Implementation of a faith-based physical activity intervention: insights from church health directors.

Churches are becoming increasingly popular settings for conducting health promotion programs. Retrospective interviews were conducted with 19 health directors from churches taking part in the evaluation of a large-scale faith-based physical activity initiative. This paper first describes program implementation, church leadership support, and changes in church leadership, and then relates these variables to program outcomes (percentage of participants meeting physical activity recommendations). Finally, barriers and successes to program implementation are reported. The most commonly reported intervention activities implemented by churches were bulletin boards related to healthy eating and physical activity (79%) followed by bulletin inserts (69%), walking programs (58%), chair exercises (48%), praise aerobics (27%), a 10-min exercise CD (26%), and an 8 week behavior change class (26%). Significant increases in physical activity were associated with churches which had ever implemented the behavior change class at the 1-year follow-up. According to health directors, pastors sometimes to often spoke about physical activity and diet from the pulpit but rarely to sometimes took part in program activities. They also reported that pastors spouses' never to rarely spoke about physical activity and diet from the pulpit, and rarely to sometimes took part in program activities. About 68% of the churches had at least one change in pastor over the 3-year study. A majority of these variables, however, were not related to changes in physical activity. Potential reasons for these lack of associations are discussed.