Background
Faith-based interventions hold promise for promoting health in ethnic minority populations.
To date, however, few of these interventions have used a community-based participatory
research (CBPR) approach, have targeted both physical activity and healthy eating,
and have focused on structural changes in the church.
Purpose
To report the results of a group randomized CBPR intervention targeting physical activity
and healthy eating in African-American churches.
Design
Group RCT. Data were collected from 2007 to 2011. Statistical analyses were conducted
in 2012.
Setting/participants
Seventy-four African Methodist Episcopal (AME) churches in South Carolina and 1257
members within them participated in the study.
Intervention
Churches were randomized to an immediate (intervention) or delayed (control) 15-month
intervention that targeted organizational and environmental changes consistent with
the structural ecologic model. A CBPR approach guided intervention development. Intervention
churches attended a full-day committee training and a full-day cook training. They
also received a stipend and 15 months of mailings and technical assistance calls to
support intervention implementation.
Main outcome measures
Primary outcomes were self-reported moderate- to vigorous-intensity physical activity
(MVPA), self-reported fruit and vegetable consumption, and measured blood pressure.
Secondary outcomes were self-reported fat- and fiber-related behaviors. Measurements
were taken at baseline and 15 months. Intent-to-treat repeated measures ANOVA tested
group X time interactions, controlling for church clustering, wave, and size, and
participant age, gender, and education. Post hoc ANCOVAs were conducted with measurement
completers.
Results
There was a significant effect favoring the intervention group in self-reported leisure-time
MVPA (d=0.18, p=0.02), but no effect for other outcomes. ANCOVA analyses showed an intervention effect
for self-reported leisure-time MVPA (d=0.17, p=0.03) and self-reported fruit and vegetable consumption (d=0.17, p=0.03). Trainings were evaluated very positively (training evaluation item means of
4.2–4.8 on a 5-point scale).
Conclusions
This faith-based structural intervention using a CBPR framework showed small but significant
increases in self-reported leisure-time MVPA. This program has potential for broad-based
dissemination and reach.
Trial registration
This study is registered at www.clinicaltrials.gov NCT00379925.
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