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).

CORE RESEARCH PUBLICATIONS:

Saunders, R. P., Wilcox, S., & Hutto, B. (2022). Influence of implementation strategies on implementation outcomes in a statewide dissemination of Faith, Activity, and Nutrition (FAN). Health Education Research, 37(6), 420–433.
DOI: 10.1093/her/cyac025
Abstract: https://pubmed.ncbi.nlm.nih.gov/36149635/

Bernhart, J.A., Dunn, C.G., Wilcox, S., Stucker, J., Kinnard, D. (2022). The FAN Program Plan: Creating a healthy church environment for physical activity and healthy eating. Dialogues in Health, 1 (December 2022), 100019. Epub available: https://doi.org/10.1016/j.dialog.2022.100019

Bernhart, J. A., Wende, M. E., Kaczynski, A. T., Wilcox, S., Dunn, C. G., & Hutto, B. (2022). Assessing the walkability environments of churches in a rural southeastern county of the United States. Journal of Public Health Management and Practice: JPHMP, 28(1), E170–E177.
DOI: 10.1097/PHH.0000000000001076
Abstract: https://pubmed.ncbi.nlm.nih.gov/31688738/

Wilcox, S., Day, K.R., Saunders, R.P., Jake-Schoffman, D.E., Kaczynski, A., Stucker, J., Dunn, C.G., Bernhart, J.A. (2022). The Faith, Activity, and Nutrition (FAN) dissemination and implementation study: changes in and maintenance of organizational practices over 24 months in a statewide initiative. International Journal of Behavioral Nutrition and Physical Activity, 19(1): 23.

Bernhart, J. A., Wilcox, S., Saunders, R. P., Hutto, B., & Stucker, J. (2021). Program implementation and church members’ health behaviors in a countywide study of the Faith, Activity, and Nutrition program. Prev Chronic Dis, 18, E05. http://dx.doi.org/10.5888/pcd18.200224

Hutto, B., Saunders, R.P., Wilcox, S., Jake-Schoffman, D.E., Bernhart, J.A., et al (2021). Pathways of influences leading to adoption of the Faith, Activity and Nutrition (FAN) program in a statewide initiative. Evaluation and Program Planning, 89, 101941. Epub ahead of print March 16, 2021. https://doi.org/10.1016/j.evalprogplan.2021.101941

• A lay summary of the study results is available here

Wilcox, S., Jake-Schoffman, D.E., Saunders, R.P., Kinnard, D., Kaczynski, A.T., Hutto, B., & James, K.L. (2021). Predictors of implementation in the Faith, Activity, and Nutrition dissemination and implementation study: application of the Consolidated Framework for Implementation Research (CFIR) in a statewide initiative. Translational Behavioral Medicine, 11(2), 419-429. Epub ahead of print March 28, 2020.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/32221601

• A lay summary of the study results is available here

Wende, M.E., Kaczynski, A.T., Bernhart, J.A, Dunn, C.G., Wilcox, S. (2020). Objective church environment audits and attendee perceptions of healthy eating and physical activity supports within the church setting. International Journal of Environmental Research and Public Health, 17, 3598.

Abstract: https://www.mdpi.com/1660-4601/17/10/3598

Wilcox, S., Saunders, R.P., Jake-Schoffman, D., Hutto,B. (2020). The Faith, Activity and Nutrition (FAN) Dissemination and Implementation Study: 24-Month organizational maintenance in a countywide initiative. Frontiers in Public Health, 8, 171.

Full version of paper: https://doi.org/10.3389/fpubh.2020.00171

Dunn, C.G., Wilcox, S., Bernhart, J.A., Blake, C.E., Kaczynski, A.T., and Tuner-McGrievy, G.M. (2019). Church leaders’ views of obesity prevention efforts for children and youth. Journal of Nutrition Education and Behavior, 52(3), 259-269.
Abstract:  https://www.ncbi.nlm.nih.gov/pubmed/31677941

• A lay summary of the study results is available here

Sharpe, P.A., Wilcox, S., Stucker, J., Kinnard, D., Bernhart, J., James, K.L. (2020). Community health advisors’ characteristics and behaviors, role performance, and volunteer satisfaction in a church-based healthy eating and physical activity intervention. J Community Health, 45(1), 88-97. Epub ahead of print, Aug 9, 2019.
Abstract:  https://www.ncbi.nlm.nih.gov/pubmed/31399893

Saunders, R.P., Wilcox, S., Jake-Schoffman, D.E., Kinnard, D., Hutto, B., Forthofer, M., Kaczynski, A.T. (2019). The Faith, Activity, and Nutrition (FAN) Dissemination and Implementation Study, Phase 1: Implementation monitoring methods and results. Health Education and Behavior, 46(3), 388-397. Epub ahead of print December 21, 2018.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30577714

Bernhart, J.A., Dunn, C.G., Wilcox, S., Saunders, R.P., Sharpe, P.A., Stucker, J. (2019). Church leaders’ barriers and facilitators before and after implementing a physical activity and nutrition intervention. Health Education Research, 34(2), 188-199. Epub ahead of print January 2, 2019.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30601982

• A lay summary of the study results is available here

Bernhart, J.A., La Valley, E.A., Kaczynski, A.T., Wilcox, S., Jake-Schoffman, D.E., Peters, N., Dunn, C.G., Hutto, B. (2020). Investigating socioeconomic disparities in the potential healthy eating and physical activity environments of churches. Journal of Religion and Health, 59(2), 1065-1079. Epub ahead of print August 21, 2018.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/30132179

Kaczynski, A.T., Jake-Schoffman, D.E., Peters, N.A., Dunn, C.G., Wilcox, S., Forthofer, M. (2018). Development and testing of the Church Environment Audit Tool in faith-based settings. American Journal of Health Behavior, 42(3), 17-26.
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/29663977

• A lay summary of the study results is available here

Sharpe, P.A., Wilcox, S., Kinnard, D., Condrasky, M.D. (2018). Community health advisors’ participation in a dissemination and implementation study of an evidence-based physical activity and healthy eating program in a faith-based setting. Journal of Community Health, 43(4), 694-704. Epub ahead of print February 2018. DOI: 10.1007/s10900-018-0473-5 PMID: 29427128
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/29427128

• A lay summary of the study results is available here

Wilcox, S., Saunders, R.P., Kaczynski, A.T., Forthofer, M., Sharpe, P.A., Goodwin, C., Condrasky, M., Kennedy, Sr., V., Jake-Schoffman, D.E., Kinnard, D., Hutto, B. (2018). Faith, Activity, and Nutrition Randomized Dissemination and Implementation Study: Countywide adoption, reach, and effectiveness, American Journal of Preventive Medicine. 54(6), 776-785. Epub ahead of print April 2018.
DOI: 10.1016/j.amepre.2018.02.018 PMID: 29656913
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/29656913

• Note: Based on this publication, the Rural Health Information hub (RHIhub) included FAN as an intervention with a “promising evidence” ranking: https://www.ruralhealthinfo.org/project-examples/1011
• An infographic displaying the study results is available here.

 

CENTER PUBLICATIONS:

Jake-Schoffman, D.E., Wilcox, S., Kaczynski, A.T., Turner-McGrievy, G., Friedman, D.B., West, D.S. (2018). E-media use and preferences for physical activity and public health information: Results of a web-based survey. Journal of Public Health Management and Practice, 24(4), 385-391. E-pub ahead of print July 2017. DOI: 10.1097/PHH.0000000000000638 PMID: 28763431
Abstract: https://www.ncbi.nlm.nih.gov/pubmed/28763431