Empowered CHOICES! A Faith-Based Community Intervention

Background and Purpose This presentation will describe an intervention to improve cardio-vascular health in African American communities by engaging Black churches and the Association of Black Cardiologists, Inc. in a faith-based coalition. In this partnership, Black churches in a southwest city implemented Changing Health Outcomes by Improving Cardiovascular Education and Screenings (CHOICES), an American Heart Association intervention, to measure results ranging from increased CVD knowledge and awareness to improved health outcomes. The presentation examines how the coalition fostered systemic change through building self-efficacy, empowerment, and community mobilization using culturally competent practices and engaging existing, credible, embedded community structures. Methods The investigation targeted four questions: (1) does training congregation members as Health Promotion Specialists (HPS) increase program success; (2) Does training HPS increase sustainability; (3) Do shared faith and positive peer pressure enhance behavioral changes, and (4) Does a Bible-based CVD intervention increase knowledge of CVD risk factors and their reduction. Employing a standard research design (a pre-test and two post-tests), investigators used attitudinal, behavioral, and biomedical indicators to measure program goals and overall effectiveness including a standardized questionnaire (i.e., HRAF-S) that self–reported general health status; nutrition knowledge; knowledge of various elements of cardio-vascular disease and prevention and diabetes; and, demographic characteristics. Body mass index and blood pressure were measured. During the final session of the program, participants completed post-tests to measure attitudinal effects, behavioral changes, blood pressure, blood glucose, and cholesterol to compare with baseline values. Follow-up assessments at 12 weeks included blood pressure, blood glucose, and cholesterol measurements. The health risk and behavioral assessment, originally administered at weeks 1 and 9, was re-administered. Results Marked increases in health related knowledge from week 1 to week 9 included positive changes in health behaviors and health-related knowledge and physical activity frequency. The number of individuals reporting a personal health care provider rose from 80% to 90%. Knowledge levels improved in both hypertension and cholesterol categories. Changes in health-related behaviors improved, especially in health-seeking efforts. Biomedical marker analysis also revealed trends in the anticipated, positive direction. Results demonstrated that a faith-based CV intervention program can be successfully implemented through Black churches. Conclusions The foundation of CHOICES is the training and empowerment of lay health educators, a model stressing community engagement and empowerment. Intersections of faith and health empowerment in the African American community identify ways to work from the inside out to create a healthier lifestyle and physical well-being. Coalitions and providers held conversations with community leaders to learn about healthcare issues. Implications for Practice Black culture offers provocative insights into the reality of Black community health revealing the need for increased emphasis on interpersonal communication while examining how race, ethnicity, and gender impact health promotion. Discussions about practice topics will include: (1) cultural competence in all interactions; (2) clear understanding of gendered roles; (3) outreach to interest centers; and, (4) coalition building among embedded structures. Coalitions can create space for wellness and social workers should broker coalition-building among industry, government, and organizations.