Organizational characteristics conducive to the implementation of health programs among Latino churches

Allen et al. Implementation Science Communications https://doi.org/10.1186/s43058-020-00052-2 (2020) 1:62 RESEARCH Implementation Science Communications Open Access Organizational characteristics conducive to the implementation of health programs among Latino churches Jennifer D. Allen1* , Rachel C. Shelton2, Lindsay Kephart3, Lina Jandorf4, Sara C. Folta5 and Cheryl L. Knott6 Abstract Background: Faith-based organizations (FBOs) can be effective partners in the implementation of health interventions to reach underserved audiences. However, little is known about the capacity they have or need to engage in these efforts. We examined inner-setting organizational characteristics hypothesized to be important for program implementation by the Consolidated Framework for Implementation Research (CFIR). Methods: This cross-sectional study involved 34 churches with predominantly Latino congregations in Massachusetts. FBO leaders completed a survey assessing inner-setting CFIR organizational characteristics, including organizational readiness, implementation climate, organizational culture, and innovation “fit” with organizational mission. Results: There was limited variability in CFIR organizational characteristics, with scores on a scale from 1 to 5 skewed toward higher values, ranging from 3.27 (SD 0.94) for implementation climate to 4.58 (SD 0.54). Twenty-one percent of the FBOs had offered health programs in the prior year. Conclusions: FBOs had high scores on most of the organizational factors hypothesized to be important for the implementation of health programs, although relatively few FBOs offered them. While this suggests that FBOs have favorable characteristics for health programming, prospective studies are needed to understand relative salience of inner-setting organizational characteristics versus factors external to the organization (e.g., policies, incentives), as well as the potential direction of relationships between internal organizational characteristics and health program offerings. Trial registration: Clinical trials identifier number NCT01740219 (clinicaltrials.gov) Keywords: Implementation science, Faith-based organizations, Organizational readiness, Evidence-based interventions, Latinos, Cancer screening * Correspondence: 1 Department of Community Health, Tufts University, 574 Boston Avenue, Medford, MA 02155, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Allen et al. Implementation Science Communications (2020) 1:62 Contributions to the literature  FBOs can be instrumental in reaching underserved audiences, but little is known about the resources or capacity they have or need to offer health programs  This is one of few studies to examine organizational factors of FBOs hypothesized to be important in the implementation of programs as hypothesized by the Consolidated Framework for Implementation Research (CFIR) Page 2 of 9 policies, or practices among Latino-serving FBOs. We focus on Latino FBOs given health disparities experienced by Latinos and the high percentage that report church membership [9]. The vast majority of prior studies have been conducted in African American FBOs which may differ from Latino FBOs in terms of denomination, size, time since establishment, and available resources [10, 11]. As such, this study can contribute to understanding FBOs that identify as serving predominantly Latino congregations.  FBOs in the sample had high scores on all measures of CFIR organizational characteristics thought to be important for Method program implementation, although relatively few FBOs had Sample and setting implemented health programs in the prior year FBOs included in this study were located in Massachusetts, offered Spanish language religious services, and reported serving a predominantly Latino congregation. We included all denominations except for Catholic churches, since our prior research has focused extensively on the implementation of innovations among Catholic FBOs and there is now a need to study other denominations, as results from one may not be generalizable to others. Note that in this paper, we use the terms “FBOs” and “churches” interchangeably. Organizations were identified through the Worldwide Web (web) using search terms [“church” or “faith-based organization” AND “Latino” or “Hispanic” AND “Massachusetts”], as well as a review of listings in White Pages. We mailed study materials to pastors in the identified churches, which included a project brochure outlining the study’s goals and procedures, a return reply form for pastors to indicate their interest in participating, the name(s) of appropriate FBO representative(s) (e.g., leaders of health ministries) to complete the survey, and the preferred mode of contact (phone/email/in-person). Approximately 2 weeks later, bilingual survey assistants called those who provided a return reply (“opt-in”) and attempted to contact those who had not yet responded or opted-out. Prior to participating, organizational consent was obtained from pastors. When the survey respondent was not the pastor, they too provided informed consent.  Additional research is needed to understand prospective relationships between internal organizational characteristics and external factors that impact health program offerings. Background Faith-based organizations (FBOs) can be valuable partners in the implementation of health promotion programs, particularly among communities that experience health inequities, structural barriers to accessing healthcare, and have high levels of mistrust of the healthcare system [1]. Over the past two decades, there has been a proliferation of intervention studies based in FBOs. Overall, empirical evidence supports that FBOs can be an important setting for and partner in the delivery of effective health interventions to address a wide variety of public health (...truncated)