Constructs from the Consolidated Framework for Implementation Research associated with church enrollment and intervention adoption in a national implementation study of a faith-based organizational change intervention.

BACKGROUND: Organizational adoption is a key but understudied step in translating evidence-based interventions into practice. The purpose of this study was to report recruitment strategies and factors associated with church enrollment and intervention adoption in a national implementation study of the Faith, Activity, and Nutrition (FAN) program. METHODS: We worked with partners using multiple strategies to disseminate intervention availability. Interested churches completed an online form. To enroll, the church coordinator (FAN coordinator) and pastor completed baseline surveys and then received intervention online training access. We compared enrolled vs. non-enrolled churches on how they heard about the study and church characteristics. We compared intervention-adopting vs. non-adopting churches on Consolidated Framework for Implementation Research (CFIR) constructs using Fisher's exact tests, χ2, or independent sample t-tests and reported differences where p < 0.10, d≥|0.35|, or the difference in percentage points was ≥ 10. RESULTS: We received 226 interest forms; 107 churches enrolled, and 85 churches adopted the intervention. Faith-based sources were the most, and paid media the least, effective in reaching churches, which were largely from the southeast with a Methodist or Baptist tradition (no differences by enrollment status). Enrolled churches were less likely to have 500 + worshipers and more likely to have attended a study information session than non-enrolled churches. Church (CFIR inner setting) and FAN coordinator characteristics, but not intervention characteristics, were related to intervention adoption. CONCLUSION: Partnerships, relationships, and "face time" are important for enrolling churches in evidence-based interventions. Church and church coordinator characteristics are related to intervention adoption. Further work on adoption conceptualization and operationalization is needed.

Use of UK faith Centre as a COVID-19 community vaccination clinic: exploring a potential model for community-based health care delivery.

INTRODUCTION: Effective and safe vaccines against COVID-19 are essential to achieve global control of the coronavirus (SARS-CoV-2). Using faith centres may offer a promising route for promoting higher vaccine uptake from certain minority ethnic groups known to be more likely to be vaccine hesitant. METHODS: This cross-sectional study explored attendees' perceptions, experiences of being offered, and receiving COVID-19 vaccination in a local mosque in Woking, Surrey, UK. About 199 attendees completed a brief questionnaire on experiences, views, motivations about attending the mosque and vaccination on site. RESULTS: The most common ethnic groups reported were White British (39.2%) and Pakistani (22.6%); 36.2% identified as Christian, 23.6% as Muslim, 5.5% as Hindu, and 17.1% had no religion. Genders was relatively equal with 90 men (45.2%) and 98 women (49.2%), and 35-44-year-olds represented the most common age group (28.1%). Views and experiences around receiving vaccinations at the mosque were predominantly positive. Primary reasons for getting vaccinated at the mosque included convenience, accessibility, positive aspects of the venue's intercultural relations, and intentions to protect oneself against COVID-19, regardless of venue type. Negative views and experiences in regards to receiving the vaccination at the mosque were less common (7% expressed no intention of recommending the centre to others), and disliked aspects mostly referred to the travel distance and long waiting times. CONCLUSIONS: Offering COVID-19 vaccination in faith centres appears acceptable for different faith groups, ensuring convenient access for communities from all religions and ethnic backgrounds.

Islamic faith-based organisations and their role in building social capital for post-disaster recovery in Indonesia.

This paper investigates the role of Islamic faith-based organisations (FBOs) in Indonesia and examines the way in which their disaster recovery aid can be successful or less successful depending on social capital formation in communities affected by a disaster. The paper argues that Islamic FBOs play a prominent role in disaster-affected communities by building new social capital or strengthening existing social capital. Failure to do so may affect a community's recovery and its long-term resilience. Applying a framework that considers three types of social capital-bonding, bridging, and linking-from a comparative perspective, the paper discusses two cases of disaster recovery: one following the earthquake that struck Aceh in 2013; and the other after the Mount Kelud volcanic eruptions in East Java in 2014. In both instances, the findings highlight the importance of the village facilitator, cultural sensitivity, and understanding of local indigenous and religious practices for successful disaster recovery.

The Perspectives of Lagos Healthcare Leaders on Faith-Institution Involvement in Hypertension Health.

BACKGROUND: Hypertension is an important challenge for the Nigerian healthcare system and multiple stakeholder mitigation is imperative. Faith institution mitigation is evolving but the opinion of healthcare leaders on their involvement in hypertension remains an important gap. OBJECTIVE: To explore the perspectives of a cross-section of leaders of healthcare institutions in Lagos (Nigeria) on faith institution-facilitated hyper tension inter vention against the background of current practice. METHODS: Attempts were made to recruit 152 healthcare institution leaders who were contacted using electronic mails, telephone conversations, institutional social media communication, institutions' web-mails and other contacts. The views of consenting leaders were gathered using an exploratory questionnaire survey, and analysed. RESULTS: The views of 23 leaders from the variety of institutions were that most (60%) hypertension cases were diagnosed during emergency presentations; and the public's hypertension health knowledge remains generally inadequate. Hypertension information dissemination was mostly verbal rather than in written/print form. Basic resources are deployed in hypertension management. There was majority support for collaboration in hypertension health promotion (90.0%), blood pressure screening (95.7%) and hypertension referral (95.5%). Fewer institutions had the resources to support hypertension health promotion (55.0%) and blood pressure screening (42.1%) compared to hypertension referral (90.9%). CONCLUSION: There is good support for faith institution involvement in hypertension health, with a particular interest in and capacity for health system referral. Deploying scarce resources to collaborate may be challenging. However, collaboration and better resources could improve hypertension prevention and management. Further work is needed for context specific innovation so faith institutions can contribute to hypertension health.

CONTEXTE: L'hypertension représente un défi majeur pour le système de santé nigérian, et une atténuation impliquant plusieurs parties prenantes est impérative. L'atténuation par les institutions religieuses est en évolution, mais l'opinion des leaders de la santé sur leur implication dans l'hypertension reste une lacune importante. OBJECTIF: Explorer les perspectives d'un échantillon de leaders d'institutions de santé à Lagos, Nigeria, sur l'intervention contre l'hypertension facilitée par les institutions religieuses, dans le contexte de la pratique actuelle. MÉTHODES: Des tentatives ont été faites pour recruter 152 dirigeants d'établissements de santé qui ont été contactés par courriels électroniques, conversations téléphoniques, communication sur les médias sociaux institutionnels, courriers électroniques des établissements et autres contacts. Les points de vue des dirigeants consentants ont été recueillis à l'aide d'une enquête par questionnaire exploratoire, puis analysés. RÉSULTATS: Les opinions de 23 dirigeants provenant de divers établissements indiquaient que la plupart des cas d'hypertension (60%) étaient diagnostiqués lors de présentations aux urgences; et les connaissances du public sur la santé liée à l'hypertension demeurent généralement insuffisantes. La diffusion d'informations sur l'hypertension se faisait principalement de manière verbale plutôt que sous forme écrite/imprimée. Des ressources de base sont utilisées dans la gestion de l'hypertension. Une majorité soutenait la collaboration dans la promotion de la santé liée à l'hypertension (90,0%), le dépistage de la tension artérielle (95,7%) et l'orientation des patients atteints d'hypertension (95,5%). Moins d'institutions avaient les ressources pour soutenir la promotion de la santé liée à l'hypertension (55,0 %) et le dépistage de la pression artérielle (42,1 %) par rapport à l'orientation vers l'hypertension (90,9 %). CONCLUSION: Il existe un soutien significatif pour l'implication des institutions religieuses dans la santé liée à l'hypertension, avec un intérêt particulier et une capacité à orienter vers le système de santé. Le déploiement de ressources limitées pour la collaboration peut présenter des défis. Cependant, la collaboration et de meilleures ressources pourraient améliorer la prévention et la gestion de l'hypertension. Des travaux supplémentaires sont nécessaires pour des innovations spécifiques au contexte afin que les institutions religieuses puissent contribuer à la santé liée à l'hypertension. MOTS- CLÉS: Hypertension, Lagos, Institutions religieuses, Responsables de la santé, Intervention.

Originalarbeiten / Original Articles. Prävention sexualisierter Gewalt an Kindern und Jugendlichen: Präventionsmaßnahmen und Schutzkonzepte in den Bereichen Sport, Musik und Kirche.

Prevention of Child Sexual Abuse: Prevention Programs and Safeguarding Concepts in the Context of Sports, Musical Education, and Religious Organizations Prevalence rates of child sexual abuse by caregivers in private and non-public institutions underscore the need for implementing safeguarding concepts. However, factors driving the implementation of prevention and safeguarding in the field are not well understood. What supportive and inhibiting factors can be identified in the implementation of safeguarding concepts and prevention programs? Content analysis of semi-structured interviews with professional and volunteer staff in clubs and institutions (n = 10, 69 % female) as well as with individuals who experienced child sexual abuse during their childhood (n = 3, 66 % female). Safeguarding concepts in clubs or religious institutions were primarily initiated by umbrella organizations. Current incidents of child maltreatment, public pressure, and media attention substantially increased the need for preventive actions. The provision of training, resources, and networking structures by umbrella organizations further facilitated their implementation. Main implementation challenges included limited personnel and time resources, lack of expertise, insufficient training opportunities, and absence of guidelines and support from umbrella organizations. Due to club leaders' limited knowledge and resources an independent implementation of safeguarding concepts is largely lacking without concrete guidelines and support from umbrella organizations. To upscale safeguarding, public policies or incentive systems such as state-funded child protection certifications are thus paramount.

Supporting Faith-Based Communities Through and Beyond the Pandemic.

The COVID-19 pandemic brought widespread and notable effects to the physical and mental health of communities across New York City with disproportionate suffering Black/African American and Hispanic/Latino communities alongside additional stressors such as racism and economic hardship. This report describes the adaptation of a previously successful evidence-based community engagement health education program for the deployment of resilience promoting workshop program in faith-based organizations in BIPOC communities in New York City. From June 2021 to June 2022, nine faith-based organizations implemented 58 workshops to 1,101 non-unique workshop participants. Most of the workshops were delivered online with more women (N = 803) than men (N = 298) participating. All organizations completed the full curriculum; the workshop focused on self-care and physical fitness was repeated most frequently (N = 13). Participants in the workshops ranged from 4 to 73 per meeting and were largely female. The Building Community Resilience Project is an easy and effective way to modify an existing, evidence-based community health education program to address new and relevant health needs such as resilience and stress amidst the COVID-19 pandemic among faith communities serving BIPOC populations. More research is needed regarding the impact of the workshops as well as adaptability for other faith traditions.

Faith-Based Organizations' Support of Veteran Congregants at Risk for Mental Health Conditions and Suicide: A Qualitative Study of Clergy Experiences in Los Angeles County.

Faith-based organizations (FBOs) are often "gatekeepers" to mental health care for congregants at risk of mental illness and suicide, especially U.S. military Veterans, but data to inform better collaboration are needed. We conducted focus groups with clergy in Los Angeles County to understand the mental health support FBOs provide and barriers to collaboration with the mental healthcare system. Clergy detailed strategies used to support the mental health of Veteran congregants. Barriers included stigma, limits in clergy training, and incomplete knowledge about community and VA mental health resources. Results suggest strategies to improve collaboration between FBOs and the mental healthcare system in Los Angeles County.

A Rapid Survey of State and Territorial Public Health Partnerships With Faith-Based Organizations to Promote COVID-19 Vaccination.

During the COVID-19 pandemic, media accounts emerged describing faith-based organizations (FBOs) working alongside health departments to support the COVID-19 response. In May 2021, the Department of Health and Human Services, Centers for Disease Control and Prevention, and the Association of State and Territorial Health Officials (ASTHO) sent an electronic survey to the 59 ASTHO member jurisdictions and four major US cities to assess state and territorial engagement with FBOs. Findings suggest that public health officials in many jurisdictions were able to work effectively with FBOs during the COVID-19 pandemic to provide essential education and mitigation tools to diverse communities. (Am J Public Health. 2022;112(3):397-400. https://doi.org/10.2105/AJPH.2021.306620).

Influence of implementation strategies on implementation outcomes in a statewide dissemination of Faith, Activity, and Nutrition (FAN).

Faith-based organizations are promising settings for implementation science because they can reach populations bearing a disproportionate burden of chronic disease. This study examined how implementation strategies influenced implementation outcomes in Faith, Activity, and Nutrition (FAN) statewide dissemination. Ninety-three (9%) of 985 invited churches enrolled; 91 (98%) and 83 (89%) completed baseline and 12-month assessments. Community Health Advisors trained and provided phone technical assistance to church committees, led by a FAN coordinator. Church committees were charged with developing plans and installing healthy eating (HE) and physical activity (PA) policies, opportunities, messages and pastor support (implementation outcomes). Structural equation modeling examined how implementation strategies influenced implementation outcomes. Nearly all (99%) FAN coordinators and 60% of pastors attended training, 57% of committees submitted program plans and 51%/54% (HE/PA) of committees met 'every few months'. Statistically significant (P < 0.05) model paths showed positive influences of strategies on implementation outcomes: pastor training on HE and PA pastor support; plan completion on HE and PA messages, PA policies and opportunities as well as FAN committee meetings and committee meetings on HE pastor support, HE policies, PA opportunities and HE and PA messages. This study advances implementation science and provides a model applicable to organizations such as worksites and schools.

Community-Based Participatory Research partnership with faith-based organizations to address obesity and glucose control.

OBJECTIVES: To explore the lived (narrative) experience of obesity and/or diabetes mellitus within focus groups consisting of individuals and community support persons residing in Genesee County, Michigan. DESIGN: Qualitative study, using Community-Based Participatory Research (CBPR) methodology to design and conduct focus group interviews. SAMPLE: Nineteen participants from faith-based organizations (FBOs) in Genesee County (74.5% Caucasian, 3.0% Hispanic American). MEASUREMENTS: Semi-structured narrative focus group interviews, using thematic coding and qualitative analysis software (Otter.com). RESULTS: Participants from diverse FBOs revealed barriers that prevent them from reaching their weight goals and preventing or controlling diabetes. A shared theme included the concern that providers do not actively inquire about patient concerns at appointments, and they fail to offer practical strategies beyond pharmaceutical interventions. CONCLUSION: Focus group interviews with community residents revealed issues and barriers patients and their support persons face in health care experiences. Utilizing CBPR (methodology) is an opportunity for advanced practice nurses (health care professionals) to co-create strategies and interventions with the community that can assist them in successfully reaching their weight loss and diabetes prevention goals.

Collaboration With African American Faith-Based Organizations to Promote Physical Activity: Lessons Learned From a Process Evaluation of a Shared-Use Agreements Program.

Chronic diseases are disproportionately high among African Americans, often caused by social determinants of health (e.g., access to physical activity opportunities), as stated by the Centers for Disease Control and Prevention. Several studies have examined practices and policies of shared-use in school-based and other settings. There is still a gap in the literature regarding how faith-based shared-use programs, practices, and policies are implemented in a virtual or hybrid setting. This evaluation reviewed program activities and partnerships and assessed program needs for quality improvement. Focus groups (n = 2) were conducted with program participants and site coordinators from five faith-based shared-use sites. A 12-question discussion guide was developed based on topics of interest predetermined by the project team to understand participant perceptions about participation, satisfaction, and recommendations. Focus group audio recordings were transcribed verbatim and reviewed using thematic analysis. The evaluators reviewed transcripts separately to confirm final coding and ensured intercoder reliability. The analysis yielded six themes and eight subthemes. Findings indicated that the program was rewarding and achievable, with suggestions for improvement. Social support was developed as a result of the program, health improvements were observed by participants, and networked partnerships were formed to promote health and wellness. The virtual platform presented limited access; therefore, adopting a hybrid approach could offer greater flexibility and reach broader audiences. It may be helpful for public health agencies to partner with faith-based organizations to jointly open their facilities. Agencies, like local health departments, may consider establishing agreements to expand shared-use to local faith-based settings.

The Evolving Landscape of Global Surgery: A Qualitative Study of North American Surgeons' Perspectives on Faith-Based and Academic Initiatives.

Faith-based missions have played a large role in surgical care delivery in low- and middle-income countries (LMIC). As global surgery is now an academic discipline, this pilot study sought to understand how different faith ideologies influence surgeon motivations and subsequent culture of the global surgery landscape. Interviews were conducted with North American surgeons who pursue global surgery significantly in their career. Points of discussion included early influences, obstacles, motivations, philosophy and approach to global surgery work, and experiences with faith-based (FBO) and non-faith-based organizations (NFBO). Notes were transcribed and thematic analysis performed. Sixteen surgeons were interviewed (11 men, 5 women, ages 39-75 years-old). Surgeons had worked in 32 countries with FBO and NFBO in intermittent or long-term capacity. Religious upbringing and current affiliations included Atheism, Protestant Christianity, Catholicism, Hinduism, Judaism, Mormonism, Islam, and nonreligious spirituality. Early influences included international upbringing (n = 7), emphasis on service (n = 9), and exposure to the religious mission concept (n = 6). The most common core motivation among all participants was addressing disparities (n = 10). Some believed that FBO and NFBO have different goals (n = 4), and only surgeons identifying with Christianity believed the goals are similar (n = 3). Participants expressed that FBO are exclusive (n = 4) and focused on proselytization (n = 6) while NFBO are humanitarian (n = 3) but less integrated into the community (n = 4). Global surgeons have shared early influences, obstacles, and desire to address disparities. Perceptions of FBO and NFBO differed based on religious background. This pilot study will inform future studies regarding the collaborations of FBO and NFBO to improve global surgical care.

M.I.C.A.H. Project HEAL: Sustainability of a Faith-Based Community Health Advisor Training Program in Urban Underserved Communities in the USA.

Faith-based organizations (FBOs) can play an important role in improving health outcomes. Lay community health advisors (CHAs) are integral to these efforts. This paper assesses the sustainability of a CHA training program for congregants in African-American and Latino FBOs and subsequent implementation of educational workshops. The program is unique in that a health care chaplain in an academic medical center was central to the program's development and implementation. Forty-eight CHAs in 11 FBOs were trained to teach workshops on cardiovascular health, mental health, diabetes, and smoking cessation. Two thousand four hundred and forty-four participants attended 70 workshops. This program has the potential to be a model to educate individuals and to address health inequities in underserved communities. Health care chaplains in other medical centers may use this as a model for enhancing community engagement and education.

Piloting a Faith-Based Hypertension Self-Care Program in a Church Setting.

ABSTRACT: Health promotion strategies offered in a faith-based setting can be effective in influencing positive self-care behaviors related to hypertension. Faith-based organizations are ideal places to reach vulnerable populations to improve blood pressure management and make a lasting impact. The purpose of this pilot study was to provide a 4-week management program to improve hypertension self-care among a congregation of African Americans. Results revealed improvements among participants related to self-care as well as lowered blood pressure readings.

Program Implementation and Church Members' Health Behaviors in a Countywide Study of the Faith, Activity, and Nutrition Program.

Implementation research of health programs in faith-based organizations is lacking. The Faith, Activity, and Nutrition (FAN) program helps churches improve physical activity and fruit and vegetable behaviors of members. This study examined associations between implementation of FAN intervention components and church members' physical activity, fruit and vegetable behaviors, and self-efficacy for improving these behaviors. FAN was implemented in 35 churches in a southeastern US county. After attending in-person training, led by community health advisors, church committees received 12 months of telephone-delivered technical assistance to implement FAN according to 4 components: increasing opportunities, increasing guidelines and policies, increasing pastor support, and increasing messages for physical activity and healthy eating in their church. In this correlational study, FAN coordinators (n = 35) for each church reported baseline practices in 2015 and 12-month follow-up implementation of the 4 components for physical activity and healthy eating in 2016. Church members (n = 893) reported perceived implementation, physical activity and fruit and vegetable behaviors, and self-efficacy at 12-month follow-up in 2016. Independent variables were coordinator-reported baseline practices, baseline-adjusted 12-month implementation, and member-perceived 12-month implementation. Multilevel modeling examined associations between independent variables and member-reported 12-month physical activity and fruit and vegetable behaviors and self-efficacy. Coordinator-reported 12-month implementation of fruit and vegetable opportunities was associated with member fruit and vegetable consumption. Member perceptions at 12 months of church physical activity opportunities, pastor support, and messages were associated with higher self-efficacy for physical activity; pastor support and messages were positively associated with physical activity. Member perceptions at 12 months of fruit and vegetable opportunities, pastor support, and messages were associated with higher fruit and vegetable consumption and self-efficacy. Member-perceived implementation was more strongly associated with member behaviors than coordinator-reported implementation. Providing opportunities for healthy eating during already scheduled events may be an effective strategy for improving fruit and vegetable behavior.

Telehealth in a Washington, DC African American Religious Community at the Onset of COVID-19: Showcasing a Virtual Health Ministry Project.

The COVID-19 pandemic, with its disproportionate health and social-economic effects on the African American community, mandates bold new models to ensure that vulnerable communities receive maximum support and services. This article highlights a social work practice innovation model adapted from a traditional social work casework model. A group of multidisciplinary leaders strategized about ways to meet the needs of older African-American adults as many traditional government agencies were not sending staff into the community due to COVID-19. The result birthed a faith-based virtual health ministry.Using a faith-based virtual health ministry, church lay leaders and other professionals partnered with Master of Social Work (MSW) level social workers using a telehealth platform with technology tools to assist shut-in older adults in Washington, DC. The project uses a structured, coordinated care telehealth support model for a marginalized population. Telehealth within the rubric of healthcare models has not been demonstrated in African American communities, particularly older adults. Meeting the needs of shut-in older adults and marginalized groups within the COVID-19 pandemic may show innovation that can be translational for local governments and traditional safety net providers within a social work milieu.

Group Coaching Among African-American Individuals with Prediabetes in a Faith-Based Setting.

Roughly 88 million adults have prediabetes and over 84% are unaware that they even have prediabetes. African-Americans have an increased risk of being diagnosed with prediabetes. Faith-based organizations have a history of serving as a primary source of social support for African-Americans. Parishioners with prediabetes from four African-American churches participated in free, evidence-based group coaching to learn how to manage and control risk factors associated with type 2 diabetes. The weekly group coaching sessions took place at a local church and they were co-facilitated by two trained professionals: a lifestyle coach and a nurse practitioner. At the conclusion of the 16-week group coaching sessions, participants had a decrease in hemoglobin A1C levels, an increase in minutes of physical activity per week, and an improvement in knowledge and behavior.

A Narrative Review of Ethnic Minority Studies for Faith-Based Health Promotion Interventions with Special Reference to the Contemporary Christian Nurse.

Heart disease, diabetes mellitus (DM) type 2, and obesity are three of the most prevalent diseases in the USA. Some obesity-related comorbidities are disproportionately higher within African-American and Hispanic communities. While governmental and local health programs offer educational opportunities encouraging long-term health behavior changes, the most accessible programs have been through faith-based communities. This narrative review investigates the outcomes of faith-based wellness programs on Latino and African-American populations with respect to general health and wellness, obesity management, DM type 2, and hypertension. Perceived authority of faith community nurses, faith leaders, and accountability and encouragement provided by faith communities are critical. Long-term behavior change is positively affected by elements faith-based organizations can provide: cultural appropriateness, community support, and self-efficacy.

Filling the Gaps: The Role of Faith-Based Organizations in Addressing the Health Needs of Today's Latino Communities.

Research on the acceptability of faith-based health promotion programs by Latino communities in the Bible Belt is limited. This study examined the needs, barriers, and facilitators related to such programs in Memphis, TN. Thirty Latino community members and ten faith leaders participated in focus groups and in-depth interviews, respectively. Health needs identified included diet, dental care, and screenings, while barriers included cost, education, lack of prevention-seeking behaviors, and need for Spanish language services. Faith leaders were aware of more health resources than community members. Despite being receptive and acknowledging the need for faith-based programs aimed at prevention and filling healthcare gaps, concerns regarding the influence of religious doctrine on health interventions were expressed by members of both groups. Faith leaders, practitioners, and community members must work together to overcome barriers related to trust and health behavior norms.

Assessing Health Needs in African American Churches: A Mixed-Methods Study.

Among major racial and ethnic groups in the USA, African Americans are the most religious, and faith-based organizations play an important role in health promotion for African Americans. This study aimed to assess health needs in African American churches using a mixed-methods approach. Based on quantitative and qualitative data collected from eight African American churches in Nebraska in 2017, the most prevalent chronic conditions among participating African American church members (n = 388) included hypertension (60.8%), allergies (41.0%), arthritis (36.4%), high cholesterol (35.8%), and diabetes (28.1%). Significant predictors of fair or poor health were identified as male sex, unemployment, delayed utilization of health care in the past 12 months due to cost, lower frequency of church attendance, and feeling down, depressed, or hopeless in the past 2 weeks. Pastors from participating churches identified cost as one of the primary barriers to providing church-based health services. There were substantial unmet health needs in African American faith communities, especially in the areas of chronic disease prevention and management, and churches would need more support to realize their full potential in faith-based health promotion.