Developing culturally congruent weight maintenance programs for African American church members

Culturally adapting an evidence-based intervention to promote a healthy diet and lifestyle for Yup'ik Alaska native communities

Underserved populations are at increased risk for obesity and related cardiovascular disease, type 2 diabetes, and other chronic diseases. Lack of access to healthy foods, sedentary behaviour, and other social environmental factors contribute to disease risk. Yup'ik Alaska Native communities are experiencing lifestyle changes that are likely to affect their cardiometabolic risks. Barrera & Castro's Cultural Adaptation Framework was used to adapt an evidence-based intervention (EBI) originally designed for Latino communities for use in Yup'ik communities. Focus groups and key informant interviews were held in two Yup'ik communities. Major themes included causes of obesity, barriers and facilitators to healthy foods and physical activity, and intervention ideas. The adaptation process was guided by a Community Planning Group of Yup'ik women and included information gathering, preliminary adaptation design, preliminary adaptation tests, and adaptation refinement. Two of the adapted educational modules were pilot tested. Involving community members as co-researchers in cultural adaptation is vital for an EBI to be effective in another population. Small group gatherings led by local lay health workers are culturally appropriate and may be an effective health promotion model in Yup'ik communities. Social environmental factors affecting healthy food availability and physical activity need further exploration.

Dyadic Peer Support to Improve Diet and Physical Activity Among African American Church Members: An Exploratory Study

This study examined how African American church members communicated and cooperated as dyads to attain health goals. Participants completed nine weeks of group classes then worked as dyads for nine weeks. Communication logs and interviews were used to assess: (1) dyad communication and (2) dyad cooperation. Thirty-two dyads from three churches completed the study. Dyads communicated an average of two times per week. Dyads experienced challenges and provided encouragement. Findings indicate African American church members cooperate and communicate as family, friend, and acquaintance dyads to achieve health goals.

Building Capacity Among Laity: A Faith-Based Health Ministry Initiative

A systematic review of topic-specific faith-based health programs determined that health outcomes can be improved though faith-based health interventions. A university research team, in partnership with the Kansas United Methodist Church and a United Methodist philanthropy, facilitated planning and development of a statewide initiative to increase the capacity of laity-led health ministry teams. The purpose of this paper is to describe the processes utilized to design and implement an initiative to increase capacity for laity-led comprehensive health ministry among Kansas United Methodist Church congregations and to share the key elements of the initiative.

Process Evaluation of a Peer-Driven, HIV Stigma Reduction and HIV Testing Intervention in Latino and African American Churches

Purpose: Faith-based organizations may be effective in addressing HIV-related disparities, but few interventions have been implemented across diverse churches. The Facilitating Awareness to Increase Testing for HIV (FAITH) intervention harnessed peer leadership to decrease HIV stigma and promote HIV testing in African American and Latino congregations. A pilot study found more consistent effects among Latino congregations. This process evaluation evaluates implementation of FAITH to better understand the pilot study's findings.

Methods: Data sources included HIV education and peer leader workshop evaluation forms, participant views of the community's perspective of HIV, and peer leader follow-up interviews. Data were triangulated with systematic observation notes and analyzed using process-related themes of recruitment, reach, context, implementation, dose-delivered, and fidelity.

Results: At the Latino churches (compared to the African American church), facilitators spent more time addressing community-based misconceptions about HIV. The peer leader model was well received, especially among Latino participants, and most said that after the workshop they felt comfortable speaking with others about HIV-related topics. Latino peer leaders reported speaking with up to 20 people within their social networks (particularly with family members); African Americans reported up to 4. Implementation challenges at the African American church may have contributed to the limited intervention effects. Nevertheless, we found the peer motivator model feasible and acceptable across diverse faith settings.

Conclusion: Peer-based models within faith settings are promising for addressing HIV. However, differences among groups in HIV knowledge, social network characteristics and norms, and church preferences may influence overall effectiveness.

Development of Participant-Informed Text Messages to Promote Physical Activity Among African American Women Attending College: A Qualitative Mixed-Methods Inquiry

The purpose of this study was to develop a participant-informed technology-based physical activity (PA) promotion tool for young overweight and obese African American (AA) women. A mixed-method 3-phase study protocol design was used to develop text messages to promote PA in AA women attending the University of Alabama at Birmingham during the Spring of 2013. Nominal focus groups and a 2-week pilot were used to generate and test participant-developed messages. Participants ( n = 14) had a mean age of 19.79 years ( SD = 1.4) and mean body mass index of 35.9 ( SD = 5.926). Focus group data identified key themes associated with the use of text messages to promote PA including message frequency, length, tone, and time of day. Participants preferred text messages that were brief, specific, and time sensitive. Results showed that text messaging was a feasible and acceptable strategy to promote PA in overweight and obese AA women in a university setting.

Review and evaluation of faith-based weight management interventions that target African American women

This integrative review was conducted to present results of the use of recommended criteria to evaluate faith-based weight management interventions (WMIs) that target African American women. This group experiences the highest prevalence of adult obesity in the US when compared to other ethnic groups. "Best practice" WMIs can help to alleviate obesity. Faith-based interventions hold promise for helping to address the problem of obesity in African American women since a significant portion of these persons views the church as a trusted entity that advocates for their well-being. No systematic evaluation of faith-based WMIs has been reported even though there is an ongoing plea for the need for better evaluation of health interventions that prioritizes comprehensive description of their attributes (e.g., linkage to theory, interventionists' background, and dosage) to enable replication and a broader assessment of their validity to include appropriateness and feasibility). Critique criteria were applied to faith-based WMIs (n = 5) that target African American women. Findings highlighted the need for increased disclosure about the (1) interventionists' background, (2) intervention's location within the church setting, and (3) nature of any "pre-intervention"’ treatment. The review also indicated the need for interventions that are (1) designed from robust research methodologies (effectiveness) that include randomization of both church setting and participants, (2) deemed appropriate from the perspective of African American women targeted, and (3) are financially feasible-without steep participant incentives/implementation costs that compromise internal validity and any positive outcomes generated.

HEALS Hypertension Control Program: Training Church Members as Program Leaders

INTRODUCTION

Health disparities related to cardiovascular diseases (CVDs) including stroke have remained higher in the African-Americans (AAs) than in other populations. HEALS is a faith-based hypertension (HTN) control program modified according to AA community needs, and delivered by the church-lay members called church health advisors (CHAs). This study examined the feasibility and acceptability of training CHAs as HEALS program leaders.

DESIGN

Four CHAs completed a 10-hour HEALS program training workshop at the Church, conducted by the nutrition experts. Workshop was evaluated by CHAs on their level of satisfaction, clarity of contents covered and comfort in delivery the program to the church congregation.

RESULTS

The overall six main HEALS curriculum components were completed. Workshop was highly evaluated by CHAs on length of training, balance between content and skills development, and level of satisfaction with program delivery.

CONCLUSION

Church-based culturally modified health promotion interventions conducted by the community lay members may be a way to reduce health disparities in ethnic minorities.

Recommendations for a culturally relevant Internet-based tool to promote physical activity among overweight young African American women, Alabama, 2010-2011

Introduction

Innovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women.

Methods

A mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes.

Results

Twenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter).

Conclusion

Incorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population.