Examining Faith-Based Communities As Leverage Points For The Prevention Of Childhood And Adolescent Obesity

Faith-based research and partnerships are becoming more popular as an approach to address the health of underserved populations including racial and ethnic minorities and rural populations. Despite growing interest in faith-health partnerships, little research is available assessing faith-based interventions as potential leverage points for the prevention of childhood and adolescent obesity and the promotion of healthy behaviors. This research aimed to examine the potential for such partnerships within the context of ongoing research partnerships in South Carolina. Specifically, the first study assessed current peer-reviewed literature to determine reporting of reach, effectiveness, adoption, implementation, and maintenance (RE-AIM elements) in faith-based nutrition and physical activity interventions; the second study used qualitative interviews to explore church leaders’ perspectives on the role of the church in health promotion for children; and the final study included a content analysis of planned and implemented activities from an ongoing faith-based partnership with the potential to impact children’s health. Findings from the systematic review of literature (n=38 interventions) show that most faith-based interventions are conceptualized and implemented at the individual/interpersonal level and few included organizational interventions such as policy or environmental change. Only three interventions included outcome measurements in children or youth. Most interventions did not provide sufficient information about REAIM elements for dissemination or implementation in community settings, emphasizing vi the need for future faith-based interventions to report on considerations for translating such evidence-based programs into health promotion practice for all ages. Findings from interviews (n=26) with church leaders showed that leaders identify important connections between physical and spiritual health for children, and identified several ways that churches could be involved in health promotion. Leaders were concerned about multiple health issues in children and youth and identified potential and ongoing approaches to impact health behaviors. Leaders spoke about opportunities for healthy and unhealthy behaviors in the church environment, the importance of role models, potential partnerships between the church and health experts, and the importance of tailoring health promotion programming to align with church goals. Assessment of proposed health-promotion activities (n=1,498) from program plans suggest that churches (n=53) enrolled in an ongoing faith-based health promotion program most often plan activities to impact the entire church population, including children and youth. Fourteen percent of planned activities specifically targeted children and youth and were built in to existing church events such as Sunday School or Vacation Bible School. Ecologically-based interventions have the potential to reach children and youth. Intervention training materials should include references to this population, and churches should be encouraged to consider children and youth when planning health intervention activities. Faith-based organizations have been acknowledged as important partners in health promotion efforts and are uniquely positioned to address childhood health behaviors such as healthy eating and physical activity, which may reduce childhood vii obesity. This dissertation highlights interest from and opportunities in faith-based settings to address children’s health behaviors. These results also provide a foundation for future research and public health interventions through a theoretically-framed examination and support the need to expand intervention and evaluation efforts for children and youth in faith-based health promotio