Academic journal article American Journal of Health Education

Designing the Healthy Bodies, Healthy Souls Church-Based Diabetes Prevention Program through a Participatory Process

Academic journal article American Journal of Health Education

Designing the Healthy Bodies, Healthy Souls Church-Based Diabetes Prevention Program through a Participatory Process

Article excerpt

Background: The Healthy Bodies, Healthy Souls (HBHS) program aims to reduce diabetes risk among urban African Americans by creating healthy food and physical activity environments within churches. Participant engagement supports the development of applicable intervention strategies by identifying priority concerns, resources, and opportunities. Purpose: We developed a church-based diabetes intervention program using participatory research methods. Methods: Thirteen planning workshops were held with church community members in 3 intervention churches to identify and prioritize foods and behaviors that congregants view as contributing to obesity and diabetes in the church community. Members of the research team moderated the workshops and introduced discussion themes. Results: Prioritized themes included problem foods in the church (fried chicken, soda) and at home (fried chicken, french fries) and healthier alternatives (baked chicken), barriers to healthy eating (time, expensive) and physical activity (commitment, laziness), healthy food-related behaviors (portion control), messages, and media tools to promote change. Discussion: Common findings across churches helped form the basis of the HBHS intervention. Tailoring intervention components to individual churches was necessary due to differences in church size, organizational structure, and resources. Translation to Health Education Practice: A participatory approach facilitated the design of culturally appropriate, potentially sustainable intervention components tailored for implementation in each church.

BACKGROUND

Participatory methods are used in research to help foster collaboration between researchers and the community, promote program ownership among participants, and incorporate local culture by engaging community stake-holders in the development, implementation, and sustainability of the program. (1,2) By using this approach, researchers are able to address barriers of distrust from the community and help ensure that the issues being addressed are relevant to the community through engagement and open communication during the research process. (3,4) Participatory methods have previously been successful in developing culturally specific interventions for disease prevention (5-8) and are recommended as a useful approach in engaging African American participants in a church-based intervention setting. (9,10) Little work has been published on how to engage churches in intervention development within churches. This article fills a research gap by describing the development of Healthy Bodies, Healthy Souls (HBHS), a church-based diabetes prevention program, through integration of formative research and participatory workshops to develop a culturally appropriate intervention to modify the food and physical activity environment of church communities as well as improve the knowledge and skills of participating church members.

Recent data indicate that the age-adjusted prevalence of obesity among adults age 20 and older is 49.5% and 34.3% for African Americans and Caucasians, respectively. (11) Diabetes prevalence is also disproportionately higher among African Americans (18.7%) than Caucasians (10.2%). (12) Differences may be partly attributable to socioeconomic differences1 (13,14) and genetic susceptibility (15); however, poor diet and physical activity are more modifiable risk factors. Interventions related to diet and physical activity are effective in reducing the incidence and delaying the progression of diabetes. (16,19) Evidence suggests that availability and access to healthy food and physical activity opportunities are favorably associated with improved dietary quality and physical activity levels. (20,24) As a result, researchers have implemented interventions to modify food and physical activity environments by working in various settings including food stores, schools, worksites, and homes (25-32); however, little has been done to work with churches as part of the food and physical activity environment. …

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