Church-based health promotion (CBHP) interventions can reach broad populations and have great potential for reducing health disparities. From a socioecological perspective, churches and other religious organizations can influence members' behaviors at multiple levels of change. Formative research is essential to determine appropriate strategies and messages for diverse groups and denominations. A collaborative partnership approach utilizing principles of community-based participatory research, and involving churches in program design and delivery, is essential for recruitment, participation, and sustainability. For African Americans, health interventions that incorporate spiritual and cultural contextualization have been effective. Evidence indicates that CBHP programs have produced significant impacts on a variety of health behaviors. Key elements of CBHP are described with illustrations from the authors' research projects.

Motivational interviewing appears to be a promising strategy for modifying dietary behavior, and Black churches are an excellent setting to implement and evaluate health promotion programs.

Healthy Body Healthy Spirit was a multicomponent intervention to increase fruit and vegetable (F & V) consumption and physical activity (PA) delivered through Black churches. Sixteen churches were randomly assigned to 3 intervention conditions. At baseline, 1,056 individuals were recruited across the 16 churches, of which 906 (86%) were assessed at 1-year follow-up. Group 1 received standard educational materials, Group 2 received culturally targeted self-help nutrition and PA materials, and Group 3 received the same intervention as did Group 2 as well as 4 telephone counseling calls based on motivational interviewing (MI) delivered over the course of 1 year. At 1-year follow-up, Groups 2 and 3 showed significant changes in both F & V intake and PA. Changes were somewhat larger for F & V. For F & V, but not PA, there was a clear additive effect for the MI intervention.

Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in public health, medical, and health promotion settings. This article provides an overview of MI, outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed, nuances associated with the use of MI in health promotion and chronic disease prevention are described, and future directions are offered.

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