A Multilevel Diabetes and CVD Risk Reduction Intervention in African American Churches: Project Faith Influencing Transformation (FIT) Feasibility and Outcomes.

Wide-reaching health promotion interventions are needed in influential, accessible community settings to address African American (AA) diabetes and CVD disparities. Most AAs are overweight/obese, which is a primary clinical risk factor for diabetes/CVD. Using a faith-community-engaged approach, this study examined feasibility and outcomes of Project Faith Influencing Transformation (FIT), a diabetes/CVD screening, prevention, and linkage to care pilot intervention to increase weight loss in AA church-populations at 8 months. Six churches were matched and randomized to multilevel FIT intervention or standard education control arms. Key multilevel religiously tailored FIT intervention components included: (a) individual self-help materials (e.g., risk checklists, pledge cards); (b) YMCA-facilitated weekly group Diabetes Prevention Program (DPP) weight loss classes; (c) church service activities (e.g., sermons, responsive readings); and (d) church-community text/voice messages to promote healthy eating and physical activity. Health screenings (e.g., weight, blood pressure, blood glucose) were held during church services to identify participants with diabetes/CVD risks and refer them to their church's DPP class and linkage to care services. Participants (N = 352 church members and community members using churches' outreach ministries) were primarily female (67%) and overweight/obese (87%). Overall, FIT intervention participants were significantly more likely to achieve a > 5 lb weight loss (OR = 1.6; CI = 1.24, 2.01) than controls. Odds of intervention FIT-DPP participants achieving a > 5 lb weight loss were 3.6 times more than controls (p < .07). Exposure to sermons, text/email messages, brochures, commitment cards, and posters was significantly related to > 5 lb. weight loss. AA churches can feasibly assist in increasing reach and impact of diabetes/CVD risk reduction interventions with intensive weight loss components among at risk AA church-populations.

Feasibility and Outcomes of an HIV Testing Intervention in African American Churches.

The updated National HIV/AIDS Strategy recommends widespread HIV education and testing and calls the faith community to assist in these efforts. Yet, limited information exist on church-based HIV testing interventions. This study examined feasibility and assessed HIV testing outcomes of Taking It to the Pews (TIPS), a multilevel HIV education and testing intervention. Four African American churches were matched and randomized to TIPS or a standard-information control arm. Intervention churches delivered the religiously-tailored TIPS Tool Kit, which included educational materials to individuals and ministry groups; pastoral activities (e.g., sermons preached, receipt of HIV testing role-modeled), responsive readings, and church bulletin inserts in church services; and HIV testing during church services and church outreach events. All churches delivered 2-3 tools/month and coordinated 3 HIV testing events. At 12 months, significant increases in receipt of HIV testing (59% vs. 42%, p = 0.008), and particularly church-based testing (54% vs. 15%, p < 0.001), relative to controls were found. TIPS has great potential to increase reach, feasibility, and impact of HIV testing in African American churches.

Physical Health Screenings Among African-American Church and Community Members.

This study sought to identify characteristics, including religiosity, related to having received health screenings among persons who attend African-American churches or receive church-based community outreach services. A sample of 602 was recruited during two phases as part of a larger project. Blood pressure, cholesterol, and blood glucose screenings were the most frequently reported screenings ever and in the last 12 months. Although religiosity was significantly related to several of the health screenings in bivariate analysis, it is not a predictor of health screenings in multivariate analyses. Innovative strategies are needed to promote screenings such as church-based health fairs.

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention.

INTRODUCTION: The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV-related stigma in US African American communities. However, there are few studies on HIV-related stigma and African American church populations. This study explored HIV-related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews. METHODS: Four African American churches located in Kansas City, MO and KS, were randomized to either intervention or comparison groups. Churches assigned to the intervention group received religiously tailored HIV education, testing and compassion messages/activities (e.g. sermons, brochures/church bulletins, testimonials) via the Taking It to the Pews HIV Tool Kit. Comparison churches received non-religiously tailored HIV information. HIV-related stigma was assessed with 543 church members and with community members served through church outreach services (e.g. food/clothing pantries, social services) in the four churches. Participants completed surveys at baseline, 6 months and 12 months to assess their HIV-related stigma beliefs, exposure to intervention components and satisfaction with the study. RESULTS: At baseline, HIV-related stigma beliefs were similar across experimental groups and were quite low. Mean HIV-related stigma scores were not significantly different between experimental groups at 6 months (p=0.92) or at 12 months (p=0.70). However, mean HIV-related stigma scores within both groups showed decreasing trends at six months, which approached significance. Analysis of previously studied HIV-related stigma factors (e.g. age, gender, income, HIV knowledge, religiosity) did not yield changes in the null findings. Intervention group participants were highly exposed to several intervention components (sermons, HIV resource tables, posters, brochures/church bulletins). Overall, participants were highly satisfied with the intervention pilot study. CONCLUSIONS: African American churches may be well positioned to increase the reach of HIV prevention interventions to church and community members and could serve an important role in addressing HIV-related stigma in their church communities. Future research is needed on measuring HIV-related stigma beliefs and on testing intensive, scalable, religiously tailored HIV interventions to impact HIV-related stigma in African American churches.