iA transdisciplinary heaith disparities research team in ACCN will partner with churches in the 5-state ACCN region to refine and test a previously piloted faith-based intervention program, 'Walk by Faith,' to address obesity by focusing on environmental and individual level changes. Community-based participatory research strategies will be used in all phases of this inten/ention that will target two behavioral causes of obesity, a sedentary lifestyle, and an unhealthy diet. The proposed project will be implemented in 5 Appalachian regions which are mainly rural, have medically underserved populations characterized by low incomes, deficits in education, poor health, increased rates of obesity, and increased cancer incidence and mortality rates. Additionally, adults living in these areas have higher rates of no leisure activity and higher rates of eating less than 5 servings of fruits and vegetables daily compared to adults living in the U.S. In addition to individual causes of obesity, an obesogenic environment promotes obesity on a population level by encouraging physical inactivity and limiting healthy food choices. The goal of the application is to test a faithbased intervention from 10 intervention churches compared to a comparison program (cancer screening tests) in 10 additional churches.
The specific aims ofthis proposal are to: 1) Refine a previously piloted faith-based intervention focused on environmental and individual level changes to increase physical activity and to improve consumption of healthy food choices among members of male and female church members; 2) implement and test the intervention program, using a group-randomized design, to decrease BMI among members of 10 randomly selected churches vs. a comparison condition in 10 churches; 3) Utilize process and outcome evaluation strategies to assess the effectiveness of the different components of the intervention, including an ehealth computer program that will track the number of steps per day and provide tailored message and letters to intervention participants; and 4) utilize the results to plan the dissemination of the inten/ention to churches located in other Appalachian states. The results of this proposed project will have immediate impact among the members of participating churches and the successful strategies could be used to improve the health of residents of other Appalachian states in the future.