Engaging Faith-Based Organizations to Promote Health Through Health Ministries in Washington, DC

Journal of Religion and Health https://doi.org/10.1007/s10943-022-01651-0 ORIGINAL PAPER Engaging Faith‑Based Organizations to Promote Health Through Health Ministries in Washington, DC Ayanna Wells1 · Robin McClave1 · Elizabeth W. Cotter1 Deborah Nix2 · Anastasia M. Snelling1 · Tom Pruski2 · Accepted: 22 July 2022 © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022 Abstract This article describes capacity building and formative assessments completed at five faith-based organizations (FBOs) in Washington, DC to inform sustainable health promotion programming led by certified health ministers. Five FBO partners were recruited with two congregation members from each FBO completing a health minister certificate program. A series of health assessments were conducted to assess each FBO’s capacity to implement evidence-based lifestyle change programs that are responsive to congregation members’ health needs. Results indicated a need for programming to support older adults in managing high blood pressure and arthritis. Health ministers represent a significant opportunity for building capacity within FBOs to deliver programming that can improve health outcomes. Keywords Faith-based health promotion · Community health · Capacity building · Health ministers Introduction Nearly two-thirds of Americans will be affected by chronic disease in their lifetime, with over 40% experiencing multiple chronic conditions (Buttorff et al., 2017). African Americans disproportionately face unfavorable social conditions that create greater risk for chronic disease including hypertension, diabetes, and stroke (Cuffee et al., 2012; Fei et al., 2017; Gaskin et al., 2014; Tsao et al., 2022; Williams et al., 2019). Lifestyle interventions yield some promising improvements in clinical outcomes relevant to chronic disease, such as blood * Elizabeth W. Cotter 1 Department of Health Studies, College of Arts and Sciences, American University, 4400 Massachusetts Avenue NW, Washington, DC 20016, USA 2 Wesley Theological Seminary, Washington, DC, USA 13 Vol.:(0123456789) Journal of Religion and Health pressure or dietary choices (Lemacks et al., 2013); however, additional strategies are needed to cultivate broader environmental and systems supports (Kumanyika, 2019), as well as enhance program engagement and retention (Lemacks et al.). To date, faith-based organizations (FBOs) have been an underutilized setting for health promotion (Levin, 2014), although success of these settings in achieving improved health outcomes across a variety of indicators has been shown (Brown et al., 2019; DeHaven et al., 2004; Hardison-Moody & Stallings, 2012; HardisonMoody & Yao, 2019; Whisenant et al., 2014). FBOs are a longstanding source of strength and support in the African American community, making them uniquely positioned to encourage healthy lifestyle modifications (Brewer & Williams, 2019). African Americans are the most likely ethnic group in the United States to report a belief in God, to report that religion is very important in their life, and to attend church services regularly (Pew Research Center, 2020). Indeed, FBOs are frequently described as the hub of the African American community, providing not only opportunities for worship, but also community resources and connections related to education, housing, social support, and food (Brewer & Williams; Mohamed et al., 2021; Williams et al., 1999). Thus, FBOs are familiar, trusted settings for African Americans to receive health information. Moreover, many African Americans perceive a strong connection between their health and spirituality (Holt & McClure, 2006), further highlighting the promise of FBOs in health promotion. Aspects of biblical scripture also align with health promotion, such as the notion of the “body as a temple,” which should be kept healthy, along with the promotion of a more holistic idea of health that considers spiritual, physical, and mental health (Holt & McClure). Faith-based interventions are commonly conducted by a health ministry that connects components of faith with health concepts, often in partnership with health professionals (Allen et al., 2015; Bopp et al., 2012). Their activities support the overall mission of the FBO (Levin, 2014). A central component of many faith-based interventions involves training congregation members to serve as lay health advisors, or “health ministers” (Ammerman et al., 2003; Kim et al., 2008; Lee et al., 2018; Yeary et al., 2011). Health ministers are respected, active members of the church who can facilitate health-based programming and generate interest in participating. Certified health ministers look at policies, systems, and environmental strategies that will support the health of the broader congregation, in addition to identifying the programs that are responsive to the needs and interests of congregants to create positive health outcomes (Health Ministries Association, 2018; Simoni et al., 2011). Utilizing a peer-to-peer approach for health-based programming increases cultural responsiveness and relevance to one’s faith-based community, while also enhancing capacity and sustainability of these programs (Allen et al., 2015; Chaudhary et al., 2019; Newlin et al., 2012). Faith-based intervention strategies implemented by a health ministry include individual-level strategies (e.g., motivational interviewing with congregation members), group-level interventions (e.g., a walking group), and church-level strategies (e.g., providing healthier food offerings at church events) (Lancaster et al.; Wilcox et al., 2010). 13 Journal of Religion and Health The present paper presents the methods and formative research results for “Faithfully Fit,” a faith-based program that aims to create a culture of health and wellness in five FBOs in Washington, DC. Faithfully Fit uses a social ecological framework (Bergeron et al., 2017; Bronfenbrenner, 1981) to improve the management and prevention of chronic disease. A social ecological framework identifies the spheres of influence on behavior, beginning with the individual factors of knowledge and attitudes, expanding to the interpersonal sphere of social relationships, then further expanding to the context of one’s role within the broader environment of organizations including schools, workplaces, faith-based communities, and finally considering systems and policies (Bronfenbrenner). In applying the social ecological model within a faith-based intervention, relevant factors include the individuals connected to the FBO (both members and leadership) and their personal beliefs, knowledge, and practice of health behaviors; the interactions of FBO leaders and members that create the social fabric of each unique place of worship; the physical environment as a place of gathering and community, and the direct and indirect information members receive about health; and finally, the influence of the broa (...truncated)