Perceived Health Needs of Church Leaders and Members: A Secondary Data Analysis of the Mid-South Congregational Health Survey.

Needs assessments have been successful in helping communities and congregations focus their health ministry efforts; however, most have used leader perceptions of congregational health needs. The purpose of this study was to examine and compare the self-reported needs of both church leaders and members to be addressed by their congregation. Church leaders (n = 369) and members (n = 459) from 92 congregations completed the 2019 Mid-South Congregational Health Survey. Frequencies and generalized linear mixed models (GLMM) were performed to examine the top 10 self-reported needs and associations by church role, respectively. Of the top 10 congregational needs, anxiety or depression, high blood pressure, stress, and healthy foods were ranked identically regardless of church role. Church leaders perceived obesity and diabetes to be important congregational health needs, whereas members perceived affordable health care and heart disease to be important congregational health needs. GLMM, controlling for within-church clustering and covariates, revealed church leaders were more likely than members to report obesity (odds ratio [OR]: 1.93, 95% confidence interval [CI] = [1.39, 2.67], p < .0001) and diabetes (OR: 1.73, 95% CI = [1.24, 2.41], p = .001) as congregational needs. Findings display similarities and differences in needs reported by church role. Including many perspectives when conducting congregational health needs assessments will assist the development of effective faith-based health promotion programs.

Prevalence of Cardiovascular Disease Risk Factors by Key Demographic Variables Among Mid-South Church Leaders from 2012 to 2017.

Cardiovascular disease (CVD) risk factors were examined among church leaders (n = 2309) who attended Mid-South United Methodist Church annual meetings between 2012 and 2017 using repeated cross-sectional data. There was a significant increase in body mass index (BMI) (b = 0.24, p = 0.001) and significant decreases in blood pressure (systolic: b = - 1.08, p < 0.001; diastolic: b = - 0.41, p = 0.002), total cholesterol (b = - 1.76, p = 0.001), and blood sugar (b = - 1.78, p = 0.001) over time. Compared to Whites, a significant increase was seen in BMI (b = 1.14, p = 0.008) among participants who self-identified as "Other," and a significant increase was seen in blood pressure (systolic: b = 1.36, p = 0.010; diastolic: b = 1.01, p = 0.004) among African Americans over time. Results indicate BMI and blood pressure are important CVD risk factors to monitor and address among church leaders, especially among race/ethnic minority church leaders.

Resolving Clinical Trial Subject Disengagement in Socioeconomically Disadvantaged Subjects.

BACKGROUND: Clinical trialists may be reluctant to enroll socioeconomically disadvantaged participants because of concerns for subject disengagement leading to noncompliance with longitudinal measures and high lost to follow-up (LTFU) rates. OBJECTIVES: We describe the LTFU problem associated with disadvantaged participants and propose strategies to reduce clinical trial disengagement. METHODS: Difficulties encountered in recruiting and retaining socioeconomically disadvantaged participants along with antecedents of disengagement are discussed. Data in the public domain were used to derive, symbolize, and map engagement by census tract. Exemplars of engaged and disengaged clinical trial participants are shared, and geospatial distribution of socio-spatial disengagement risk is presented. RESULTS: Subject disengagement can be visualized by geospatial informatics suggesting areas of low and high socio-spatial disengagement risk. By failing to enroll socioeconomically disadvantaged subjects, researchers may deliberately exclude those who may benefit the most because of significant health disparities. DISCUSSION: We propose a study of realistic LTFU rates for disadvantaged participants. Realistic clinical trial end points and methods may reduce disengagement among disadvantaged participants.

The Guanacaste Volcanic Arc Sliver of Northwestern Costa Rica.

Recent studies have shown that the Nicoya Peninsula of northwestern Costa Rica is moving northwestward ~11 mm a-1 as part of a tectonic sliver. Toward the northwest in El Salvador the northern sliver boundary is marked by a dextral strike-slip fault system active since Late Pleistocene time. To the southeast there is no consensus on what constitutes the northern boundary of the sliver, although a system of active crustal faults has been described in central Costa Rica. Here we propose that the Haciendas-Chiripa fault system serves as the northeastern boundary for the sliver and that the sliver includes most of the Guanacaste volcanic arc, herein the Guanacaste Volcanic Arc Sliver. In this paper we provide constraints on the geometry and kinematics of the boundary of the Guanacaste Volcanic Arc Sliver that are timely and essential to any models aimed at resolving the driving mechanism for sliver motion. Our results are also critical for assessing geological hazards in northwestern Costa Rica.