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Healthy Eating and Physical Activity Interventions in Faith-Based Settings: A Systematic Review Using the Reach, Effectiveness/Efficacy, Adoption, Implementation, Maintenance Framework

  • Caroline G. Dunn
    Correspondence
    Address correspondence to: Caroline G. Dunn, PhD, RD, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge 414, Boston MA 02115.
    Affiliations
    Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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  • Sara Wilcox
    Affiliations
    Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Ruth P. Saunders
    Affiliations
    Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Andrew T. Kaczynski
    Affiliations
    Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Christine E. Blake
    Affiliations
    Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Gabrielle M. Turner-McGrievy
    Affiliations
    Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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      Context

      Faith-based health interventions may improve obesity-related health behaviors, including healthy eating and physical activity. However, the generalizability of results and comprehensiveness of reporting for critical design elements sufficient for large-scale implementation and broad public health impact are unclear. This review assesses the degree to which faith-based healthy eating and physical activity programs report intervention elements using the reach, effectiveness/efficacy, adoption, implementation, maintenance framework.

      Evidence acquisition

      A systematic literature search was initiated in June 2017, and updated searches concluded in December 2019. Articles were included if they (1) were published in an English language peer-reviewed journal, (2) were conducted in the U.S., (3) were interventions, (4) included individual-level healthy eating or physical activity behavioral outcomes, (5) were conducted within an organizational setting, and (6) were faith-based. Intervention elements were extracted, and comprehensiveness of reporting for intervention elements was assessed according to reach, effectiveness/efficacy, adoption, implementation, maintenance domains.

      Evidence synthesis

      A total of 38 interventions (46 articles) met the inclusion criteria. Most were conducted at the individual/interpersonal level (66%); few included additional elements of policy or environmental change (34%). Most interventions showed favorable changes in at least 1 health behavior outcome. No intervention addressed all reach, effectiveness/efficacy, adoption, implementation, maintenance indicators. The mean level of reporting was low for all reach, effectiveness/efficacy, adoption, implementation, maintenance dimensions (reach: 2.3 of 5 [SD=1.0] indicators, efficacy/effectiveness: 2.3 of 4 [SD=0.8] indicators, adoption: 3.7 of 6 [SD=1.4] indicators, implementation: 1.3 of 3 [SD=0.6] indicators, maintenance: 0.3 of 3 [SD=0.5] indicators).

      Conclusions

      Studies reporting outcomes of faith-based interventions to improve healthy eating/physical activity behaviors lack the information necessary to understand the potential for broad dissemination and implementation in community settings. Future studies should report on the considerations for the translation and dissemination of evidence-based programs to expand public health impact.
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