Engaging in regular physical activity (PA) contributes to positive health outcomes, including longevity, better quality of life, and reduced incidence of cardiovascular diseases, diabetes, depression, certain cancers, and obesity; however, only a minority of U.S. adults meet the minimum guidelines for moderate to vigorous PA (MVPA), and Latinos are less likely than whites to report meeting the guidelines. Public parks comprise local infrastructure that can be leveraged for community PA, but tend to be underutilized, particularly in low-income communities. Parks in low-income and minority communities tend to have less PA programming, especially targeting adults, and higher crime and other factors that affect park use. There is a need for interventions that address community concerns, target the built environment, and ?activate? park use. Churches are credible, stable entities that have significant reach within Latino communities and a history of social service provision and advocacy related to health and well-being. Our research has found that church-based interventions can be effective across a wide range of health issues and types of churches. We propose to combine approaches from our team's extensive prior work with churches and parks to conduct a cluster randomized controlled trial of a multi-level intervention that links Latino Catholic churches (n=12) with their local parks to increase PA among Latino parishioners (n=1500) in Los Angeles.
The specific aims are to: (1) Examine the impact of a multi-level church-based intervention that links Catholic parishes to their local parks on Latino parishioners' PA and health-related outcomes (effects on parishioners' MVPA and self-reported PA, heart rate/fitness, waist circumference, waist to hip ratio, body fat, mental health, and perceived social support for PA); (2) Explore differences in the effectiveness of the intervention by gender; and (3) Evaluate factors associated with intervention implementation (facilitators, barriers, fidelity, and replication costs) for future dissemination. Our approach targets multiple levels to promote health-enhancing PA through park-based fitness classes led by kinesiology students, peer leader-led walking groups, park-based church events, and church-based PA support activities. It integrates churches' vast social networks, moral authority, and influence with parks' structural and organizational capacity and kinesiology student interns' professional expertise. The intervention makes use of innovative partnerships within and across sectors ? faith-based, local parks/city government, and local universities. Our inter-sectoral, collaborative approach makes our intervention scalable and sustainable in real- world settings and incorporates action at multiple levels (individuals, churches, and neighborhoods). To our knowledge, this will be the first study to examine the effectiveness of an integrated church and park-based intervention on Latinos' PA, and it will provide a sustainable model of PA programming in low-income communities. If the intervention proves effective, the increased community capacity through this partnership will lay the groundwork for scale-up across the largest diocese in the U.S. and, potentially, the nation.

Public Health Relevance

We propose a cluster randomized controlled trial of a multi-level intervention that links Latino Catholic churches (n=12) with their local parks to increase physical activity among Latino parishioners (n=1500) in Los Angeles. The study will examine the impact of the intervention on Latino parishioners' PA and health-related outcomes; explore differences in the intervention's effectiveness by gender; and evaluate factors associated with implementation for future dissemination. If successful, the intervention has the potential for sustainability and scale-up across the largest diocese in the U.S. and potentially across the nation.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA218188-02
Application #
9693690
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Perna, Frank
Project Start
2018-05-02
Project End
2023-04-30
Budget Start
2019-05-01
Budget End
2020-04-30
Support Year
2
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
006914071
City
Santa Monica
State
CA
Country
United States
Zip Code
90401