Promoting Policy and Environmental Change in Faith-Based Organizations

Abstract

High rates of heart disease, cancer, and stroke exist in rural South Georgia where the Emory Prevention Research Center's Cancer Prevention and Control Research Network provided mini-grant funding to six churches to implement policy and environmental change to promote healthy eating and physical activity. This study sought to determine whether perceptions of the health promotion environment changed over time and whether perceived environmental change was associated with healthy behavior at church and in general. This study used a single-group pre-post design with 1-year follow-up. Parishioners (N = 258) completed self-administered questionnaires assessing perceptions of the church health promotion environment relative to healthy eating and physical activity, eating behavior and intention to use physical activity facilities at church, and eating and physical activity behaviors generally. Results indicate that perceived improvements in church nutrition environments were most strongly associated with decreases in unhealthy food consumed and stronger intentions to use physical activity resources at church (ps ≤ .05). Perceived changes in the physical activity environment were unrelated to church or general behavior. Findings suggest that church environments may play an important role in supporting healthy eating and physical activity at church; however, whether the influence of the church environment extends to other settings is unknown.

Evaluability assessment of “growing healthy communities,” a mini-grant program to improve access to healthy foods and places for physical activity

“…These entities are critical for built environment change in rural U.S. communities that often lack private investment. The local MSWV organizations interviewed for this project recognized the beneficial nature of the GHC funding for community health through increasing access to healthy food and places for physical activity, echoing findings from other rural mini-grant research focused on ecological determinants of healthy behaviors in the rural U.S. [5, 6, 29, 30] The successful implementation of the funding by MSWV organizations despite barriers highlighted in the results suggests that local economic development organizations may be successful mini-grant implementation partners for public health initiatives in rural areas in addition to child care centers, non-profits, schools, health departments, and faith-based organizations evidenced in prior research [5, 13, 14]. Specifically, these economic development organizations may be valuable partners to implement rural multi-sector collaborations espoused in the National Physical Activity Plan [31] and COCOMO nutrition strategies [17].…”

“…Extant literature highlights the wide range of public health initiatives supported by mini-grants, including physical activity [3–9], healthy eating [5, 7, 8, 10], childhood wellbeing [11], and other objectives outlined in Healthy People 2020 [1, 12]. For such public health initiatives, mini-grant funding varies substantially per funded project, from as low as $40 to as much as $50,000 [7].…”

“…The limited literature suggests that rural mini-grant recipients, such as schools, churches, neighborhoods, and youth groups, do not necessarily have to have a primary focus on health but can adapt and collaborate to address priority health topics at the community-level [1, 8, 12]. Specifically, child care centers [13], community-based organizations [14], and faith-based organizations [5] have demonstrated the capability to improve access to healthy food and places for physical activity through policy, systems, and environment change within their own organizational contexts (e.g., healthier potluck after church service). Mini-grants are attractive for smaller organizations because funding is primarily or exclusively directed to implementation with little to no funding redirected to outside organizations for evaluation [1].…”

Social Environmental Correlates of Health Behaviors in a Faith-Based Policy and Environmental Change Intervention

“…Of the five churches that sought to change the PA environment, two (Churches 4 and 6) exhibited significant improvements in the church social environment for PA from baseline to follow-up. The three churches that experienced no significant change in the church social environment for HE or PA also reported fewer changes to their churches' physical environment, as reported elsewhere (Arriola et al, 2016). Main outcome analyses explored change in perceived church social environments relative to church eating behavior and intention to use church PA resources as well as diet and physical activity behaviors generally.…”

Objective Church Environment Audits and Attendee Perceptions of Healthy Eating and Physical Activity Supports within the Church Setting

“…Some research has looked at the impact of environmental interventions on church member perceptions of the church environment, self-efficacy, and health behaviors, but measurement of these environments were often subjective [18][19][20]. For example, one study observed the role of perceived church environment on health behaviors and showed that providing messaging in sermons and church bulletins, HE programs, and healthy foods was associated with increased HE but not PA [18,19]. This research did not measure any elements of the PA environment in relation to PA behavior, which might explain the non-significant results.…”