The Black Church and CVD: Are We Our Brother's Keeper? seeks to investigate if the use of scripture,sermon, prayer, and song by rural Black churches as cultural tools: (1) accounts for the effectiveness of achurch-based, social support intervention that is guided by male lay health advisors, called Navigators, and alocal health department chronic disease nurse in improving African American men's adherence to their CVDcare plan; and (2) moderates the influences of social support from Navigators and the nurse on men'sbehaviors to manage and control CVD. The study involves three phases, which are described in thefollowing specific aims.
Aim 1 : Characterize and measure variation in the use of current cultural tools by 26 rural Black churches ofOrange County, NC by clergy demographics, Sunday congregation attendance, and type of communityservice activities through a telephone survey with 260 clergy and laity.
Aim 2 : Identify the meanings and impetus for expressing and exchanging social support transferred bycurrent cultural tools, used by rural Black churches, to African American men, ill with CVD throughethnographic participant observation in three representative churches and critical incident techniqueinterviews with 45 African American men, who have been diagnosed with CVD.
Aim 3 : Design, implement, and evaluate a 12-month lay health advisory intervention within the three largestBlack church congregations in northern Orange County, with a fourth Black church serving as a comparison,in partnership with the chronic disease nurse of Orange County Health Department. Six men will be trainedas Navigators to: screen 60 men in their congregation at risk for CVD; refer men diagnosed with CVD tohealth resources; provide them with physical activity and nutrition education; organize 'men's healthchallenge' activities to disseminate CVD-related messages through scripture, sermon, prayer, and song; andmonitor their adherence to their prescribed CVD care plan. The primary outcome, increased proportion ofmen adhering to their CVD care plans, and secondary outcomes, improved social support, sense of mastery,and help seeking to manage and control their CVD, will be measured using a quasi-experimental cohortstudy design. To detect the moderating effects of the intervention and comparison Black churches' use ofcultural tools, a pre-/post- intervention cross-section study design will measure frequency of integration of theimportance and support of men's help seeking for health through: sacred scripture in worship and teaching,spirituals or gospel music in regular worship service, prayer or meditation group activities, references insermons, and community service activities.
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