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Williams MV, Flórez KR, Branch CA, Hawes-Dawson J, Mata MA, Oden CW, Derose KP. Lessons Learned about Developing Faith and Public Health Partnerships to Address Health Disparities. Community Health Equity Res Policy 2024; 44:229-238. [PMID: 36879511 PMCID: PMC10480341 DOI: 10.1177/2752535x231151850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Partnerships between public health and faith-based organizations draw on the strengths of both sectors to achieve a shared interest in promoting health and reducing disparities. However, information about implementation of faith and public health partnerships-particularly those involving diverse racial-ethnic groups-is limited. This paper reports on findings from qualitative interviews conducted with 16 public health and congregational leaders around the country as part of the early phase of the development of a faith and public health partnership to address health disparities in Los Angeles, CA. We identified eight themes regarding the barriers and facilitators to building faith and public health partnerships and distilled these into 10 lessons for developing such approaches. These interviews identified that engaging religious organizations often requires building congregational capacity of the congregation to participate in health programs; and that trust is a critically important element of these relationships. Further, trust is closely related to how well each organization involved in the partnership understands their partners' belief structures, approaches to addressing health and well-being and capacities to contribute to the partnership. Tailoring congregational health programs to match the interests, needs and capacity of partners was identified as an important approach to ensuring that the partnership is successful. But, this is complicated by working across multiple faith traditions and the racial-ethnic backgrounds, thus requiring increased and diverse communication strategies on the part of the partnership leadership. These lessons provide important information for faith and public health leaders interested in developing partnered approaches to address health in diverse urban communities.
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Affiliation(s)
- Malcolm V Williams
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
| | - Karen R Flórez
- Department of Environmental, Occupational and Geospatial Sciences, City University of New York's Graduate School of Public Health and Health Policy, New York, NY, USA
| | | | | | | | | | - Kathryn P Derose
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA
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Payán DD, Flórez KR, Williams MV, Oden CW, Mata MA, Branch CA, Whitley MD, Derose KP. Sermons to Address Obesity in Partnership With African American and Latino Churches. J Nutr Educ Behav 2021; 53:811-815. [PMID: 34120832 PMCID: PMC8440423 DOI: 10.1016/j.jneb.2021.04.469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Denise D Payán
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California Merced, Merced, CA.
| | - Karen R Flórez
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | | | - Clyde W Oden
- Bethel African Methodist Episcopal Church, Oxnard, CA
| | | | | | | | - Kathryn P Derose
- RAND Corporation, Santa Monica, CA; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
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Mendel P, Green HD, Palar K, Kanouse DE, Bluthenthal RN, Mata MA, Oden CW, Derose KP. Congregational involvement in HIV: A qualitative comparative analysis of factors influencing HIV activity among diverse urban congregations. Soc Sci Med 2019; 246:112718. [PMID: 31931449 DOI: 10.1016/j.socscimed.2019.112718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
Abstract
Religious congregations can potentially reach disproportionately affected populations with HIV programming, however, factors that influence congregational involvement in HIV are not well-studied. Utilizing comparative case methods and in-depth qualitative data from a diverse sample of 14 urban congregations, we examine a range of attitudinal, organizational, resource, and demographic factors to systematically identify different case scenarios-i.e., combinations of characteristics-associated with the level and types of HIV activities in which the congregational cases tended to be involved. For example, White or mixed race congregations with active gay constituencies and an African-American congregation with a strong lay HIV champion were among the high HIV involvement case scenarios, compared to African-American congregations with a health emphasis but no lay HIV champion among the medium HIV involvement scenarios, and fundamentalist African-American and Latino congregations among the low HIV involvement scenarios. Two key factors that appeared influential across case scenarios included the existence of lay champions for HIV activities and the general theological orientation of the congregation.
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Affiliation(s)
| | - Harold D Green
- RAND Corporation, Santa Monica, CA, USA; Indiana University, Bloomington, IN, USA
| | - Kartika Palar
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Ricky N Bluthenthal
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Clyde W Oden
- Bethel Oxnard African Methodist Episcopal Church, Oxnard, CA, USA
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Hidalgo BE, Derose KP, Kanouse DE, Mendel PJ, Bluthenthal RN, Oden CW. Urban Religious Congregations' Responses to Community Substance Use: An Exploratory Study of Four Cases. J Relig Health 2019; 58:1340-1355. [PMID: 30835054 PMCID: PMC6610588 DOI: 10.1007/s10943-019-00788-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Faith-based drug treatment programs are common, and many are implemented through congregations; however, little is documented about how congregations conceptualize and implement these programs. We use case study analysis to explore congregational approaches to drug treatment; qualitative findings emerged in three areas: (1) religion's role in congregational responses to substance use, (2) relationships between program participants and the broader congregation, and (3) interactions between congregational programs and the external community. Congregational approaches to drug treatment can be comprehensive, but work is needed to evaluate such efforts. Congregants' attitudes may influence whether program participants become members of a sustaining congregational community.
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Affiliation(s)
- Benjamin E Hidalgo
- RAND Corporation, 1776 Main St, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Kathryn P Derose
- RAND Corporation, 1776 Main St, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - David E Kanouse
- RAND Corporation, 1776 Main St, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Peter J Mendel
- RAND Corporation, 1776 Main St, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | - Clyde W Oden
- Bethel African Methodist Episcopal Church, Oxnard, CA, USA
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Payán DD, Flórez KR, Bogart LM, Kanouse DE, Mata MA, Oden CW, Derose KP. Promoting Health from the Pulpit: A Process Evaluation of HIV Sermons to Reduce HIV Stigma and Promote Testing in African American and Latino Churches. Health Commun 2019; 34:11-20. [PMID: 29053386 PMCID: PMC5927848 DOI: 10.1080/10410236.2017.1384352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Embedding health messages into sermons is a potentially valuable strategy to address HIV and other health disparities in churches that predominantly serve racial and ethnic minorities. This study explores implementation of an HIV sermon as part of a multi-component intervention in three churches (Latino Catholic, Latino Pentecostal, and African American Baptist) in high HIV prevalence areas of Los Angeles County, California. Clergy were given an HIV sermon guide that included local public health data, stigma reduction cues, HIV testing messages, and a sample sermon. Findings are based on a process evaluation (i.e., reach, dose delivered, fidelity, and implementation) and in-depth content analysis to explore HIV frames and messages used by clergy. Sermons were audio-recorded, transcribed verbatim, and coded using an inductive approach. Complementary data were collected through systematic observation. Overall, five clergy delivered nine HIV sermons to majority African American or Latino audiences. On average, 174 congregants were reached per sermon. We found large variation in fidelity to communicating key HIV messages from the sermon guide. While promoting HIV testing from the pulpit seemed viable and acceptable to all the participating clergy, fewer embedded explicit stigma reduction cues. Most spoke about HIV using compassionate and non-judgmental terms, however, issue framing varied across clergy. Structured training of clergy may be necessary to implement the more theoretically driven stigma reduction cues included in the sermon guide. More research is needed on the viability and acceptability of embedding specific health promotion messages into sermons.
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Affiliation(s)
- Denise D. Payán
- School of Social Sciences, Humanities and Arts, University of California, Merced
- Health Program, RAND Corporation
| | - Karen R. Flórez
- Health Program, RAND Corporation
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York
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Derose KP, Williams MV, Branch CA, Flórez KR, Hawes-Dawson J, Mata MA, Oden CW, Wong EC. A Community-Partnered Approach to Developing Church-Based Interventions to Reduce Health Disparities Among African-Americans and Latinos. J Racial Ethn Health Disparities 2018; 6:254-264. [PMID: 30120736 DOI: 10.1007/s40615-018-0520-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/01/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
Faith and public health partnerships offer promise to addressing health disparities, but examples that incorporate African-Americans and Latino congregations are lacking. Here we present results from developing a multi-ethnic, multi-denominational faith and public health partnership to address health disparities through community-based participatory research (CBPR), focusing on several key issues: (1) the multi-layered governance structure and activities to establish the partnership and identify initial health priority (obesity), (2) characteristics of the congregations recruited to partnership (n = 66), and (3) the lessons learned from participating congregations' past work on obesity that informed the development of a multi-level, multi-component, church-based intervention. Having diverse staff with deep ties in the faith community, both among researchers and the primary community partner agency, was key to recruiting African-American and Latino churches. Involvement by local health department and community health clinic personnel provided technical expertise and support regarding health data and clinical resources. Selecting a health issue-obesity-that affected all subgroups (e.g., African-Americans and Latinos, women and men, children and adults) garnered high enthusiasm among partners, as did including some innovative aspects such as a text/e-mail messaging component and a community mapping exercise to identify issues for advocacy. Funding that allowed for an extensive community engagement and planning process was key to successfully implementing a CBPR approach. Building partnerships through which multiple CBPR initiatives can be done offers efficiencies and sustainability in terms of programmatic activities, though long-term infrastructure grants, institutional support, and non-research funding from local foundations and health systems are likely needed.
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Affiliation(s)
| | | | - Cheryl A Branch
- Los Angeles Metropolitan Churches, Los Angeles, CA, 90011, USA
| | - Karen R Flórez
- CUNY Graduate School of Public Health and Health Policy, New York, NY, 10027, USA
| | | | | | | | - Eunice C Wong
- RAND Corporation, 1776 Main St., Santa Monica, CA, 90401, USA
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Hawes-Dawson J, Derose KP, Aunon FM, Dominguez BX, Felton A, Mata MA, Oden CW, Paffen S. Achieving Broad Participation in Congregational Health Surveys at African American and Latino Churches. Field methods 2017; 29:79-94. [PMID: 28163659 PMCID: PMC5289823 DOI: 10.1177/1525822x16648588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Congregation-based health program evaluations often rely on surveys, but little documentation is available regarding specific methods and challenges. Here we describe methods used to achieve acceptable response rates (73-79%) to a survey of HIV-related attitudes and behaviors in 2 African American and 3 Latino churches in high HIV prevalence communities in Los Angeles County. Survey participation was enhanced by: conducting survey sessions at church-based meetings (e.g., women's Bible study) and after worship services; employing diverse survey staff; providing participation incentives for pastors, church coordinators, and survey participants; and working collaboratively and respectfully with congregational leaders. Achieving broad participation in church-based surveys on sensitive health topics is feasible when done collaboratively with congregational leaders and with a flexible protocol, which permits tailoring survey approaches to cultural and organizational contexts and leverages available resources appropriately.
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Affiliation(s)
| | | | - Frances M Aunon
- Clinical Psychology, University of Washington, Seattle, Washington
| | | | | | | | - Clyde W Oden
- Bryant Temple African Methodist Episcopal Church, Los Angeles, California
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Derose KP, Griffin BA, Kanouse DE, Bogart LM, Williams MV, Haas AC, Flórez KR, Collins DO, Hawes-Dawson J, Mata MA, Oden CW, Stucky BD. Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos. AIDS Behav 2016; 20:1692-705. [PMID: 27000144 PMCID: PMC4945375 DOI: 10.1007/s10461-015-1280-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n = 1235) and found statistically significant (p < 0.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p < 0.001). Stigma reduction and HIV testing may have synergistic effects in community settings.
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Affiliation(s)
- Kathryn P Derose
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | | | - David E Kanouse
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Laura M Bogart
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Malcolm V Williams
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | - Karen R Flórez
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | | | | | | | - Clyde W Oden
- Bryant Temple African Methodist Episcopal Church, Los Angeles, CA, USA
| | - Brian D Stucky
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
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Derose KP, Bogart LM, Kanouse DE, Felton A, Collins DO, Mata MA, Oden CW, Domínguez BX, Flórez KR, Hawes-Dawson J, Williams MV. An intervention to reduce HIV-related stigma in partnership with African American and Latino churches. AIDS Educ Prev 2014; 26:28-42. [PMID: 24450276 PMCID: PMC3947594 DOI: 10.1521/aeap.2014.26.1.28] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
HIV-related stigma negatively affects prevention and care, and community-based interventions are needed. Here we describe the development of a multi-ethnic, faith-based intervention to reduce HIV stigma that included: educational workshops on HIV, testing, and stigma; peer leader workshops using role plays and drawing on principles of motivational interviewing; a pastor-delivered sermon on HIV that incorporated theological reflection and an imagined contact scenario; and congregation-based HIV testing events. Lessons learned include: partnership development is essential and requires substantial investment; tailoring intervention components to single race-ethnic groups may not be preferable in diverse community settings; and adapting testing processes to be able to serve larger numbers of people in shorter time frames is needed for congregational settings. This development process successfully combined the rigorous application of social science theory and community engagement to yield a multifaceted HIV stigma reduction intervention appropriate for Protestant and Catholic churches in African American and Latino communities.
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Derose KP, Mendel PJ, Palar K, Kanouse DE, Bluthenthal RN, Castaneda LW, Corbin DE, Domínguez BX, Hawes-Dawson J, Mata MA, Oden CW. Religious congregations' involvement in HIV: a case study approach. AIDS Behav 2011; 15:1220-32. [PMID: 20953903 PMCID: PMC3087861 DOI: 10.1007/s10461-010-9827-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Comparative case studies were used to explore religious congregations' HIV involvement, including types and extent of activities, interaction with external organizations or individuals, and how activities were initiated and have changed over time. The cases included 14 congregations in Los Angeles County representing diverse faith traditions and races-ethnicities. Activities fell into three broad categories: (1) prevention and education; (2) care and support; and (3) awareness and advocacy. Congregations that engaged early in the epidemic focused on care and support while those that became involved later focused on prevention and education. Most congregations interacted with external organizations or individuals to conduct their HIV activities, but promoting abstinence and teaching about condoms were conducted without external involvement. Opportunities exist for congregations to help address a variety of HIV-related needs. However, activities that are mission-congruent, such as providing pastoral care for people with HIV, raising HIV awareness, and promoting HIV testing, appear easier for congregations to undertake than activities aimed at harm reduction.
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Derose KP, Mendel PJ, Kanouse DE, Bluthenthal RN, Castaneda LW, Hawes-Dawson J, Mata M, Oden CW. Learning about urban congregations and HIV/AIDS: community-based foundations for developing congregational health interventions. J Urban Health 2010; 87:617-30. [PMID: 20361357 PMCID: PMC2900568 DOI: 10.1007/s11524-010-9444-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Religious congregations are important community institutions that could help fight HIV/AIDS; however, barriers exist, particularly in the area of prevention. Formative, participatory research is needed to understand the capacity of congregations to address HIV/AIDS. This article describes a study that used community-based participatory research (CBPR) approaches to learn about congregation-sponsored HIV activities. CBPR strategies were used throughout the study, including proposal development, community expert interviews, Community Advisory Board, congregational telephone survey, congregational case studies, and congregational feedback sessions. Involving community consultants, experts, and advisory board members in all stages of the study helped the researchers to conceptualize congregational involvement in HIV, be more sensitive to potential congregational concerns about the research, achieve high response rates, and interpret and disseminate findings. Providing preliminary case findings to congregational participants in an interactive feedback session improved data quality and relationships with the community. Methods to engage community stakeholders can lay the foundation for future collaborative interventions.
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MacDonald WS, Oden CW. Role clarification and sanction in two cases of bronchial asthma. J Asthma Res 1977; 14:189-97. [PMID: 914730 DOI: 10.3109/02770907709104337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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