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.

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.

Feasibility and Acceptability of the Project Faith Influencing Transformation Intervention in Faith-Based Settings.

African Americans (AAs) are disproportionately burdened with diabetes and prediabetes. Predominately AA churches may be optimal settings for reaching AAs at greatest diabetes risk, along with related morbidities and mortalities. The current study used the RE-AIM framework to qualitatively examine the feasibility, acceptability, and satisfaction with the Project Faith Influencing Transformation (FIT) intervention, a diabetes risk reduction intervention in AA churches. Participants were (N = 21) church and community members who also participated in the larger Project FIT intervention and were primarily female, with an average age of 60 years (SD = 11.1). Participants completed a brief survey and focus group discussion. Participants discussed intervention effectiveness in changing health behaviors and outcomes, with high rates of adoption, acceptability, and satisfaction across churches that conducted the intervention. Participants also discussed outreach to members of the broader community, the role of the pastor, and challenges to intervention implementation and maintenance-tailored strategies to improve intervention effectiveness are discussed. Given the significant diabetes disparities that exist for AAs, it is imperative to continue to investigate best practices for reaching communities served by churches with sustainable, relevant health programming. This study has the potential to inform more effective, tailored diabetes prevention interventions for high-risk AAs in faith-based settings.

A systematic review and meta-analysis of the effectiveness of hypertension interventions in faith-based organisation settings.

Background: Hypertension is the global, leading cause of mortality and is the main risk factor for cardiovascular disease. Community-based partnerships can provide cost-saving ways of delivering effective blood pressure (BP) interventions to people in resource-poor settings. Faith-based organisations (FBOs) prove important potential health partners, given their reach and community standing. This potential is especially strong in hard-to-reach, socio-economically marginalised communities. This systematic review explores the state of the evidence of FBO-based interventions on BP management, with a focus on randomised controlled trials (RCTs) and cluster RCTs (C-RCTs). Methods: Seven academic databases (English = 5, Chinese = 2) and grey literature were searched for C-/RCTs of community-based interventions in FBO settings. Only studies with pre- and post-intervention BP measures were kept for analysis. Random effects models were developed using restricted maximum likelihood estimation (REML) to estimate the population average mean change and 95% confidence interval (CI) of both systolic and diastolic blood pressure (SBP and DBP). The overall heterogeneity was assessed by successively adding studies and recording changes in heterogeneity. Prediction intervals were generated to capture the spread of the pooled effect across study settings. Results: Of the 19 055 titles identified, only 11 studies of fair to good quality were kept for meta-analysis. Non-significant, average mean differences between baseline and follow-up for the intervention and control groups were found for both SBP (0.78 mm of mercury (mmHg) (95% CI = 2.11-0.55)) and DBP (-0.20 mm Hg (95% CI = -1.16 to 0.75)). Subgroup analysis revealed a significant reduction in SBP of -6.23 mm Hg (95% CI = -11.21 to -1.25) for populations with mean baseline SBP of ≥140 mm Hg. Conclusions: The results support the potential of FBO-based interventions in lowering SBP in clinically hypertensive populations. However, the limited evidence was concentrated primarily in Christian communities in the US More research is needed to understand the implications of such interventions in producing clinically meaningful long-term effects in a variety of settings. Further research can illuminate factors that affect success and potential expansion to sites outside the US as well as non-Christian FBOs. Current evidence is inadequate to evaluate the potential of FBO-based interventions in preventing hypertension in non-hypertensive populations. Intervention effects in non-hypertensive population might be better reflected through intermediate outcomes.

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.

Mighty Men: A Pilot Test of the Feasibility and Acceptability of a Faith-Based, Individually Tailored, Cluster-Randomized Weight Loss Trial for Middle-Aged and Older African American Men.

Two in five African American men have obesity, but they are underrepresented in community-based weight loss interventions. This pilot effectiveness trial examines the acceptability and feasibility of the first weight loss study for African American men that includes randomization and individual tailoring. Using a community-based, cluster-randomized, longitudinal parallel group design, four churches were randomized to a control condition or a weight loss condition. Each church received physical activity equipment, a coordinator, and small group physical activity sessions. A total of 71 African American men (mean age: 58.5) enrolled and received a Fitbit, Bluetooth-enabled scale, a t-shirt, gift cards for participation, and 45 min of small group physical activity led by a certified personal trainer. Men in the weight loss condition also received 45 min of health education and individually tailored SMS text messages. Multiple metrics suggest that Mighty Men was feasible, yet the acceptability of the intervention components was mixed. Participants in both the weight loss and control conditions lost weight between zero and 6 months (p < .001), but body fat (p = .005) and visceral fat percentage (p = .001) of men in the weight loss condition decreased while men in the control condition did not (p < .05). An increase in physical activity was seen among men in the weight loss condition (p = .030) but not among men in the control condition (p < .05). It is acceptable and feasible to conduct a 6-month weight loss intervention with African American men that includes randomization and individually tailored text messages.

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.

Planning the Implementation of a Multilevel Blood Pressure Control Intervention in Chicago: Community and Clinical Perspectives.

Objectives: Hypertension is associated with high morbidity and mortality. The complications of hypertension disproportionately impact African American residents in Chicago's South Side neighborhood. To inform the implementation of an evidence-based multilevel hypertension management intervention, we sought to identify community member- and clinician-level barriers to diagnosing and treating hypertension, and strategies for addressing those barriers. Methods: We conducted 5 focus groups with members of faith-based organizations (FBOs) (n=40) and 8 focus groups with clinicians and administrators (n=26) employed by community health centers (CHCs) located in Chicago's South Side. Results: Participants across groups identified the physical environment, including lack of access to clinics and healthy food, as a risk factor for hypertension. Participants also identified inconsistent results from home blood pressure monitoring and medication side effects as barriers to seeking diagnosis and treatment. Potential strategies raised by participants to address these barriers included (1) addressing patients' unmet social needs, such as food security and transportation; (2) offering education that meaningfully engages patients in discussions about managing hypertension (eg, medication adherence, diet, follow-up care); (3) coordinating referrals via community-based organizations (including FBOs) to CHCs for hypertension management; and (4) establishing a setting where community members managing hypertension diagnosis can support one another. Conclusions: Clinic-level barriers to the diagnosis and treatment of hypertension, such as competing priorities and resource constraints, are exacerbated by community-level stressors. Community members and clinicians agreed that it is important to select implementation strategies that leverage and enhance both community- and clinic-based resources.

Migração em tempos de covid-19: impactos e estratégias de enfrentamento / Migration in times of covid-19: effects and coping strategies / Migración en tiempos del covid-19: impactos y estrategias de afrontamiento

Em 2020, o mundo enfrentou uma grave emergência de saúde pública devido à pandemia de COVID-19, que impactou significativamente a mobilidade humana e a vida cotidiana de milhares de imigrantes ao redor do mundo. Este artigo fez uso de entrevistas online e por telefone com imigrantes que chegaram ao Brasil a partir de 2016, para identificar as estratégias de enfrentamento adotadas durante a pandemia. Foi realizada uma análise transversal das entrevistas com o auxílio do software Atlas.ti 9, usando a técnica sistemática de categorização iterativa. Com base em uma perspectiva sociocultural em psicologia, o artigo introduz os impactos iniciais da pandemia em diferentes esferas da vida cotidiana desses imigrantes e apresenta as estratégias mobilizadas para restaurar continuidades funcionais e relacionais em um momento no qual as rupturas provocadas pela migração e pela pandemia se sobrepõem. Entre outros, podese identificar como os entrevistados ativaram rapidamente as redes sociais locais e transnacionais virtualmente, mobilizando competências e habilidades aprendidas durante a migração.(AU)

In 2020, the world faced a serious public health emergency due to the COVID-19 pandemic, which has significantly impacted human mobility and the daily lives of thousands of immigrants around the world. This article uses online and telephone interviews conducted with migrants who arrived in Brazil in 2016, to identify coping strategies employed during the pandemic. A transversal analysis of all interviews was conducted with the aid of the software Atlas.ti 9, using a systematic approach of iterative categorization. From a sociocultural perspective in psychology, the article introduces the initial impacts of the pandemic in different spheres of everyday life of these immigrants. With this everyday context, we present the strategies mobilized by immigrants to restore functional and relational continuities at a moment in which the ruptures caused by migration and the pandemic overlap. In particular, we identify how interviewees rapidly activated local and transnational social networks virtually, mobilizing skills learnt during migration.(AU)

En 2020, el mundo se enfrentó a un grave estado de emergencia en salud pública debido a la pandemia del COVID-19, que impactó significativamente la movilidad humana y la vida cotidiana de miles de inmigrantes en todo el mundo. Este artículo realizó entrevistas en línea y por teléfono con inmigrantes quienes llegaron a Brasil a partir de 2016, con el fin de identificar sus estrategias de afrontamiento adoptadas durante la pandemia. Se realizó un análisis transversal de las entrevistas con la ayuda del software Atlas.ti 9, utilizando la técnica sistemática de categorización iterativa. Desde una perspectiva sociocultural en Psicología, este artículo expone los impactos iniciales de la pandemia en diferentes ámbitos de la vida cotidiana de estos inmigrantes y presenta las estrategias movilizadas para restaurar las continuidades funcionales y relacionales en un momento en que se superponen las rupturas causadas por la migración y la pandemia. Entre otros aspectos, se puede identificar cómo los entrevistados activaron virtualmente las redes sociales locales y transnacionales movilizando habilidades y destrezas aprendidas durante la migración.(AU)

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.

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.

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.

Partnering With Faith-Based Organizations to Offer Flu Vaccination and Other Preventive Services.

In 2019, just one-half of Americans received their influenza vaccine, despite it being safe, effective, and important in preventing serious infection, hospitalization, and death. Black children receive fewer influenza vaccines than their White counterparts. Vaccine hesitancy can hinder influenza vaccine uptake and is partially fueled by ongoing systemic racism and historical abuse leading to medical mistrust in communities of color. Building trust may enhance the transfer of reliable vaccine information and may move people along the spectrum of vaccine intention. We sought to partner with faith-based organizations through a community influenza vaccination event to increase vaccination rates. By leveraging the reach and expertise of trusted voices, such as church "first ladies" and local community leaders, we were able to administer 600 pediatric influenza vaccines between 2016 and 2019. In addition, this event served as a platform to assess whether youth attendees had a place for regular medical care ("medical home") (>80% did in each year assessed) and to conduct preventive screenings. Most children, as reported by their caregivers, had recent medical check-ups (85% in 2016, 84% in 2017, and 82% in 2018). Of the children screened, more than one-third had an abnormal body mass index and one-half had abnormal dentition. By partnering with organizations that are well-embedded in the local community, such as faith-based organizations, health care groups may be able to maximize the impact of their health promotion campaigns.

Surveillance for substandard and falsified medicines by local faith-based organizations in 13 low- and middle-income countries using the GPHF Minilab.

This study evaluates the use of the Global Pharma Health Fund (GPHF) Minilab for medicine quality screening by 16 faith-based drug supply organizations located in 13 low- and middle-income countries. The study period included the year before the COVID-19 pandemic (2019) and the first year of the pandemic (2020). In total 1,919 medicine samples were screened using the GPHF Minilab, and samples showing serious quality deficiencies were subjected to compendial analysis in fully equipped laboratories. Thirty-four (1.8%) of the samples were found not to contain the declared active pharmaceutical ingredient (API), or less than 50% of the declared API, or undeclared APIs, and probably represented falsified products. Fifty-four (2.8%) of the samples were reported as substandard, although the true number of substandard medicines may have been higher due to the limited sensitivity of the GPHF Minilab. The number of probably falsified products increased during the COVID-19 pandemic, especially due to falsified preparations of chloroquine; chloroquine had been incorrectly advocated as treatment for COVID-19. The reports from this project resulted in four international WHO Medical Product Alerts and several national alerts. Within this project, the costs for GPHF Minilab analysis resulted as 25.85 € per sample. Medicine quality screening with the GPHF Minilab is a cost-effective way to contribute to the global surveillance for substandard and falsified medical products.