Faith, Activity, and Nutrition: Dissemination in Underserved Communities

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DESCRIPTION (provided by applicant): Together, physical inactivity and poor diet make up the second leading modifiable cause of death in the US. Racial disparities in these behaviors and associated health outcomes present major public health challenges. The specific aims of the USC PRC for 2014-2019 build on a long and successful history of applied research and practice in underserved communities: 1) grow the Center infrastructure; 2) engage communities, state and local health departments, and other stakeholders to inform our activities; 3) implement an integrated set of strategies to disseminate Center research findings, products, and programs; 4) contribute to the development of skilled community members and public health professionals through training and technical assistance; 5) evaluate Center activities and outcomes; and 6) conduct an applied public health prevention research project. Achievement of these aims will lead to the following long-term outcomes: 1) increased translation of research into practice and policy; 2) improved environmental and system-wide strategies; 3) widespread use of evidence-based programs and policies; 4) enhanced community capacity for health promotion and disease prevention; 5) increased skilled public health professionals and community members; 6) expanded resources for applied public health research; and 7) increased recognition of and support for USC PRC research and activities. The USC PRC's applied research project will study the dissemination and implementation of an evidence-based program shown previously to significantly increase physical activity and fruit and vegetable intake in churches in South Carolina (Faith, Activity, and Nutrition; FAN). Guided by two theoretical frameworks, the specific aims of the applied research project are to: 1) examine the adoption and reach of FAN in churches and organizational factors associated with adoption; 2) characterize implementation fidelity and multilevel factors associated with implementation; 3) describe organizational maintenance of FAN and factors associated with maintenance; and 4) study the effectiveness of FAN. In Phase 1, we will randomize churches in a rural county with a high proportion of African American residents to receive training in FAN from a community health advisor (n=40) or to be part of a delayed intervention control group (n=20). This phase will allow us to study dissemination and implementation in a range of diverse religious denominations and gain greater understanding of how local coalitions can reach faith-based communities as settings for intervention. In Phase 2, we will work with two large faith denominations in SC, including one that is predominantly African American, to disseminate the program statewide. This phase will allow us to identify key considerations in program dissemination, adoption, and implementation and to examine the potential for broader geographic dissemination. Increasing physical activity and fruit and vegetable consumption are important goals of the CDC's Winnable Battles and the National Center for Chronic Disease Prevention and Health Promotion's environmental approach to preventing chronic disease and promoting health.