Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

Abstract

Background: Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. Faith in Action (Fe en Acción) is an evidence-based promotora-led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women. Methods: We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of Faith in Action and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach. Results: Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers' behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: (1) health behavior change training for pastors and staff, (2) tailored messaging, (3) developing community collaborations, and (4) gaining denominational support. Conclusions: While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.

The association between religiosity, spirituality, and breast cancer screening: A cross-sectional analysis of Alberta’s Tomorrow Project

“…Public health authorities in the United States have successfully utilized religious venues to implement health promotion campaigns. For example, campaigns to increase physical activity have been implemented in underserved communities in the United States by delivering important public health messaging through faith-based organizations ( Haughton et al, 2020 ). Targeting religious or spiritual institutions, such as churches, also targets important social environments that may influence individual’s thinking and behavior, including cancer screening.…”

Two-year outcomes of Faith in Action/Fe en Acción: a randomized controlled trial of physical activity promotion in Latinas

“…Enhancing the capacity in FBOs to implement and sustain multilevel PA interventions may augment the effectiveness and sustainability of PA programs in churches. Given their influential role, FBO leaders have the potential to influence the attitudes and health behaviors of churchgoers [ 54 , 55 ]. Pastors are decision makers who can facilitate the successful implementation and maintenance of program activities in church settings.…”

Participant Perspectives on the Effects of an African American Faith-Based Health Promotion Educational Intervention: a Qualitative Study

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