Population and Setting. The study involved 889 participants from 303 churches in South Carolina. The participants were at least 18 years old and attended church services at least twice a month at baseline. Individuals (n=889) from 303 churches (170 immediate and 133 delayed) were trained.
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Theory (or theories) the Intervention was Based on. The study intervention was based on two theoretic models: the social ecology model and the transtheoretical model. The social ecology model was used because it effectively captures the process by which members of the church minister to each other. Moreover, it has been shown in previous studies that in some cases, the intervention ministered by peers is more effective than intervention given by professionals. The study also used the transtheoretical model to ensure that the intervention reached all members of the congregation.
Intervention Description. The study used the community-based participatory research (CBPR) approach wherein members of the congregation or church were trained to administer the interventions to the participants.
Randomly chosen African Methodist Episcopal churches were given training in the programme either immediately or after one year. The researchers gave the participating churches messages that were to be incorporated in the Pastor’s sermons and displayed on bulletin boards, announcement pages and other media in order to widen the reach of the programme. They likewise adapted a 10-minute exercise CD that was originally designed for use at worksites and made it suitable for church settings. Additionally, they encouraged the churches to set policies that would encourage the members to favour healthy food choices and physical activity.
The researchers conducted an 8-week volunteer-led programme to teach physical activity and healthy eating to the participants and developed action-oriented programmes to meet the diverse interests and abilities of the congregation.
Research Design. The study used a randomized design with a delayed intervention control group.
Measure(s) of Physical Activity. The study used the Behavioral Risk Factor Surveillance System (BRFSS) physical activity module to measure the intensity of the participants’ physical activity and to find out the proportion of participants who meet the recommendations of the Centers for Disease Control and Prevention–American College of Sports Medicine.
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Measure(s) of Theoretical & other Psychological Constructs. Behaviour Change Consortium algorithm was used to measure the change in the stage of readiness for physical activity.
A survey questionnaire was used to measure the respondents’ awareness of and participation in the programme, the participants’ interest in joining physical activity programmes, whether or not the participants were encouraged by members of their church to join exercise programmes, the Pastor’s support, as well as whether the church implemented or was implementing the programmes.
Results. Among survey respondents, there was no significant increase in physical activity despite the fact that 67% of the respondents were aware of the programme. Support from the church Pastoral was found to be significantly associated with physical activity.
Limitations of the article mentioned by the authors. The study authors stated several limitations of the study. These include a higher attrition rate than planned, limited generalizability of the study, training not received on time by some of the participating churches, inability to conduct a detailed process evaluation, use of conservative assessment approach, and reduced statistical power. The study design — delayed intervention — was also viewed to be less than ideal for the study.
Limitations of the article NOT mentioned by the authors. Modelling was not mentioned in the study as a possible limitation. Even if the Pastor or the trained members of the congregation verbally promoted the programme, if they did not actually demonstrate adherence to the programme (meaning, they did not lead by example), the programme is deemed to fail. The selection of leaders to train should have included criteria that required the participants to be physically active and into healthy nutrition.
Wilcox, Sara, et al. “Increasing Physical Activity Among Church Members.” American Journal of Preventive Medicine, vol. 32, no. 2, 2007, pp. 131–38. Crossref, doi:10.1016/j.amepre.2006.10.009.