CORE RESEARCH PROJECT: FAITH, ACTIVITY, AND NUTRITION- DISSEMINATION IN UNDERSERVED COMMUNITIES

FUNDING SOURCE: CDC 2014-2019

PRINCIPAL INVESTIGATOR: Sara Wilcox, PhD

CO-INVESTIGATORS:

Faith, Activity, and Nutrition (FAN), was developed and tested in partnership with the 7th Episcopal District of the African Methodist Episcopal Church (www.health-e-ame.org).  This faith-based program targets organizational change within the church to be more supportive of physical activity and healthy eating.  In a previous grant funded by the National Institutes of Health, the program was shown to increase leisure-time physical activity and fruit and vegetable intake in AME church members.  The program is included as a National Cancer Institute Research-tested Intervention Programs

For the 2014-2019 funding cycle, the USC PRC, in partnership with Fairfield Behavioral Health Services, Fairfield Community Coordinating Council, the South Carolina Conference of the United Methodist Church, and Clemson University, will study the dissemination and implementation of FAN, using a train-the-trainer model where lay church members are trained to train other churches in their county, district, or region in how to implement FAN.

This applied research project has two phases. In Phase 1, we will work with 60 Fairfield County churches of any denomination to adopt and implement FAN in partnership with Fairfield Behavioral Health Services and Fairfield Community Health Partners.  Fairfield County has been identified by the South Carolina Department of Health and Environmental Control (state health department) as 1 of 5 counties in SC “in most need” relative to obesity and chronic health indicators. Churches will be randomized to receive training in FAN (n=40) or to be part of a delayed intervention group (n=20). This phase will allow us to study dissemination and implementation in a range of religious denominations. We will also gain greater understanding of how county-level health-related coalitions can reach faith-based communities as settings for intervention.

In Phase 2, the USC PRC will partner with a large religious denomination in SC to study larger-scale dissemination and to identify key considerations in program dissemination, adoption, and implementation. Also, because this denomination is part of larger regional, national, and international organizing network, we will examine the potential for even broader geographic dissemination in the future. By studying two distinct ways of working with churches (i.e., a “bottom-up” approach through a county-level coalition versus a more “top-down” approach through distinct church denominational structures), we will also be able to understand the advantages and limitations of each.

Using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) as a guide, the study has three primary specific aims:

  1. Examine the adoption and reach of Faith, Activity, and Nutrition in churches in underserved communities and identify organizational factors associated with adoption.
  2. Characterize implementation fidelity and identify multilevel factors associated with implementation of Faith, Activity, and Nutrition in churches in underserved communities. The Consolidated Framework for Implementation Research (CFIR) will guide the selection and measurement of the multilevel factors that may influence implementation.
  3. Describe organizational maintenance of Faith, Activity, and Nutrition in churches in underserved communities and identify factors associated with maintenance. Implementation will be assessed 12 and 24 months after training.

 We also have two secondary specific aims:

    • In Phase 1, study the effectiveness of Faith, Activity, and Nutrition in churches in underserved communities with regard to changes in physical activity and diet.
    • Compare and contrast two approaches to dissemination and implementation of the program (county-level coalitions versus church denominational structures).