Church‐based education: An outreach program for African Americans with hypertension

Abstract

The goals of this education outreach demonstration study were to prepare a cadre of registered nurses (RN) as Church Health Educators (CHE), and to test the efficacy of a hypertension (HBP) education and support program in African American (AA) churches for persons with HBP in managing blood pressure (BP). In this two-phase study, RNs were prepared as CHEs in phase 1 and a convenience sample of 97 subjects with HBP was taught by the CHEs in phase 2. The intervention's content included the bases of HBP and HBP management strategies, and was taught in eight 1-hour sessions. Using a pre-test-post-test design, data on knowledge, social support and BP were collected at baseline (pre), post-intervention (post1) and 3 months post-intervention (post2). Major findings include: (1) there was a significant increase in knowledge scores from pre to post1 and post2 (P < or = 0.0001; F = 95.08; df = 1.79); (2) education, age and number of years with HBP explained 49% of the variance associated with HBP knowledge; (3) systolic BP (SBP) and mean arterial BP (MAP) significantly decreased from pre to post1 and post2 (SBP-p < or = 0.0001, F = 18.35, df = 1.91; MAP-p < or = 0.0001, F = 17.80, df = 1.86); (4) DBP significantly decreased from pre to post1 only (p < or = 0.008, F = 17.48, df = 1.91); and (5) relationships were found between social support and DBP, and social support and MAP. Issues that emerged from this study with implications for outreach programming include recruitment and retention, randomization, selective sampling, intervention design and use of volunteers.

High Blood Pressure Knowledge Among Primary Care Patients with Known Hypertension: A North Carolina Family Medicine Research Network (NC-FM-RN) Study

“…Specific public health strategies should continue to be developed to improve message delivery to African-Americans and people with less education. Community interventions, like those that have been conducted in settings such as churches, 22 barber shops, 23 and beauty shops, 24 may be particularly well-suited to reaching people with educational messages about high BP.…”

The FAITH Trial: Baseline Characteristics of a Church-based Trial to Improve Blood Pressure Control in Blacks

“…The FAITH trial was designed to test the effect of a churchbased lifestyle intervention delivered by LHAs on BP reduction in hypertensive Blacks in New York City. Similar to other faith-based trials in hypertensive adults, [20][21][22][23] our sample comprised mostly well-educated, retired, and female participants. However, a strength of FAITH was its focus on Black adults with uncontrolled HTN, a population that has a disproportionately greater burden of HTN-related outcomes including heart failure, stroke, and end-stage renal disease.…”

“…37 These groups also have different dietary patterns 37 and may have different challenges and attitudes toward managing their BP. Although little examination of the health status and behaviors of these subpopulations of African descent have been done in [20][21][22][23]35,38,39 to our knowledge, FAITH is the first trial to rigorously evaluate the effect of a peer-led lifestyle intervention on BP reduction in a cohort of hypertensive Blacks. For example, some of the studies used a pre-post quasi-experimental design, and did not report baseline BP, making it difficult to determine their true impact of the intervention on BP reduction.…”

“…In contrast to other churchbased interventions in Blacks, [20][21][22][23][34][35][36] FAITH recruited an ethnically diverse sample of participants of African descent. Although most studies look at Blacks in the United States as a whole, they are not a monolithic group.…”

A Spiritually Based Approach to Breast Cancer Awareness: Cognitive Response Analysis of Communication Effectiveness

“…A church-based telephone counseling intervention for breast cancer screening was effective for reducing mammography nonadherence (Duan, Fox, Derose, & Carson, 2000). Hypertension programs using community health educators were effective for increasing knowledge (Smith, 1992) and decreasing blood pressure (Smith, Merritt, & Patel, 1997). A church-based program conducted by trained lay volunteers was more effective for weight loss than a control condition (McNabb, Quinn, Kerver, Cook, & Karrison, 1997).…”