Sara Wilcox1, Ruth P Saunders2, Andrew T Kaczynski2, Melinda Forthofer3, Patricia A Sharpe4, Cheryl Goodwin5, Margaret Condrasky6, Vernon L Kennedy5, Danielle E Jake-Schoffman7, Deborah Kinnard4, Brent Hutto4. 1. Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. Electronic address: wilcoxs@mailbox.sc.edu. 2. Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. 3. Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina. 4. Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina. 5. Fairfield Behavioral Health Services, Winnsboro, South Carolina. 6. Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, South Carolina. 7. Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Abstract
INTRODUCTION: Faith-based organizations can contribute to improving population health, but few dissemination and implementation studies exist. This paper reports countywide adoption, reach, and effectiveness from the Faith, Activity, and Nutrition dissemination and implementation study. DESIGN: This was a group-randomized trial. Data were collected in 2016. Statistical analyses were conducted in 2017. SETTING/PARTICIPANTS: Churches in a rural, medically underserved county in South Carolina were invited to enroll, and attendees of enrolled churches were invited to complete questionnaires (n=1,308 participated). INTERVENTION: Churches (n=59) were randomized to an intervention or control (delayed intervention) condition. Church committees attended training focused on creating opportunities, setting guidelines/policies, sharing messages, and engaging pastors for physical activity (PA) and healthy eating (HE). Churches also received 12 months of telephone-based technical assistance. Community health advisors provided the training and technical assistance. MAIN OUTCOMES MEASURES: The Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided measurement of adoption and reach. To assess effectiveness, church attendees completed post-test only questionnaires of perceptions of church environment, PA and fruit and vegetable (FV) self-efficacy, FV intake, and PA. Regression models controlled for church clustering and predominant race of congregation, as well as member age, gender, education, and self-reported cancer diagnosis. RESULTS: Church adoption was 42% (55/132). Estimated reach was 3,527, representing 42% of regular church attendees and 15% of county residents. Intervention church attendees reported greater church-level PA opportunities, PA and HE messages, and PA and HE pastor support (p<0.0001), but not FV opportunities (p=0.07). PA self-efficacy (p=0.07) and FV self-efficacy (p=0.21) were not significantly higher in attendees of intervention versus control churches. The proportion of inactive attendees was lower in intervention versus control churches (p=0.02). The proportion meeting FV (p=0.27) and PA guidelines (p=0.32) did not differ by group. CONCLUSIONS: This innovative dissemination and implementation study had high adoption and reach with favorable environmental impacts, positioning it for broader dissemination. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02868866.
RCT Entities:
INTRODUCTION: Faith-based organizations can contribute to improving population health, but few dissemination and implementation studies exist. This paper reports countywide adoption, reach, and effectiveness from the Faith, Activity, and Nutrition dissemination and implementation study. DESIGN: This was a group-randomized trial. Data were collected in 2016. Statistical analyses were conducted in 2017. SETTING/PARTICIPANTS: Churches in a rural, medically underserved county in South Carolina were invited to enroll, and attendees of enrolled churches were invited to complete questionnaires (n=1,308 participated). INTERVENTION: Churches (n=59) were randomized to an intervention or control (delayed intervention) condition. Church committees attended training focused on creating opportunities, setting guidelines/policies, sharing messages, and engaging pastors for physical activity (PA) and healthy eating (HE). Churches also received 12 months of telephone-based technical assistance. Community health advisors provided the training and technical assistance. MAIN OUTCOMES MEASURES: The Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework guided measurement of adoption and reach. To assess effectiveness, church attendees completed post-test only questionnaires of perceptions of church environment, PA and fruit and vegetable (FV) self-efficacy, FV intake, and PA. Regression models controlled for church clustering and predominant race of congregation, as well as member age, gender, education, and self-reported cancer diagnosis. RESULTS: Church adoption was 42% (55/132). Estimated reach was 3,527, representing 42% of regular church attendees and 15% of county residents. Intervention church attendees reported greater church-level PA opportunities, PA and HE messages, and PA and HE pastor support (p<0.0001), but not FV opportunities (p=0.07). PA self-efficacy (p=0.07) and FV self-efficacy (p=0.21) were not significantly higher in attendees of intervention versus control churches. The proportion of inactive attendees was lower in intervention versus control churches (p=0.02). The proportion meeting FV (p=0.27) and PA guidelines (p=0.32) did not differ by group. CONCLUSIONS: This innovative dissemination and implementation study had high adoption and reach with favorable environmental impacts, positioning it for broader dissemination. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02868866.
Authors: Sara Wilcox; Marilyn Laken; Allen W Parrott; Margaret Condrasky; Ruth Saunders; Cheryl L Addy; Rebecca Evans; Meghan Baruth; May Samuel Journal: Contemp Clin Trials Date: 2010-03-30 Impact factor: 2.226
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Authors: Ruth P Saunders; Sara Wilcox; Danielle E Jake-Schoffman; Deborah Kinnard; Brent Hutto; Melinda Forthofer; Andrew T Kaczynski Journal: Health Educ Behav Date: 2018-12-21
Authors: John A Bernhart; Elizabeth A La Valley; Andrew T Kaczynski; Sara Wilcox; Danielle E Jake-Schoffman; Nathan Peters; Caroline G Dunn; Brent Hutto Journal: J Relig Health Date: 2020-04
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Authors: Megan A McVay; Kellie B Cooper; Marissa L Donahue; Montserrat Carrera Seoane; Nipa R Shah; Fern Webb; Michael Perri; Danielle E Jake-Schoffman Journal: Obes Sci Pract Date: 2022-02-23
Authors: Penny A Ralston; Kandauda K A S Wickrama; Catherine C Coccia; Jennifer L Lemacks; Iris M Young-Clark; Jasminka Z Ilich Journal: Am J Prev Med Date: 2019-12-19 Impact factor: 5.043
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Authors: John A Bernhart; Marilyn E Wende; Andrew T Kaczynski; Sara Wilcox; Caroline G Dunn; Brent Hutto Journal: J Public Health Manag Pract Date: 2022 Jan-Feb 01