Promoting Health from the Pulpit: A Process Evaluation of HIV Sermons to Reduce HIV Stigma and Promote Testing in African American and Latino Churches
Promoting Health from the Pulpit: A Process Evaluation of HIV Sermons to Reduce HIV Stigma and Promote Testing in African American and Latino Churches
复制标题
DOI：
10.1080/10410236.2017.1384352
复制
发表时间：
2019-01-02
影响因子：
3.9
通讯作者：
Derose, Kathryn P.
中科院分区：
文献类型：
--
作者：
Payan, Denise D.;Florez, Karen R.;Derose, Kathryn P.
在布道中嵌入健康信息是一种潜在的有价值的战略，可以解决主要服务于种族和少数民族的教会中的艾滋病毒和其他健康差距。这项研究探讨了在加利福尼亚州洛杉矶县艾滋病毒高发区的三个教堂(拉丁裔天主教徒、拉丁裔五旬节派教徒和非裔美国人浸礼会)作为多组成部分干预措施的一部分，艾滋病毒布道的实施情况。神职人员收到了一份艾滋病毒布道指南，其中包括当地公共卫生数据、减少耻辱的线索、艾滋病毒检测信息和一个布道样本。调查结果基于过程评估(即覆盖范围、提供的剂量、保真度和实施)和深入的内容分析，以探索神职人员使用的艾滋病毒框架和信息。布道被录音，逐字转录，并使用归纳法进行编码。通过系统观察收集补充数据。总体而言，五名神职人员向以非裔美国人或拉丁裔为主的听众发表了九次艾滋病毒布道。平均而言，每次布道接触到174名会众。我们发现，在传达布道指南中关键的艾滋病毒信息时，保真度存在很大差异。虽然在讲坛上推动艾滋病毒检测似乎是可行的，所有参与的神职人员都可以接受，但嵌入的明显减少污名的线索更少了。大多数人使用同情和非评判的术语谈论艾滋病毒，然而，不同的神职人员的问题框架各不相同。对神职人员进行有系统的培训可能是必要的，以执行布道指南中包含的更多理论上驱动的减少耻辱的线索。需要对在布道中嵌入特定健康促进信息的可行性和可接受性进行更多的研究。
Embedding health messages into sermons is a potentially valuable strategy to address HIV and other health disparities in churches that predominantly serve racial and ethnic minorities. This study explores implementation of an HIV sermon as part of a multi-component intervention in three churches (Latino Catholic, Latino Pentecostal, and African American Baptist) in high HIV prevalence areas of Los Angeles County, California. Clergy were given an HIV sermon guide that included local public health data, stigma reduction cues, HIV testing messages, and a sample sermon. Findings are based on a process evaluation (i.e., reach, dose delivered, fidelity, and implementation) and in-depth content analysis to explore HIV frames and messages used by clergy. Sermons were audio-recorded, transcribed verbatim, and coded using an inductive approach. Complementary data were collected through systematic observation. Overall, five clergy delivered nine HIV sermons to majority African American or Latino audiences. On average, 174 congregants were reached per sermon. We found large variation in fidelity to communicating key HIV messages from the sermon guide. While promoting HIV testing from the pulpit seemed viable and acceptable to all the participating clergy, fewer embedded explicit stigma reduction cues. Most spoke about HIV using compassionate and non-judgmental terms, however, issue framing varied across clergy. Structured training of clergy may be necessary to implement the more theoretically driven stigma reduction cues included in the sermon guide. More research is needed on the viability and acceptability of embedding specific health promotion messages into sermons.