM, (2) structural support, and (3) structural homonegativity. The relationship between Black MSM and their religious environments is complex and should be investigated using measures that accurately reflect their lived experiences.
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Affiliation(s)
- Tiffany M Eden
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599-7440, USA.
| | - Stacy W Smallwood
- Department of Health Policy & Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Derrick D Matthews
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Drive, Campus Box 7440, Chapel Hill, NC, 27599-7440, USA
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Rosenthal AE, Spezia M, Sosnowy C, Chan PA. Acceptability of HIV Prevention Approaches Among USA Faith-Based Leaders. JOURNAL OF RELIGION AND HEALTH 2023; 62:1658-1675. [PMID: 36515812 DOI: 10.1007/s10943-022-01705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
HIV/AIDS disproportionately impacts underserved communities in the USA. This study evaluated the acceptability of partnering with faith communities to improve HIV prevention, screening, and engagement in care with a focus on Hispanic/Latinx (H/L) communities. We engaged faith-based leaders to identify how the cultural competence and foundations of trust within these communities may be leveraged to improve HIV-related healthcare access for underserved groups including H/L individuals. Using a semi-structured qualitative interview approach, we interviewed N = 20 faith-based leaders in Providence County, Rhode Island (RI). Data were analyzed using the framework approach which utilized inductive generation of themes and systematic grouping into predetermined categories. Seven of the 20 interviewees self-identified as H/L faith leaders and discussed needs specific to H/L communities including destigmatization of HIV, increased access to care, and partnerships founded on mutual respect. The other 13 faith leaders did not personally identify as H/L but all served communities with significant H/L populations. We included these individuals given their communities already performed HIV and/or other health outreach and could provide insight into what approaches could be adapted to the needs expressed by H/L leaders. All interviewees were accepting of developing partnerships with outside organizations to engage in HIV prevention, and all identified potential solutions to identified barriers. Results suggested that faith-based outreach should be further investigated as a method of improving HIV prevention in the general and H/L populations.
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Affiliation(s)
- Alex E Rosenthal
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
| | - Marie Spezia
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Collette Sosnowy
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Philip A Chan
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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25
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Community-Based Approach to Assess Obstructive Respiratory Diseases and Risk in Urban African American Churches. J Immigr Minor Health 2023; 25:389-397. [PMID: 36307622 PMCID: PMC9616427 DOI: 10.1007/s10903-022-01405-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
Asthma, and chronic obstructive pulmonary disease (COPD) are significant health problems that have disparate effects on many Americans. Misdiagnosis and underdiagnosis are common and lead to ineffective treatment and management. This study assessed the feasibility of applying a two-step case-finding technique to identify both COPD and adult asthma cases in urban African American churches. We established a community-based partnership, administered a cross-sectional survey in step one of the case-finding technique and performed spirometry testing in step two. A total of 219 surveys were completed. Provider-diagnosed asthma and COPD were reported in 26% (50/193) and 9.6% (18/187) of the sample. Probable asthma (13.9%), probable COPD (23.1%), and COPD high-risk groups (31.9%) were reported. It is feasible to establish active case-finding within the African American church community using a two-step approach to successfully identify adult asthma and COPD probable cases for early detection and treatment to reduce disparate respiratory health outcomes.
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26
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Conrick KM, Smith MB, Rooney L, Morgan E, Rowhani-Rahbar A, Moore M. Openness to church-based firearm safety interventions among Protestant Christian firearm owners. Public Health 2023; 216:45-50. [PMID: 36796220 DOI: 10.1016/j.puhe.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/14/2022] [Accepted: 12/29/2022] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Protestant Christians are more likely to own firearms and not store them locked/unloaded compared to those from other religions. This study examines how Protestant Christians view the relationship between their religious and firearm beliefs and how that informs openness to church-based firearm safety interventions. STUDY DESIGN Grounded theory analysis of 17 semi-structured interviews with Protestant Christians. METHODS Interviews, conducted August-October 2020, focused on firearms owned, carrying/discharge/storage behaviors, Christian belief compatibility with firearm ownership, and openness to church-based firearm safety interventions. Audio-recorded interviews were transcribed verbatim and analyzed using grounded theory techniques. RESULTS Participant perspectives varied on firearm ownership motivations and compatibility of Christian values with firearm ownership. Variation in these themes and in openness to church-based firearm safety interventions resulted in clustering of participants into three groups. Group 1 owned firearms for collecting/sporting purposes and intricately connected their Christian identity with firearm ownership, but they were not open to intervention due to perceived high firearm proficiency. Group 2 did not connect their Christian identity to their firearm ownership; some believed these identities were incompatible, so were also not open to intervention. Group 3 owned firearms for protection and believed church, as a community hub, was an excellent location for firearm safety interventions. CONCLUSIONS The clustering of participants into groups varying in openness to church-based firearm safety interventions suggests it is feasible to identify Protestant Christian firearm owners open to intervention. This study presents a first step in coupling firearm owner characteristics with community-based, tailored interventions with promise for efficacy.
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Affiliation(s)
- K M Conrick
- School of Social Work, University of Washington, Seattle, WA, USA; Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA.
| | - M B Smith
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA; Pediatric Critical Care Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - L Rooney
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA
| | - E Morgan
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - A Rowhani-Rahbar
- Firearm Injury & Policy Research Program, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - M Moore
- School of Social Work, University of Washington, Seattle, WA, USA; Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, USA
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27
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Syed U, Kapera O, Chandrasekhar A, Baylor BT, Hassan A, Magalhães M, Meidany F, Schenker I, Messiah SE, Bhatti A. The Role of Faith-Based Organizations in Improving Vaccination Confidence & Addressing Vaccination Disparities to Help Improve Vaccine Uptake: A Systematic Review. Vaccines (Basel) 2023; 11:449. [PMID: 36851325 PMCID: PMC9966262 DOI: 10.3390/vaccines11020449] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/18/2023] Open
Abstract
The COVID-19 pandemic underscored the importance of vaccination to support individual health across the life-course, with vaccination playing a central strategy role in mitigating transmission and disease. This required unprecedented mobilization and coordination across all sectors to meet people where they are, enable equitable access, and build vaccination confidence. A literature search was conducted with combinations of the keywords and variations of vaccination and faith-based organizations (FBOs). Search inclusion criteria were: (1) FBO programs that supported public health emergency efforts, including vaccination efforts as the primary outcome; and (2) articles written in English language. A total of 37 articles met inclusion criteria (n = 26 focused on general public health campaigns, n = 11 focused on vaccination efforts). The findings related to public health campaigns fell into four themes: FBO's ability to (1) tailor public health campaigns; (2) mitigate barriers; (3) establish trust; and (4) disseminate and sustain efforts. The findings related to vaccine uptake efforts fell into three themes: (1) pre-pandemic influenza and HPV vaccination efforts, (2) addressing vaccine disparities in minority communities, and (3) enabling COVID-19 vaccination. This review demonstrated that FBOs have a vital role in both public health campaigns and vaccination initiatives to support high vaccine uptake and confidence.
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Affiliation(s)
- Uzma Syed
- South Shore Infectious Diseases and Travel Medicine Consultants, Bayshore, NY 11706, USA
| | - Olivia Kapera
- School of Public Health, University of Texas Health Science Center, Austin Campus, Austin, TX 78712, USA
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX 75027, USA
| | - Aparajita Chandrasekhar
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX 75027, USA
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX 75207, USA
| | - Barbara T. Baylor
- Caucus on Public Health and the Faith Community, Atlanta, GA 30331, USA
| | - Adebola Hassan
- Illinois Department of Public Health, Chicago, IL 60612, USA
| | - Marina Magalhães
- School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Farshid Meidany
- Black Pearl Consulting & Research, Leesburg, VA 20175-3012, USA
| | | | - Sarah E. Messiah
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX 75027, USA
- School of Public Health, University of Texas Health Science Center, Dallas Campus, Dallas, TX 75207, USA
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Carter A. Mapping the Influence: A Nexus Analysis Approach to Addressing Food Access. HEALTH COMMUNICATION 2023; 38:228-237. [PMID: 34167398 DOI: 10.1080/10410236.2021.1945196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
One innovative approach toward addressing community-level food access is nexus analysis. This framework suggests that social actions do not happen outside of context, but rather are embedded within unique political, cultural and economic histories. In this paper, I conduct a case study analysis of the South Memphis Farmers Market (SMFM), a community-based, resident-led farmers market located in South Memphis, TN. Drawing on an understanding that neighborhood-level institutions such as farmers markets serve as an intermediary space to examine the nexus of macro-level (e.g., how resources are drawn within a community) and micro-level processes (e.g., how residents determine what food to buy and who to buy it from), this paper traces the success of the SMFM as an illustration of positive local response to the question of "good food" access. Through its history, location and connection to its predominantly Black patrons, the SMFM was able to effectively address structural and cultural barriers as a means of improving food access. Findings from the study may offer insights to the theorization of culture and space in community-based health campaigns.
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Affiliation(s)
- Andrew Carter
- Department of Public Health and Recreation, San Jose State University
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Valero-Martínez C, Martínez-Rivera C, Zhen-Duan J, Fukuda M, Alegría M. Attitudes toward COVID-19 Vaccine Uptake: A Qualitative Study of Mostly Immigrant Racial/Ethnic Minority Older Adults. Geriatrics (Basel) 2023; 8:17. [PMID: 36826359 PMCID: PMC9956127 DOI: 10.3390/geriatrics8010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
(1) Background: Few qualitative studies address diverse older adults' perceptions of COVID-19 vaccination in the United States, including non-English speakers and immigrant populations. This study aims to understand the attitudes of diverse, primarily immigrant older adults in the U.S. toward the COVID-19 vaccine and its influences on their vaccination decision-making. (2) Methods: The research team conducted semi-structured interviews (N = 100) in 2021 focused on understanding ethnically/racially diverse older adults' perceptions of the COVID-19 vaccine. Interviews were recorded, coded, and analyzed using a thematic analysis approach. (3) Results: Thematic analyses identified three themes. (1) Older adults showed mixed attitudes toward the COVID-19 vaccine associated with information consumed and trust in healthcare systems; (2) health concerns and underlying medical conditions were the most influential factors of vaccine uptake; and (3) systemic barriers and trusted figures impacted vaccination decision-making of older adults. (4) Conclusions: Accessible information in diverse languages tailored to the community's fears is needed to combat vaccine mistrust. Vaccine rollout programs need to tackle the fear of vaccine side effects. Attitudes of religious leaders, family members, and physicians considerably influenced vaccine uptake, suggesting their role as trusted members for vaccine messaging for older, primarily immigrant adults. Systemic barriers, namely lack of transportation and inaccessible vaccination sites, contributed to vaccine deterrence.
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Affiliation(s)
- Carla Valero-Martínez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychology, Faculty of Social Sciences, Río Piedras Campus, University of Puerto Rico, San Juan, PR 00925, USA
| | - Christopher Martínez-Rivera
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Marie Fukuda
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
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30
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Sanusi A, Elsey H, Golder S, Sanusi O, Oluyase A. Cardiovascular health promotion: A systematic review involving effectiveness of faith-based institutions in facilitating maintenance of normal blood pressure. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001496. [PMID: 36962921 PMCID: PMC10022319 DOI: 10.1371/journal.pgph.0001496] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/17/2022] [Indexed: 01/21/2023]
Abstract
Globally, faith institutions have a range of beneficial social utility, but a lack of understanding remains regarding their role in cardiovascular health promotion, particularly for hypertension. Our objective was assessment of modalities, mechanisms and effectiveness of hypertension health promotion and education delivered through faith institutions. A result-based convergent mixed methods review was conducted with 24 databases including MEDLINE, Embase and grey literature sources searched on 30 March 2021, results independently screened by three researchers, and data extracted based on behaviour change theories. Quality assessment tools were selected by study design, from Cochrane risk of bias, ROBINS I and E, and The Joanna Briggs Institute's Qualitative Assessment and Review Instrument tools. Twenty-four publications contributed data. Faith institution roles include cardiovascular health/disease teaching with direct lifestyle linking, and teaching/ encouragement of personal psychological control. Also included were facilitation of: exercise/physical activity as part of normal lifestyle, nutrition change for cardiovascular health, cardiovascular health measurements, and opportunistic blood pressure checks. These demand relationships of trust with local leadership, contextualisation to local sociocultural realities, volitional participation but prior consent by faith / community leaders. Limited evidence for effectiveness: significant mean SBP reduction of 2.98 mmHg (95%CI -4.39 to -1.57), non-significant mean DBP increase of 0.14 mmHg (95%CI -2.74 to +3.01) three months after interventions; and significant mean SBP reduction of 0.65 mmHg (95%CI -0.91 to -0.39), non-significant mean DBP reduction of 0.53 mmHg (95%CI -1.86 to 0.80) twelve months after interventions. Body weight, waist circumference and multiple outcomes beneficially reduced for cardiovascular health: significant mean weight reduction 0.83kg (95% CI -1.19 to -0.46), and non-significant mean waist circumference reduction 1.48cm (95% CI -3.96 to +1.00). In addressing the global hypertension epidemic the cardiovascular health promotion roles of faith institutions probably hold unrealised potential. Deliberate cultural awareness, intervention contextualisation, immersive involvement of faith leaders and alignment with religious practice characterise their deployment as healthcare assets.
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Affiliation(s)
- Abayomi Sanusi
- Department of Health Sciences, University of York, York, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
| | - Su Golder
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Adejoke Oluyase
- Cicely Saunders Institute of Palliative Care & Rehabilitation, King's College London, London, United Kingdom
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Nicol JU, Iwu-Jaja CJ, Hendricks L, Nyasulu P, Young T. The impact of faith-based organizations on maternal and child health care outcomes in Africa: taking stock of research evidence. Pan Afr Med J 2022; 43:168. [PMID: 36825129 PMCID: PMC9941616 DOI: 10.11604/pamj.2022.43.168.32983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/20/2022] [Indexed: 12/12/2022] Open
Abstract
This evidence synthesis aimed at assessing the effectiveness of Faith-Based Organisations (FBOs) on Maternal and Child Health (MCH) outcomes; and explore the perceptions and experiences of the users and providers of MCH services delivered by FBOs in Africa. This review considered studies from African countries only. Both reviews and primary studies focusing on MCH services provided by FBOs were considered. Quantitative, qualitative, and mixed methods reviews were included with no restriction on the date and language. Primary outcomes included maternal mortality ratio, neonatal mortality, infant mortality, child mortality, quality of care, views, experiences, and perceptions of users of FBOs. We searched up to November 2020 in the Joanna Briggs Institute (JBI) Database of Systematic Reviews and Implementation Reports, the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, PROSPERO register, PDQ-evidence, Health Systems Evidence, CINAHL, EMBASE, and PubMed. We searched references cited by similar studies that may be potentially eligible for inclusion. We then updated the search for primary studies from December 2009 - October 2020. One systematic review and six primary studies met the eligibility criteria for inclusion. Methodological quality varied. These observational and qualitative studies found that FBOs offered the following MCH services - training of healthcare workers, obstetric services, health promotion, sexual education, immunization services, and intermittent preventive therapy for malaria. Maternal and Child Health (MCH) services provided by FBO suggest a reduction in maternal morbidity and mortality. Increased uptake of maternal healthcare services, and increased satisfaction were reported by users of care. However, costs of providing these services varied across the studies and users. This review shows that FBOs play an important role in improving access and delivery of MCH services and have the potential of strengthening the health system at large. Rigorous research is needed to ascertain the effectiveness of FBO-based interventions in strengthening the health systems in Africa.
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Affiliation(s)
- Jeannine Uwimana Nicol
- Center for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa,,School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kicukiro, Kigali, Rwanda,,Corresponding author: Jeannine Uwimana Nicol, Center for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Chinwe Juliana Iwu-Jaja
- Center for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lynn Hendricks
- Center for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa,,Social Research Methodology Group, Faculty of Social Sciences, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Peter Nyasulu
- Center for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Taryn Young
- Center for Evidence Based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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32
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Lohiniva AL, Nurzhynska A, Alhassan H, Shetye M, Ayiku P. Understanding Factors Influencing Polio Vaccine Uptake in Ghana-Developing Meaningful Community Mobilization and Engagement Strategies in Collaboration with Religious Leaders. Am J Trop Med Hyg 2022; 107:1345-1350. [PMID: 36315999 PMCID: PMC9768250 DOI: 10.4269/ajtmh.22-0271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/05/2022] [Indexed: 12/30/2022] Open
Abstract
This qualitative study explores how religious leaders in Ghana view polio and polio vaccine-related knowledge and perceptions of the community members. It also examines the personal characteristics of those who are most likely to accept or reject the vaccine. On the basis of the findings, this study provides a set of evidence-based recommendations to support religious leaders' efforts to create polio vaccine demand in their communities. The study is based on focus group discussions conducted with religious leaders from various geographic locations across Ghana. The discussions were transcribed verbatim and analyzed thematically. Twenty religious leaders, including Christian, Muslim, and leaders of traditional African religions, participated in the study. The findings show that both religious leaders and community members lack knowledge and have multiple culturally and religiously influenced explanations for polio. In addition, the findings reveal that vaccine safety and efficacy are linked to emotional narratives, and receiving the polio vaccine is not a social norm in all communities. Educated mothers in urban settings were identified as those most receptive to the polio vaccine. To create polio vaccine demand, religious leaders need to combat misinformation and the negative perceptions about the vaccine. Recommendations include conveying high-quality information to community members, developing tactics to address culturally and religiously sensitive matters, using emotionally inspired personal accounts to enhance positive attitudes toward polio vaccines and act as catalysts for positive social norms towards the polio vaccine. Educated mothers from urban areas can be engaged as champions in vaccine demand creation.
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Affiliation(s)
- Anna-Leena Lohiniva
- UNICEF Ghana, Accra, Ghana;,Address correspondence to Anna-Leena Lohiniva, UNICEF Country Office, P.O. Box 5051, 4-8 Rangoon Close, Accra-North, Ghana. E-mail:
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33
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Walters K, Benjamins MR. Religious Beliefs About Health and the Body and their Association with Subjective Health. JOURNAL OF RELIGION AND HEALTH 2022; 61:4450-4465. [PMID: 33501629 DOI: 10.1007/s10943-020-01178-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/31/2020] [Indexed: 06/12/2023]
Abstract
Evidence supports an association between religion and spirituality and health outcomes. The aim of this study is to examine religious beliefs related to health and their relationship to self-rated health in a large and diverse population-based sample in Chicago. Three religious beliefs were assessed-the importance of prayer for health, God's will as the most important factor in getting well, and sanctity of the body. All three beliefs were highly prevalent, especially among racial/ethnic minorities. Unadjusted models showed a significant association between two of the beliefs and self-rated health, which did not persist in the adjusted models. This study provides insight into different belief patterns among racial/ethnic groups and has practical implications for both clinicians and public health practitioners.
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Affiliation(s)
- Kelly Walters
- Chicago Medical School at Rosalind Franklin University, 3333 Green Bay Rd, North Chicago, IL, 60064, US
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Derose KP, Cohen DA, Han B, Arredondo EM, Perez LG, Larson A, Loy S, Mata MA, Castro G, De Guttry R, Rodríguez C, Seelam R, Whitley MD, Perez S. Linking churches and parks to promote physical activity among Latinos: Rationale and design of the Parishes & Parks cluster randomized trial. Contemp Clin Trials 2022; 123:106954. [PMID: 36206951 PMCID: PMC9783594 DOI: 10.1016/j.cct.2022.106954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Regular physical activity (PA) contributes to positive health outcomes, but a minority of US adults meet minimum guidelines for moderate-to-vigorous PA (MVPA) and muscle-strengthening, and Latinos are less likely than whites to meet these guidelines. Public parks can be leveraged for community PA but tend to be underutilized, while churches have reach within Latino communities and can influence parishioners' health. METHODS We are conducting a cluster randomized controlled trial to examine the impact of a multilevel, faith-based intervention linking Catholic parishes (n = 14) to their local parks on adult Latino parishioners' (n = 1204) MVPA and health-related outcomes. Our approach targets multiple levels (individual, group, church, and neighborhood-park) to promote health-enhancing PA through park-based exercise classes led by kinesiology students, peer leader-led walking groups, park-based church events, church-based PA support activities, and environmental advocacy. Data are collected at churches by trained bilingual/bicultural research assistants using accelerometry, surveys, and biometric procedures. We will implement a set of hierarchical repeated-measure linear models to examine effects on the primary outcome (MVPA) and secondary outcomes (self-reported PA, heart rate/fitness, waist circumference, waist-to-hip ratio, body fat, mental health, and perceived social support for PA). We will also conduct a process evaluation. CONCLUSION To our knowledge, this will be the first study examining efficacy of an integrated church and park-based intervention on Latino adults' PA and represents a scalable model of PA programming for low-income communities. The intervention makes use of innovative partnerships within and across sectors - faith-based, local parks/city government, and local universities - further facilitating sustainability. CLINICALTRIALS govID: NCT03858868.
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Affiliation(s)
- Kathryn P Derose
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA; University of Massachusetts Amherst, Department of Health Promotion & Policy, 705 N. Pleasant St, Amherst, MA 01003, USA.
| | - Deborah A Cohen
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA; Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S Los Robles, Pasadena, CA 91101, USA.
| | - Bing Han
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA; Kaiser Permanente Southern California, Department of Research and Evaluation, 100 S Los Robles, Pasadena, CA 91101, USA.
| | - Elva M Arredondo
- San Diego State University, Psychology Department and Institute for Behavioral and Community Health Studies, 9245 Sky Park Ct, #221, San Diego, CA 92123, USA.
| | - Lilian G Perez
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Anne Larson
- California State University, Los Angeles, School of Kinesiology, 5151 State University Drive, Los Angeles, CA 90032, USA.
| | - Steven Loy
- California State University, Northridge, Department of Kinesiology, 18111 Nordhoff Street, Northridge, CA 91330, USA.
| | - Michael A Mata
- Los Angeles First Church of the Nazarene, 3401 W. Third St., Los Angeles, CA 90020, USA
| | - Gabriela Castro
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Rebecca De Guttry
- Pardee RAND Graduate School, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Claudia Rodríguez
- Pardee RAND Graduate School, 1776 Main St, Santa Monica, CA 90401, USA.
| | - Rachana Seelam
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA.
| | | | - Sergio Perez
- Archdiocese of Los Angeles, San Gabriel Pastoral Region, 16009 E Cypress, Irwindale, CA 91706, USA.
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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 IN 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] [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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Jackson C, Al Azdi Z, Kellar I, Mdege ND, Fairhurst C, Ferdous T, Hewitt C, Huque R, Marshall AM, Semple S, Sheikh A, Siddiqi K. "Everything the hujur tells is very educative but if I cannot apply those in my own life then there is no meaning": a mixed-methods process evaluation of a smoke-free homes intervention in Bangladesh. BMC Public Health 2022; 22:1889. [PMID: 36221089 PMCID: PMC9552417 DOI: 10.1186/s12889-022-14283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Second-hand smoke exposure from tobacco significantly contributes to morbidity and mortality worldwide. A cluster RCT in Bangladesh compared a community-based smoke-free home (SFH) intervention delivered in mosques, with or without indoor air quality (IAQ) feedback to households to no intervention. Neither was effective nor cost-effective compared to no intervention using an objective measure of second-hand smoke. This paper presents the process evaluation embedded within the trial and seeks to understand this. METHODS A mixed method process evaluation comprising interviews with 30 household leads and six imams (prayer leader in mosque), brief questionnaire completed by 900 household leads (75% response), fidelity assessment of intervention delivery in six (20%) mosques and research team records. Data were triangulated using meta-themes informed by three process evaluation functions: implementation, mechanisms of impact and context. RESULTS IMPLEMENTATION: Frequency of SFH intervention delivery was judged moderate to good. However there were mixed levels of intervention fidelity and poor reach. Linked Ayahs (verses of the Qur'an) with health messages targeting SHS attitudes were most often fully implemented and had greatest reach (along with those targeting social norms). Frequency and reach of the IAQ feedback were good. MECHANISMS OF IMPACT Both interventions had good acceptability. However, views on usefulness of the interventions in creating a SFH were mixed. Individual drivers to behaviour change were new SFH knowledge with corresponding positive attitudes, social norms and intentions. Individual barriers were a lack of self-efficacy and plans. CONTEXT Social context drivers to SFH intervention implementation in mosques were in place and important. No context barriers to implementation were reported. Social context drivers to SHS behaviour change were children's requests. Barriers were women's reluctance to ask men to smoke outside alongside general reluctance to request this of visitors. (Not) having somewhere to smoke outside was a physical context (barrier) and driver. CONCLUSIONS Despite detailed development and adaption work with relevant stakeholders, the SFH intervention and IAQ feedback became educational interventions that were motivational but insufficient to overcome significant context barriers to reduce objectively measured SHS exposure in the home. Future interventions could usefully incorporate practical support for SFH behaviour change. Moreover, embedding these into community wide strategies that include practical cessation support and enforcement of SFH legislation is needed. TRIAL REGISTRATION Current Controlled Trials ISRCTN49975452.
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Affiliation(s)
- Cath Jackson
- Department of Health Sciences, University of York, York, UK.
- Valid Research Ltd, Wetherby, UK.
| | | | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, UK
| | | | | | | | | | | | | | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, Scotland, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
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Ibrahim A, Came H, Cairncross C, Khalifa M. Learnings on Doing Health Research with Muslim Communities in Aotearoa New Zealand from a Study on Health and Ramadan. JOURNAL OF RELIGION AND HEALTH 2022; 61:3795-3805. [PMID: 35226294 DOI: 10.1007/s10943-022-01524-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
The Muslim community is a vibrant part of New Zealand society. As this community grows, researchers will need to strengthen engagement and collaboration to tailor the delivery of services. Given the paucity of the literature, this conceptual paper drawing on a study on health and Ramadan presents an exemplar for doing research with Muslim communities. This paper proposes several key elements (i) the importance of relationships, (ii) engagement with imams (mosque leaders), (iii) cultural and religious safety, (iv) a gendered approach and (v) utilizing religious festivals. These findings will be of interest to policy makers, practitioners and scholars wishing to engage with this community.
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Affiliation(s)
- Abduraouf Ibrahim
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand.
| | - Heather Came
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand
| | - Carolyn Cairncross
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand
| | - Marwa Khalifa
- Faculty Health and Environmental Sciences, Auckland University of Technology, Private Bag, 92006, Auckland, 1142, New Zealand
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38
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Shannon C, Dwyre C, Grafton K. Faith Community Nurses Key to Promoting Health in At-Risk Communities: An Integrative Review. J Christ Nurs 2022; 39:228-235. [PMID: 36048595 DOI: 10.1097/cnj.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT An integrative literature review was conducted to identify recommendations to implement culturally congruent and spiritually connected approaches to health promotion in at-risk faith communities. Five themes emerged from an analysis of 48 articles meeting criteria for the review. Review results repeatedly highlighted the impact nurses-more specifically faith community nurses (FCNs)-can have on at-risk population outcomes and bridging the gap between minority communities and the healthcare establishment. Five recommended action steps provide program guidance to FCNs for promoting faith-based health in at-risk minority communities.
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Ralston PA, Young-Clark I, Wickrama K(A, Coccia C, Lemacks JL, Battle AM, Hart C, Ilich JZ. Dissemination trial for Health for Hearts United: Model development, preliminary outcomes and lessons learned. Contemp Clin Trials Commun 2022; 29:100979. [PMID: 36052174 PMCID: PMC9424356 DOI: 10.1016/j.conctc.2022.100979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cardiovascular disease CVD), the leading cause of death in the U.S., is a particular problem for African Americans (AAs). Church-based health interventions are effective in reducing CVD risk, yet few have been successfully disseminated. This paper describes the model development, preliminary health outcomes, and lessons learned from the Health for Hearts United (HHU) dissemination trial which evolved from the longitudinal Reducing CVD Risk Study in a two-county area in North Florida. Community-based participatory research approaches and the socio-ecological model guided the study. Methods Data for this paper were from health leaders (n = 25) in the first six churches investigated, and the outreach participants (n = 86) they engaged. Health leaders completed survey items (daily servings of fruits/vegetables [F/V], fat consumption [FAT], and daily minutes of physical activity [PA]) and clinical measures (body mass index [BMI]; waist, hip and abdomen circumferences; and systolic and diastolic blood pressure [BP]). For outreach participants, a brief CVD Awareness Quiz was administered. Data were analyzed using description statistics, Pearson correlations, and repeated measures analysis of variance. Results Findings showed that the dissemination model was implemented by 100% of the churches, and resulted in health outcomes changes for health leaders (significant increases between pre- and post-test in F/V; significant decreases in FAT, BMI, abdomen circumference, with educational level and marital status as selected significant covariates) and in a significant increase in CVD awareness for outreach participants. Lessons learned are discussed. Although preliminary, the results suggest that the HHU dissemination model has promise for reducing CVD risk in AA's.
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Affiliation(s)
- Penny A. Ralston
- , Center on Better Health and Life for Underserved Populations, Florida State University, P.O. Box 3064191, Tallahassee, FL, 32306-1491, USA
| | - Iris Young-Clark
- , Center on Better Health and Life for Underserved Populations, Florida State University, USA
| | - Kandauda (A.S.) Wickrama
- Georgia Athletic Association Endowed Professor of Human Development and Family Science Research, University of Georgia, USA
| | - Catherine Coccia
- , Department of Dietetics & Nutrition, Florida International University, USA
| | - Jennifer L. Lemacks
- College of Nursing and Health Professions, University of Southern Mississippi, USA
| | | | | | - Jasminka Z. Ilich
- , Institute for Successful Longevity, Consulting Faculty, Center on Better Health and Life for Underserved Populations, Florida State University, USA
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40
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Buro AW, Roman Candelaria K, Bailey R, Luna F, Albizu-Jacob A, Stern M, Redwine L. Exploration of Multilevel Barriers and Strategies That Affected Early COVID-19 Vaccination and Testing in Rural Latino Communities in Southwest Florida. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11785. [PMID: 36142059 PMCID: PMC9517188 DOI: 10.3390/ijerph191811785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has disproportionately impacted multiple racial and ethnic minority groups, including Latinos residing in rural communities. Low rates of vaccination and testing combined with social determinants of health have contributed significantly to this disparate impact. Given the needs and constraints unique to rural Latino migrant and immigrant communities, this qualitative study examined multilevel barriers and strategies that affect COVID-19 vaccination and testing uptake among these communities in southwest Florida. Four focus groups (n = 25) were conducted between March and April 2021 with various key stakeholders, including rural Latino community members, local leaders, and community health workers ('Promotoras de Salud'). Themes that aligned with barriers to COVID-19 vaccination and testing included fear, lack of control, misinformation, lack of accessibility, and institutional/policy issues; themes that aligned with strategies to improve COVID-19 vaccination and testing uptake included faith, taking care of self, and community and family resilience. Recommendations for improving future pandemic responses for rural Latino communities include incorporating multiple levels of intervention, such as consideration of the role of the family, involving trusted community members, and ensuring the development and implementation of fair and consistent policies.
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Affiliation(s)
- Acadia W. Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA
| | - Kevin Roman Candelaria
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | | | | | - Alexandra Albizu-Jacob
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Laura Redwine
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
- Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Lumpkins CY, Goeckner R, Hale J, Lewis C, Gunville J, Gunville R, Daley CM, Daley SM. In Our Sacred Voice - An Exploration of Tribal and Community Leader Perceptions as Health Communicators of Disease Prevention among American Indians in the Plains. HEALTH COMMUNICATION 2022; 37:1180-1191. [PMID: 34949125 DOI: 10.1080/10410236.2021.2008108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
American Indians (AI) are disproportionately and significantly impacted by disease morbidity, mortalityand poor behavioral health outcomes. Health promotion and health communication programs exist to address these health disparities and health conditions; however, few programs fully integrate holistic approaches when targeting AI populations. The objective of this study was to explore how tribal and community leaders throughout the Central Plains (Kansas, Iowa, Missouri, and South Dakota) viewed themselves as health communicators and health promoters within their communities. Members of the Center for American Indian Community Health (CAICH) conducted 39 in-depth interviews with members of federally recognized tribes living in reservation communities as well as urban tribal communities across the region. Results from the sample show that these individuals do not necessarily see themselves as the "authority" health communicator or health promoter within their tribe or community. They did perceive themselves and others as gatekeepers of pertinent health information. Social and cultural authority within culturally centered messaging and collective delivery of this type of health information from trusted sources within tribes and communities is perceived to bolster health communication programs and positively impact health outcomes among AI populations.
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Affiliation(s)
- Crystal Y Lumpkins
- Department of Family Medicine and Community Health, University of Kansas Medical Center
- William Allen White School of Journalism and Mass Communications, University of Kansas-Lawrence
| | | | - Jason Hale
- Lehigh College of Health, Institute for Indigenous Studies
| | - Charley Lewis
- Lehigh College of Health, Institute for Indigenous Studies
| | | | - River Gunville
- Lehigh College of Health, Institute for Indigenous Studies
| | - Chris M Daley
- Lehigh College of Health, Institute for Indigenous Studies
| | - Sean M Daley
- Lehigh College of Health, Institute for Indigenous Studies
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42
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Teizazu H, Hirsch JS, Parker RG, Wilson PA. Framing HIV and AIDS: how leaders of black religious institutions in New York City interpret and address sex and sexuality in their HIV interventions. CULTURE, HEALTH & SEXUALITY 2022; 24:904-919. [PMID: 33810778 PMCID: PMC8486886 DOI: 10.1080/13691058.2021.1898676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
This study explored how leaders of Black churches active in the fight against HIV conceptualised sex and sexuality when describing HIV interventions within their institutions. We analysed interviews with pastors and identified three frames through which leaders understood and communicated about sex and sexuality: (1) an evasive frame, in which participants avoided discussing behaviours and populations that have historically been disparaged within the church by emphasising involuntary risk exposure; (2) an agentic frame, which recognised sexual behaviour that differed from heteronormative conduct; and, (3) a pluralist frame, which allowed individuals to maintain their own beliefs about appropriate sexual conduct. Participants used frames to engage in a range of HIV interventions while upholding stigmatising beliefs about sexual behaviour and identity.
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Affiliation(s)
- Hawi Teizazu
- Sociomedical Sciences, Columbia University, New York, NY, USA
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Abstract
ABSTRACT Faith-based health programs reach broad populations and can reduce health disparities. Nurses working in communities and churches can promote health behaviors that may reduce the incidence and impact of chronic conditions. This 5-week faith-based health outreach resulted in improvement of health-promoting behaviors, including better stress management, among women.
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Affiliation(s)
- Tiffany Leschber
- Tiffany Leschber, DNP, APRN, FNP-C , is a family nurse practitioner working in family practice in central Texas
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44
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Tan MM, Musa AF, Su TT. The role of religion in mitigating the COVID-19 pandemic: the Malaysian multi-faith perspectives. Health Promot Int 2022; 37:daab041. [PMID: 33928389 PMCID: PMC8135627 DOI: 10.1093/heapro/daab041] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Social distancing is crucial in breaking the cycle of transmission of COVID-19. However, many religions require the faithful to congregate. In Malaysia, the number of COVID-19 cases spiked up from below 30 in February 2020 to more than a thousand a month later. The sudden increase was mostly linked to a large Islamic gathering attended by 16,000 near the capital, Kuala Lumpur. Another large COVID-19 cluster was from a church gathering in Kuching, Sarawak. Within a few weeks, Malaysia became the worst hit country by COVID-19 in Southeast Asia. While religious leaders have advised social distancing among their congregants, the belief that "God is our shield" is often cited for gathering. There is a need to promote sound decision-making among religious adherents so that they will not prioritize their loyalty to the subjective interpretation of religion over evidence-based medicine. Malaysia, a multi-cultural and multi-faith country, is an example of how religious beliefs could strongly influence health behaviours at individual and community levels. In this article, we detail the religious aspects of COVID-19 prevention and control in Malaysia and discuss the possible role of religious organizations in encouraging sound decision-making among religious adherents in mitigating this crisis. We make recommendations on how to promote a partnership between the healthcare system and religious organizations, and how religion and faith could be integrated into health promotion channels and resources in the response of COVID-19 and future communicable diseases.
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Affiliation(s)
- Min Min Tan
- South East Asia Community Observatory (SEACO) & Global Public Health, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
| | - Ahmad Farouk Musa
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor 47500, Malaysia
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Wilmoth S, Perez A, He M. Latino church-going parents' insights on childhood obesity prevention. HEALTH EDUCATION RESEARCH 2022; 36:541-553. [PMID: 33942087 DOI: 10.1093/her/cyab021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/10/2021] [Accepted: 04/14/2021] [Indexed: 06/12/2023]
Abstract
Childhood obesity continues to be a priority health concern in the United States. Faith communities present a viable venue for health promotion programming. The majority of obesity prevention programming focuses on African American populations. Subsequently, insights for obesity prevention programming in Latino faith communities are lacking. This qualitative study aimed to gain insight into Latino church-going parents' perspectives on childhood obesity and faith-based obesity prevention strategies. Participants were Latino church-going parents with children ages 10-18, recruited from predominantly Latino churches in south Texas, United States. Focus groups were conducted with a total of 56 Latino participants from nine churches. Discussions were audio-taped and transcribed verbatim. Inductive content analysis was performed and assisted by NVivo. Participants were aware of the obesity facing their congregations. Parents' affirmation of the physical body being God's Temple supported the development of obesity prevention programs in faith community settings. Participants suggested integration of spiritual and physical health promotion through health sermons, Bible study, Sunday school, nutrition classes and physical activities for both children and adults. In brief, Latino church-going parents were concerned about childhood obesity and perceived the need for developing obesity prevention programs integrating both faith and health promotion.
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Clements AD, Cyphers NA, Whittaker DL, Hamilton B, McCarty B. Using Trauma Informed Principles in Health Communication: Improving Faith/Science/Clinical Collaboration to Address Addiction. Front Psychol 2022; 12:781484. [PMID: 35002868 PMCID: PMC8727867 DOI: 10.3389/fpsyg.2021.781484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Problematic substance use is a pressing global health problem, and dissemination and implementation of accurate health information regarding prevention, treatment, and recovery are vital. In many nations, especially the US, many people are involved in religious groups or faith communities, and this offers a potential route to positively affect health through health information dissemination in communities that may have limited health resources. Health information related to addiction will be used as the backdrop issue for this discussion, but many health arenas could be substituted. This article evaluates the utility of commonly used health communication theories for communicating health information about addiction in religious settings and identifies their shortcomings. A lack of trusting, equally contributing, bidirectional collaboration among representatives of the clinical/scientific community and religious/faith communities in the development and dissemination of health information is identified as a potential impediment to effectiveness. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) tenets of trauma-informed practice, although developed for one-on-one use with those who have experienced trauma or adversity, are presented as a much more broadly applicable framework to improve communication between groups such as organizations or communities. As an example, we focus on health communication within, with, and through religious groups and particularly within churches.
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Affiliation(s)
- Andrea D Clements
- Department of Psychology, College of Arts and Sciences, East Tennessee State University, Johnson City, TN, United States.,Uplift Appalachia, Johnson City, TN, United States.,Ballad Health Strong BRAIN Institute, East Tennessee State University, Johnson City, TN, United States
| | - Natalie A Cyphers
- Division of Nursing, DeSales University, Center Valley, PA, United States
| | | | - Bridget Hamilton
- Center for Nursing Research, College of Nursing, East Tennessee State University, Johnson City, TN, United States
| | - Brett McCarty
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States.,Divinity School, Duke University, Durham, NC, United States
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Dascalu S, Flammer PG, Ghafari M, Henson SC, Nascimento R, Bonsall MB. Engaging Religious Institutions and Faith-Based Communities in Public Health Initiatives: A Case Study of the Romanian Orthodox Church During the COVID-19 Pandemic. Front Public Health 2022; 9:768091. [PMID: 34976927 PMCID: PMC8717894 DOI: 10.3389/fpubh.2021.768091] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
The success of public health interventions is highly dependent on the compliance of the general population. State authorities often implement policies without consulting representatives of faith-based communities, thereby overlooking potential implications of public health measures for these parts of society. Although ubiquitous, these challenges are more readily observable in highly religious states. Romania serves as an illustrative example for this, as recent data identify it as the most religious country in Europe. In this paper, we discuss the contributions of the Romanian Orthodox Church (ROC), the major religious institution in the country, to the national COVID-19 mitigation efforts. We present not only the positive outcomes of productive consultations between public health authorities and religious institutions but also the detrimental impact of unidirectional communication. Our work highlights that an efficient dialogue with faith-based communities can greatly enhance the results of public health interventions. As the outlined principles apply to a variety of contexts, the lessons learned from this case study can be generalized into a set of policy recommendations for the betterment of future public health initiatives worldwide.
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Affiliation(s)
- Stefan Dascalu
- Department of Zoology, University of Oxford, Oxford, United Kingdom.,Avian Influenza Research Group, The Pirbright Institute, Woking, United Kingdom
| | - Patrik G Flammer
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Mahan Ghafari
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Shaun C Henson
- Ian Ramsey Centre for Science and Religion, University of Oxford, Oxford, United Kingdom.,Faculty of Theology and Religion, University of Oxford, Oxford, United Kingdom
| | - Roger Nascimento
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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48
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Goberdhan S, Gobin R, Perreira O, Sharma M, Ramdeen M, Harding S. Formative Exploration of the Feasibility of Embedding Community Assets Into Primary Health Care: Barbershop and Place of Worship Readiness in Guyana. J Prim Care Community Health 2022; 13:21501319221135949. [PMID: 36373680 PMCID: PMC9666845 DOI: 10.1177/21501319221135949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Community engagement is key to improving the quality of primary health care
(PHC), with asset-based interventions shown to have a positive impact on
equity and health outcomes. However, there tends to be a disconnect between
community-based interventions and PHC, with a lack of evidence on how to
develop sustainable community—primary care partnerships. This paper reports
on the formative phases of 2 studies exploring the feasibility of embedding
community assets, namely places of worship and barbershops, into the PHC
pathway for the prevention and control of NCDs in deprived settings. It
describes the participatory approach used to map and gather contextual
readiness information, including the enablers and constrainers for
collaborative partnerships with PHC. Methods: Grounded in community-based participatory research, we used elements of
ground-truthing and participatory mapping to locate and gather contextual
information on places of worship and barbershops in urban and rural
communities. Local knowledge, gathered from community dialogs, led to the
creation of sampling frames of these community assets. Selected places of
worship were administered a 66-item readiness questionnaire, which included
domains on governance and financing, congregation profile, and existing
health programs and collaborations. Participating barbershops were
administered a 40-item readiness questionnaire, which covered barbers’
demographic information, previous training in health promotion, and barbers’
willingness to deliver health promotion activities. Results: Fourteen barbershops were identified, of which 10 participated in the
readiness survey, while 240 places of worship were identified, of which 14
were selected and assessed for readiness. Contextual differences were found
within and between these assets regarding governance, accessibility, and
reach. Key enablers for both include training in health promotion, an
overwhelming enthusiasm for participation and recognition of the potential
benefits of a community—primary care partnership. Lack of previous
collaborations with the formal health system was common to both. Conclusion: The participatory approach extended reach within underserved communities,
while the readiness data informed intervention design and identified
opportunities for partnership development. Contextual differences between
community assets require comprehensive readiness investigations to develop
suitably tailored interventions that promote reach, acceptance, and
sustainability.
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49
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Brown NR, Alick CL, Heaston AG, Monestime S, Powe N. The Black Church and Public Health: A Key Partnership for Theory Driven COVID-19 Recovery Efforts. J Prim Care Community Health 2022; 13:21501319221097672. [PMID: 35619243 PMCID: PMC9150224 DOI: 10.1177/21501319221097672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 epidemic has negatively impacted the Black community in the United States. Despite current disease mitigation efforts, work is still needed to ensure that Black individuals living in the United States understand their risks regarding COVID-19 infection whether vaccinated or unvaccinated. Thus, the current article posits that the Black church, in concert with public health practitioners, is a venue through which theoretically based health messages should be designed and disseminated regarding COVID-19 recovery efforts. The Health Belief Model and the Harm Reduction approach are posed as theoretical frameworks to facilitate the design of such messages.
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Affiliation(s)
| | - Candice L. Alick
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Shanada Monestime
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
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50
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Clements AD, Cyphers N, Whittaker DL, McCarty B. Initial Validation and Findings From the Willing/Ready Subscale of the Church Addiction Response Scale. Front Psychol 2021; 12:733913. [PMID: 34733210 PMCID: PMC8558616 DOI: 10.3389/fpsyg.2021.733913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Addiction has been a global health crisis over recent decades and worsened substantially during COVID-19 lockdowns. We report on the development, validation, and findings from an instrument developed to assess the readiness of churches in the Appalachian Highlands to address addiction. The Church Addiction Response Scale (CARS) is a 41-item, three section measure assessing "What are your views about addiction?" (14 items), "What are your views about interacting with people who are addicted to drugs?" (11 items), and "What do you think the church's role is in addressing addiction?" (16 items). The CARS was found to be unidimensional with strong internal consistency and initial evidence of construct validity was positive. Most respondents reported willingness to assist people living with addiction, but many reported that they felt underprepared, thus were not ready. Areas of preparation were largely those that could be addressed through training, such as understanding the physiology and psychology of addiction, available treatment options, and how to avoid doing harm. Thus, with adequate training, the likelihood of equipping a church-based workforce to provide support for people living with addiction seems attainable.
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Affiliation(s)
- Andrea D Clements
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States.,Uplift Appalachia, Johnson City, TN, United States.,East Tennessee State University Ballad Health Strong BRAIN Institute, Johnson City, TN, United States
| | - Natalie Cyphers
- Division of Nursing, DeSales University, Center Valley, PA, United States
| | | | - Brett McCarty
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States.,Duke Divinity School, Duke University, Durham, NC, United States
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