Three new
studies have investigated the effectiveness of church-based healthcare
strategies for improving breast cancer screening, combating obesity and
increasing physical activity.
Researchers
from Colorado, Texas and Kansas generally found positive outcomes when
healthcare strategies were approached in a church setting, particularly in
Latin and African American communities.
The Tepeyac
Project was a church-based health promotion project that was conducted from
1999 through 2005 to increase breast cancer screening rates among Latinas in
Colorado. In the study conducted by scientists from the University of Colorado
Health Sciences Center, researchers evaluated the program among enrollees in
the state's five major insurance plans.
The study
compared the Tepeyac Project's two interventions: the Printed Intervention and
the Promotora Intervention. In the first intervention, the researchers mailed
culturally tailored education packages to 209 Colorado Catholic churches. In
the second, promotoras (peer counselors) in four Catholic churches delivered
breast-health education messages personally.
Mammogram
claims were compared from the five insurance plans in the analysis at baseline
(1998-1999) and during follow-up (2000-2001) for Latinas who had received the
interventions.
The
mammogram rate for Latinas in the Printed Intervention remained the same from
baseline to follow-up (58 percent vs. 58 percent). In the Promotora
Intervention, the rate was 59 percent at the start of the study and 61 percent
at follow-up. Rates increased modestly over time and varied widely by insurance
type. After adjusting for age, income, urban versus rural location, disability
and insurance type, the study found that women exposed to the Promotora
Intervention had a significantly higher increase in mammograms than did women
exposed to the Printed Intervention.
The study
authors concluded that for insured Latinas, personally delivering church-based
education through peer counselors appears to be a better breast-health
promotion method than mailing printed educational materials to churches.
In a related
study, researchers from the University of Texas Health Science Center at San
Antonio explained that obesity has reached epidemic levels, with nearly two-thirds
of the U.S. population considered overweight or obese. The study authors
suggested that Latinos have some of the highest rates of overweight, obesity
and sedentary lifestyles.
The study
examined knowledge, attitudes and behaviors about nutrition and exercise among
Latinas aged 40 years and older residing in a low-income community in Houston,
Texas, and the applicability of an evidence-based church program to promote
healthy energy balance.
A
qualitative assessment was conducted through 10 focus groups with 75 women
recruited through three Catholic churches, community groups and leaders.
Participants
identified barriers and enabling factors to healthy nutrition and physical
activity. The study found that barriers included lack of awareness about nutrition
and physical activity, cultural beliefs and socioeconomic and environmental
factors.
Preferred
strategies were group activities with direct guidance from qualified
individuals and interpersonal contact among participants, social support with
positive reinforcement for behavior change or maintenance and a friendly
environment for learning and achieving suitable goals. The church was
considered a powerful resource to influence Latinas to improve their health,
exercise and nutrition practices.
The study
authors concluded that using the church environment to reach Latina women aged
40 years and older is a feasible and culturally appropriate strategy. The study
authors believe that the church environment provides a safe, comfortable and
familiar atmosphere for women that addresses specific cultural barriers and
safety concerns of family members.
And finally,
a study conducted by researchers at Kansas State University analyzed the
outcome of Health-e-AME, a three-year intervention designed to promote physical
activity at African Methodist Episcopal churches across South Carolina based on
a community-participation model designed to disseminate interventions through
trained volunteer health directors.
Researchers
used the RE-AIM (Reach, Effectiveness, Adoption, Implementation and
Maintenance) framework to evaluate the intervention through interviews with 50
health directors.
The study
found that 80 percent of the churches that had a health director trained during
the first year of the intervention, and 52 percent of churches that had a
health director trained during the second year, adopted at least one component
of the intervention. Lack of motivation or commitment from the congregation was
the most common barrier to adoption. Intervention activities reached
middle-aged women mainly.
The
researchers reported that the intervention was moderately well implemented, and
adherence to its principles was adequate. Maintenance analysis showed that
individual participants in the intervention's physical activity components
continued their participation as long as the church offered them, but churches
had difficulties continuing to offer physical activity sessions. The effectiveness
analysis showed that the intervention produced promising, but not significant,
trends in levels of physical activity.
The study
authors concluded that the use of the RE-AIM framework to evaluate this
intervention serves as a model for a comprehensive evaluation of the health
effects of community programs to promote health.
Previous studies have looked the effects of prayer, spiritual healing and
healing touch on various aspects of health. For more information on these,
please visit Natural Standard's Health & Wellness database.