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01.12.2017 | Research | Ausgabe 1/2017 Open Access

Implementation Science 1/2017

Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study

Zeitschrift:
Implementation Science > Ausgabe 1/2017
Autoren:
Mary Ann Scheirer, Sherie Lou Z. Santos, Erin K. Tagai, Janice Bowie, Jimmie Slade, Roxanne Carter, Cheryl L. Holt
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s13012-017-0576-x) contains supplementary material, which is available to authorized users.

Abstract

Background

Sustainability of evidence-based health promotion interventions has received increased research attention in recent years. This paper reports sustainability data from Project HEAL (Health through Early Awareness and Learning) a cancer communication implementation trial about early detection, based in African American churches. In this paper, we used a framework by Scheirer and Dearing (Am J Publ Health 101:2059-2067, 2011) to evaluate multiple dimensions of sustainability from Project HEAL.

Methods

We examined the following dimensions of sustainability: (a) continued benefits for intervention recipients, (b) continuation of intervention activities, c) maintaining community partnerships, (d) changes in organizational policies or structures, (e) sustained attention to the underlying issues, (f) diffusion to additional sites, or even (g) unplanned consequences of the intervention. Project HEAL provided a three-workshop cancer educational series delivered by trained lay peer community health advisors (CHAs) in their churches. Multiple sources of sustainability were collected at 12 and 24 months after the intervention that reflect several levels of analysis: participant surveys; interviews with CHAs; records from the project’s management database; and open-ended comments from CHAs, staff, and community partners.

Results

Outcomes differ for each dimension of sustainability. For continued benefit, 39 and 37% of the initial 375 church members attended the 12- and 24-month follow-up workshops, respectively. Most participants reported sharing the information from Project HEAL with family or friends (92% at 12 months; 87% at 24 months). For continuation of intervention activities, some CHAs reported that the churches held at least one additional cancer educational workshop (33% at 12 months; 24% at 24 months), but many more CHAs reported subsequent health activities in their churches (71% at 12 months; 52% at 24 months). No church replicated the original series of three workshops. Additional data confirm the maintenance of community partnerships, some changes in church health policies, and continued attention to health issues by churches and CHAs.

Conclusions

The multiple dimensions of sustainability require different data sources and levels of analysis and show varied sustainability outcomes in this project. The findings reinforce the dynamic nature of evidence-based health interventions in community contexts.
Zusatzmaterial
Additional file 1: 12-month Men’s Participant Survey. This survey was completed by male Project HEAL participants at the 12-month workshop. (PDF 2820 kb)
13012_2017_576_MOESM1_ESM.pdf
Additional file 2: 12-month Women’s Participant Survey. This survey was completed by female Project HEAL participants at the 12-month workshop. (PDF 2806 kb)
13012_2017_576_MOESM2_ESM.pdf
Additional file 3: 24-month Men’s Participant Survey. This survey was completed by male Project HEAL participants at the 24-month workshop. (PDF 2786 kb)
13012_2017_576_MOESM3_ESM.pdf
Additional file 4: 24-month Women’s Participant Survey. This survey was completed by female Project HEAL participants at the 24-month workshop. (PDF 2776 kb)
13012_2017_576_MOESM4_ESM.pdf
Additional file 5: 12-month CHA Interview Guide. This CHA interview guide was used by study staff to interview Project HEAL CHAs at the 12-month workshop. (PDF 2662 kb)
13012_2017_576_MOESM5_ESM.pdf
Additional file 6: 24-month CHA Interview Guide. This CHA interview guide was used by study staff to interview Project HEAL CHAs at the 24-month workshop. (PDF 2620 kb)
13012_2017_576_MOESM6_ESM.pdf
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