Designing and Pilot-Testing a Church-Based Community Program to Reduce Obesity among African Americans
Cowart, Luvenia W., Biro, Diana J., Wasserman, Timothy, Stein, Ruth Federman, Reider, Lindsey R., Brown, Betty, ABNF Journal
Abstract: Obesity raises the risk for many chronic diseases and poor health outcomes. African Americans have the highest rates of excess weight in the nation, and standard weight management programs have not worked well with this population. The Genesis Health Project, a community-designed, culturally competent intervention to reduce obesity and promote healthy lifestyles, represents a successful partnership among Syracuse University, local Black churches, and several sponsors to empower families of color to adopt and sustain positive health practices across the lifespan. This article describes the Phase I design and pilot-testing of this demonstration project, and reports the results of the first-year nutrition education/exercise-fitness program. Participant feedback indicates notable shifts toward healthier food choices, cooking methods, and exercise habits, as well as increased motivation, improved health indicators, and revamped church menus. Lessons learned from this project can be helpful in developing other community/faith-based health promotion programs for African Americans.
Key Words: Obesity among African Americans, Minority Health Education and Promotion, Culturally Competent Healthy Lifestyles Intervention, Church-based Health Program, Community Development Approach
The obesity epidemic in the United States is a serious health concern. The health consequences of excess weight include increased risks for hypertension, stroke, heart disease, diabetes, certain cancers, sleep apnea, asthma, arthritis, complications during pregnancy or surgery, respiratory distress, cognitive decline, lower quality of Ufe, and premature death (USDHHS, 2001). Beyond the detrimental impacts for individuals, families, and communities, we all bear the financial burden of escalating healthcare costs for chronic illnesses.
African Americans have the highest rates of excess weight in the nation and are thus at greater risk for many serious diseases. According to the CDC (2003), while 65% of U.S. adults are overweight [BMI of 25.0-29.9] and 31% of this group are obese [BMI of 30.0 or above], 70% of African Americans are overweight, with 38% obese. By gender, 77% of Black women are overweight with nearly 49% obese; 63% of Black men are overweight with 28% obese (CDC, 2002). These figures illustrate a clear health disparity for this vulnerable population, and effective interventions and treatments for overweight people of color remain a challenge. The Genesis Health Project, launched in 2004 at Syracuse University, is a community-driven, culturally competent intervention to reduce obesity and promote healthy lifestyles among African Americans in Syracuse, New York. It targets Black families at churches in a low-income area, and is helping them improve their eating and exercise habits. The key goal is to empower participants to adopt and sustain positive health practices across the lifespan.
Phase I of this demonstration project involved building a partnership with the churches and community sponsors, assessing the health needs and program interests of church members, and designing a pilot nutrition education-exercise program with participants' input. This article describes the design and pilot testing stage, reports findings, discusses lessons learned, and offers specific recommendations for developing healthy lifestyle programs for African Americans.
LITERATURE REVIEWAND CONCEPTUAL FRAMEWORKS
Why is obesity so severe among African Americans? High obesity rates in this population are often associated with poor eating habits and sedentary lifestyles (Han, Tijhuis, Lean, & Seidell, 1998). African Americans have traditionally eaten more meat and other high-sodium, high-fat, and high-calorie foods; they consume fewer fruits, vegetables, fiber, and calcium (Han et al., 1998; Paschal, Lewis, Martin, Dennis-Shipp, & Sanders Simpson, 2004). Low physical activity also fosters weight gain. While ~23% of U. …