Building on a 3-yr partnership, the Palmetto Conference of the AME Church and three state Universities in South Carolina will partner for this study. The specific study aims are to: (1) use a community-based participatory research (CBPR) approach to engage church leaders in developing a combined physical activity (PA) and nutrition intervention, (2) test the 18-mo intervention that targets social, cultural, and policy influences within the church, (3) assess the role of pastor support of and participation in the intervention, and (4) disseminate the program across the state and more broadly. A CBPR approach will guide all study activities. Representatives from each partnering organization will participate in monthly planning meetings in year 1. The logic model will be used to build consensus about the scope of the program, process evaluation, and project management. Two waves of interventions will be conducted, beginning in year 2. In total, 13 clusters of churches (60 churches within them) will be randomized to an immediate or delayed intervention. The 18-month intervention, based on social ecology and the trans-theoretical model, will target the social, cultural, and policy environments within the church to support increased PA and the DASH diet (low fat and sodium, high F&Vs and grains). Local health committees and key church decision makers (pastors and church cooks) will be trained to implement the program. Primary outcomes, measured at baseline and 18- months, are blood pressure (SBP, DBP), PA (self-reported mins/wk);and F&V consumption (svgs/d). Secondary outcomes are PA (accelerometer mins/wk), fat and fiber-related behaviors, and stage of change. A total of 15 participants from 18 small churches, 25 participants from 30 medium churches, and 50 participants from 12 large churches will be recruited for measurements (N = 1620). Accelerometer readings will be collected from a sub-sample (N = 620), and a comprehensive process evaluation will be conducted. Faith-university partnerships provide a way to deliver health promotion messages in a culturally and ethnically relevant manner. Interventions that result from these partnerships have great potential to contribute to eliminating health disparities, a Healthy People 2010 objective. The inclusion of PA, use of a CBPR approach, engagement of church decision makers, and focus on the church's social, cultural, and policy influences make this project innovative.
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