Physical activity (PA) has been shown to decrease the risk of chronic disease outcomes that affect a large proportion of the African American community. Despite known benefits, PA is low among African American women. Additional work is needed to identify successful strategies for increasing and maintaining participation in PA, particularly among populations with the highest prevalence of poor health outcomes associated with non- or low participation in health-related behaviors. Churches are central in the African American community for spiritual guidance as well as a source of communication, social support, and networking and are recognized as an ideal setting for health education and health promotion efforts. Several studies have been conducted within churches to increase physical activity levels among African Americans and have shown promise for promoting health behaviors. However, the specific mechanisms by which tenets of faith operate to impact constructs within established behavior change theories have not been adequately elucidated. In addition, it is not clear whether a faith-based intervention is more appropriate than other strategies for maintaining changes in behavior after an intensive intervention. The goal for the proposed study is to determine the impact of strategies for increasing and maintaining levels of PA in church settings. Sedentary African American women (>18 years), with no risk factors for adverse outcomes associated with increasing daily PA, will be recruited and randomized to one of three conditions-a faith-based intervention, a non-faith-based intervention, or a control. We will recruit 480 participants from 24 churches. Randomization to intervention conditions will occur at the church level. Both active interventions will include 24 group-based sessions, which will begin with weekly sessions (n = 16 sessions), and then phase to less frequent contact with bi-weekly sessions (n = 4 sessions) and monthly sessions (n = 4 sessions). Participants in the control group will receive standard educational material encouraging participation in daily physical activity. Follow-up data will be measured immediately after the 24 sessions and one year after randomization to determine immediate and sustained changes in PA behaviors. The primary outcome of interest is change in steps/day. Secondary outcomes of interest include daily moderate-to-vigorous PA, meeting national PA recommendations, body mass index, and health-related quality of life. For outcomes of interest, we will compare the effect of the active intervention with the control group. We expect treatment effects to emerge such that assignment to either of the active interventions is associated with greater changes in outcomes of interest compared to the control group. We will also evaluate the mechanisms by which a faith-based intervention impacts constructs in the proposed conceptual model to promote increases in daily physical activity, and we further hypothesize that changes in the faith-based intervention group will be greater than changes in the non-faith-based intervention group.
This project is relevant because it addresses a significant public health issue-increasing physical activity levels among African American women in community-based and culturally relevant settings, a segment of the population most in need of interventions focused on decreasing risk factors associated with chronic disease. If successful, the proposed project will add to existing literature by describing an approach that is successful for initiating and sustaining change in a behavior that is a risk factor for various health outcomes associated with low levels of physical activity.
