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Faith-based interventions hold promise for increasing physical activity (PA) and thereby reducing health disparities. This paper examines the perceived influences on PA participation, the link between spirituality and health behaviors and the role of the church in promoting PA in African Americans. Participants (n = 44) were adult members of African American churches in South Carolina. In preparation for a faith-based intervention, eight focus groups were conducted with sedentary or underactive participants. Groups were stratified by age (<55 years versus >or=55 years), geography and gender. Four general categories were determined from the focus groups: spirituality, barriers, enablers and desired PA programs. Personal, social, community and environmental barriers and enablers were described by both men and women, with no apparent differences by age. Additionally, both men and women mentioned aerobics, walking programs, sports and classes specifically for older adults as PA programs they would like available at church. This study provides useful information for understanding the attitudes and experiences with exercise among African Americans, and provides a foundation for promoting PA through interventions with this population by incorporating spirituality, culturally specific activities and social support within the church.

Six focus groups were conducted with underactive African American (n = 16) and white (n = 23) women aged 50 years and older, residing in a nonmetropolitan county in South Carolina, to examine perceptions, barriers, and motivators related to exercise. Transcripts were coded and codes were entered into NUD*IST to assist with organizing and reporting themes. Participants could not reach consensus on the frequency, intensity, and duration of exercise needed for older women, and emphasized that PA recommendations should consider age, health, and physical abilities. While benefits and barriers to exercise were similar to those found in other groups, the risk of "overdoing it," being "too old," and environmental barriers specific to rurality were unique. Exercise enablers were also similar to those found in other groups, but rural women discussed the role that the church played in supporting exercise. Other enablers included transportation, free facilities, and age-appropriate programs. Results indicate the need to tailor recommendations and advice to older women, and to consider the rural context in which they live.

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a "program life cycle" framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

This study examined factors influencing strength training (ST) in two convenience samples of older rural women. Focus group (FG) participants were 23 Caucasian and 16 African American women aged 67.5 +/- 9.2 years. Survey participants were 60 Caucasian and 42 African American women, aged 70.59 +/- 9.21 years. FG participants answered questions about the risks, benefits, and barriers to ST. Survey participants completed measures of demographics, physical activity (including ST), depression and stress, decisional balance for exercise (DBE), barriers to PA, and social support (SS). Regression modeling examined correlates of ST. FG participants identified physical health gains and improved appearance as ST benefits. African American women also included mental health benefits and "feeling good". Both Caucasian and African American groups named physical health problems as risks of ST. Caucasian women identified time constraints, lack of ST knowledge, physical health problems, lack of exercise facilities, and the cost of ST as barriers. African American women cited being "too tired", physical health problems, lack of support, and other family and work responsibilities. The linear regression model explained 23.2% of the variance in hours per week of ST; DBE and family SS were independent positive correlates. This study identified correlates to participation in ST in older rural women and provides a basis for developing ST interventions in this population.

This review provides a summary of physical activity interventions delivered in faith-based organizations. Electronic databases were searched to identify relevant studies. After screening, a total of n = 27 articles matched our inclusion criteria; 19 were identified as faith-based interventions (some spiritual or Biblical element included in the intervention) and 8 as faith-placed interventions (no spiritual component). Among all interventions, the most common research design was a randomized controlled trial. African American women were the most commonly targeted population and predominately Black churches were the most common setting. The majority of studies used self-report measures of physical activity. Most of the interventions did not use a theoretical framework to shape the intervention and weekly group sessions were the most frequently reported intervention approach. Overall, 12 of the faith-based and 4 of the faith-placed interventions resulted in increases in physical activity. Recommendations for future faith-based physical activity interventions include more rigorous study design, improved measures of physical activity, larger sample sizes, longer study and follow-up periods, and the use of theory in design and evaluation. Although limited, literature on faith-based physical activity interventions shows significant promise for improving physical activity participation and associated health outcomes.

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Churches are becoming increasingly popular settings for conducting health promotion programs. Retrospective interviews were conducted with 19 health directors from churches taking part in the evaluation of a large-scale faith-based physical activity initiative. This paper first describes program implementation, church leadership support, and changes in church leadership, and then relates these variables to program outcomes (percentage of participants meeting physical activity recommendations). Finally, barriers and successes to program implementation are reported. The most commonly reported intervention activities implemented by churches were bulletin boards related to healthy eating and physical activity (79%) followed by bulletin inserts (69%), walking programs (58%), chair exercises (48%), praise aerobics (27%), a 10-min exercise CD (26%), and an 8 week behavior change class (26%). Significant increases in physical activity were associated with churches which had ever implemented the behavior change class at the 1-year follow-up. According to health directors, pastors sometimes to often spoke about physical activity and diet from the pulpit but rarely to sometimes took part in program activities. They also reported that pastors spouses' never to rarely spoke about physical activity and diet from the pulpit, and rarely to sometimes took part in program activities. About 68% of the churches had at least one change in pastor over the 3-year study. A majority of these variables, however, were not related to changes in physical activity. Potential reasons for these lack of associations are discussed.