Research article
Increasing Physical Activity Among Church Members: Community-Based Participatory Research

https://doi.org/10.1016/j.amepre.2006.10.009Get rights and content

Background

Faith-based interventions using a community-based participatory approach hold promise for eliminating ethnic health disparities. This study evaluated the effects of a volunteer-led statewide program to increase physical activity among members of African-American churches.

Methods

African Methodist Episcopal churches within six regions (Conferences) were randomly assigned to receive training in the program immediately or 1 year later. A cohort of 20 randomly selected churches and 571 members within them took part in telephone surveys at baseline (May–September 2003) and 1 year (May–August 2004) and 2 years later (June-September 2005). Primary outcomes were physical activity participation, meeting physical activity recommendations, and stage of readiness for physical activity change. Statistical analyses were completed in April 2006.

Results

Volunteers (N=889) from 303 churches were trained. Among survey respondents, physical activity did not increase significantly over time, although 67% were aware of the program. Program awareness was significantly related to all three physical activity outcomes and to fruit and vegetable consumption. Pastoral support was significantly associated with physical activity.

Conclusions

Although this intervention reached a large number of churches and created awareness of intervention components, no effects on physical activity behaviors were found. Potential reasons for the lack of significant effects are discussed.

Introduction

The church is an important source of support for African Americans,1 and is a setting where health promotion programs can be implemented in a socially, culturally, and spiritually acceptable manner.2, 3 Sharing decision making and resources with faith-based organizations in an atmosphere of mutual respect and benefit, or a community-based participatory research (CBPR) approach,4 can assist in addressing the underrepresentation of persons of color in prevention research.5, 6, 7 To date, few examples of faith-based interventions that specifically target physical activity exist, particularly interventions that are delivered by members of the congregation and use a CBPR approach. Several have targeted physical activity along with dietary practices with mixed outcomes.8, 9, 10 The paucity of studies in this area underscores the need to focus specifically on faith-based promotion of physical activity with African Americans, particularly promotion that includes members of the congregation in a true CBPR approach.

Physical activity is an important target for intervention, as rates of participation are lower in African American than Caucasian adults, particularly for women.11 Corresponding to the lower prevalence of regular physical activity, rates of cardiovascular disease, hypertension, and diabetes are substantially higher among African Americans than Caucasians.12 Eliminating ethnic disparities in disease morbidity and mortality is a national public health goal outlined in Healthy People 2010.13

This article describes findings from a faith-based CBPR intervention that targeted physical activity. It is a partnership among the African Methodist Episcopal (AME) Church, the Medical University of South Carolina (MUSC), and the University of South Carolina (USC). The primary research question was to determine whether a volunteer-led intervention increased participation in moderate-intensity physical activity, meeting current recommendations for physical activity,14 and progression in stage of readiness for change. Secondary aims were to determine the impact of the intervention on outcomes such as body mass index, fruit and vegetable consumption, and program awareness.

Section snippets

Methods

The methods from the Health-E-AME faith-based physical activity initiative have been described in detail elsewhere15 and are summarized below.

Sample Baseline Characteristic

Eleven rosters were obtained from immediate intervention churches (four small, four medium, three large) and nine from delayed intervention churches (four small, three medium, two large) resulting in 571 baseline telephone surveys. As reported elsewhere,15 the sample was diverse by age, education, and household income. More women (68%) than men participated. Most were overweight (34%) or obese (42%). Just more than one half (53%) reported hypertension, 32% high cholesterol, and 25% diabetes.

Discussion

Over a 2-year intervention period, 889 individuals from 303 churches were trained. Changes were not detected in the three physical activity outcomes, although program awareness was related to all three physical activity outcomes and fruit and vegetable consumption. Speaking with church members about physical activity and Pastor support for physical activity, two activities the program targeted, were associated with higher rates of physical activity participation at the follow-up periods.

Several

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