# Presentation: 695043

## The Glorifying Our Spiritual & Physical Existence for Life (G.O.S.P.E.L.) Program

- Debbie Gold
- Program Manager
- Office of Health Promotion & Substance Abuse Prevention
- Montgomery County Department of
- Health & Human Services
- 240-777-1772

## The History 

- Cigarette Restitution Funds
- Partnership with the Black Minister’s Conference of Montgomery County
- Support of Ministers

## Faith Based Approach

-  “An effective way to reach and educate people with the highest risk of suffering the consequences of tobacco use is for churches to become tobacco prevention and education centers.”
- Source: Tobacco Prevention in the African American Church
- “The combination of the church’s firm standing and its history of taking care of the community – and, of course, its spiritual benefits – make it an important conduit to people who are typically hard to reach by outsiders.”
- Source: “It Is Well With My Soul: Churches And Institutions Collaborating For Public Health”By Reverend Melvin Tuggle

## The Mission

- To increase knowledge
- and awareness among
- African Americans
- regarding health
- disparity issues,
- especially those
- disparities related to
- tobacco use.

## Program Development

- Planning meetings with the Black Minister’s Conference
- Logo created with biblical reference:
- Initial Effort: Display Tables

## Health Promoter Model

- Each church recruited 1- 4 community outreach workers
- Training conducted for outreach team
- Comprehensive training manual
- Table of Contents
- Introduction
- Health Disparities
- Asthma and Lung Disease
- Diabetes
- Smoking Prevention/Cessation
- Cardiovascular
- Infant Mortality
- Stroke
- Obesity/Physical Fitness
- Oral Cancer
- Behavioral Approaches
- Forms and Reporting
- Resource Information

## Monthly Meetings

- Hot Topics – Each month there is a different focus. Topics are discussed, resource material is distributed and supporting activities scheduled.
- Sample topics:
- - Nutrition				- Asthma
- - Heart Health			- Secondhand Smoke
- - Hypertension			- Brown Bag
- - Great American Smokeout	- Motivation
- - Walking Clubs			- Women’s Health

## Presentation Boards

## Evaluation Component

- Partnership with Uniformed Services Center for Health Disparities
- Development and administration of the GOSPEL Cares Survey

## G.O.S.P.E.L. CARES: A HEALTH EDUCATION PROGRAM 

- African Americans experience a greater disease burden and are more likely to die prematurely than Caucasians from problems related to cardiovascular disease (CVD) and diabetes (NHANES, 2002;  Office of Minority Health, 2004). To more effectively address health problems impacting ethnic minorities, researchers, practitioners and public health professionals are realizing the importance of implementing culturally appropriate health programs in community settings such as the church (e.g., Kumanyika & Charleston, 1992; Sbrocco et al., 2005).
- G.O.S.P.E.L. (Glorifying Our Spiritual and Physical Existence for Life) is a community-based health education program developed in 2003 to provide accessible health information to African Americans through their churches, with the goal of reducing health disparities.*  The program is coordinated by the Montgomery County DHHS Office of Health Promotion and Substance Abuse Prevention.  2-4 volunteer health outreach workers per church receive ongoing training from the DHHS.  Monthly meetings focus on a key health topic or theme.  Outreach workers then disseminate topic-related health education materials and organize health education efforts around this theme in their home churches.
- The purpose of the *G.O.S.P.E.L. Cares* survey was to identify the health concerns and interests of G.O.S.P.E.L. program congregations, and to assess church members’ familiarity with G.O.S.P.E.L. initiatives.  This information will be used to inform outreach workers and may help in guiding the choice of programs and information for G.O.S.P.E.L.  Additionally, this survey can be implemented yearly to assess changes in utilization of G.O.S.P.E.L., or changes in the health information needs of program members.

**Discussion**
*G.O.S.P.E.L. Cares* respondents’ self-reported health concerns and interests suggest a continued need for this program.  Although the majority were insured and indicated access to and utilization of health services, self-reported CVD-related risk factors, particularly obesity, hypertension, and hypercholesterolemia were prevalent.  Of note, approximately 24% and 30% of respondents were interested in stress/anxiety and depression, more traditional mental health issues, which have not been customarily addressed in church settings. Also noteworthy, interest in diabetes information far exceeded those reporting a diagnosis of diabetes.  Possibly, individuals may be interested in diabetes in order to help family members manage the disease.   Given the amount of time congregants spent at church and the contribution of modifiable risks to health disparities, there is significant potential benefit to providing health awareness and prevention efforts in the church setting.
- This project represents an important area of investigation and program development because of its content as well as the partnering of community members, public health officials, and scientists. Preliminary results suggest that G.O.S.P.E.L. is a well-utilized, accessible program and an important opportunity for providing community-based health education to African Americans.  Future studies should be conducted to examine longitudinal changes in health knowledge, health interests and health outcomes in G.O.S.P.E.L. church congregations.

***G.O.S.P.E.L. CARES*****: A HEALTH EDUCATION PROGRAM **
**NEEDS ASSESSMENT IN **
**AFRICAN AMERICAN CHURCHES**
- Lauren D. Hill, PhD,1,2 Tracy Sbrocco, PhD,1,2 Jaime R. Lanier, MPH 2, Nicole A. Vaughn, PhD1, Chiao-Wen Hsiao, BS, 1,2
- Dawnavan S. Davis, MS,1 Debbie Gold,BGS,3 Lenora Sherard, MPH3; 1Uniformed Services University of the Health Sciences (USU),
- 2USU Center for Health Disparities Research and Education, 3 Montgomery County DHHS

**Method**
- Researchers from the USU Center for Health Disparities collaborated closely with DHHS and G.O.S.P.E.L. program representatives to design and implement a written survey to assess the health concerns and interests of congregants and the impact of the first year of the G.O.S.P.E.L. program.
- The questionnaire assessed demographic information and a range of health factors including health care access and utilization, health history (including hypertension, diabetes, CVD and obesity), exercise, smoking, stress and depression.  The survey was 16 pages long and took approximately 20 minutes to complete.
- Study participants were adults 18 years and older, who provided confidential, anonymous information.  Participants received $6 in cash for participating.
- Four of the 8 churches comprising the G.O.S.P.E.L. membership elected to participate in the study, which took place during the summer and fall of 2004.  Surveys were administered after church services or special activities (e.g., summer picnic) by teams of USU researchers and G.O.S.P.E.L. outreach workers.

**Results**
- Data from 228 respondents at 4 churches were analyzed for the current investigation.  96% of respondents identified themselves as Black or African American. Respondents’ mean age was 52.13 years (SD = 14.19), and 59% were married.  Approximately 58.8% worked full time, 10.1% worked part-time, and 19.7% were retired. All respondents were non-smokers, although 20% lived with a smoker.
- 95% had some type of health insurance (private 84.2%, public 21.9%).  92% had visited a doctor’s office or clinic within the past year, and 76% reported having a routine physical within the past 12 months. Respondents reported a range of CVD-related health problems as told to them (i.e., diagnosed) by a physician (Table 1).

- Table 1 presents diagnosed health problems (by self-report) and interest for 8 CVD-related health concerns.  Within reported diagnosis and interest, items are ranked with the ranking listed in parentheses.  There was consistency in the rankings with respondents most interested in their diagnosed problems, which included hypertension, high cholesterol, and weight management.
- Despite self-reported height/weight data indicating that 81% were obese or overweight (Figure 1), only 32% had been told by a health care provider that they were overweight or obese (Table 1). Obese respondents (BMI > = 30) were 6.8 times more likely than those who were overweight (BMI 24-29.9), to be told to have overweight/obesity issues by a health care provider (OR = 7.83, 95%CI=3.88-15.78) and were 1.3 times more likely to be interested in overweight/obesity-related health information (OR = 2.28, 95% CI = 1.26,4.11).

- * For information about the G.O.S.P.E.L. Program, contact Debbie Gold, BGS at _[debbie.gold@montgomerycountymd.gov](mailto:debbie.gold@montgomerycountymd.gov)__ or 240-777-1772._
- For more information about the study, contact Lauren D. Hill, PhD at
- _[lhill@usuhs.mil](mailto:lhill@usuhs.mil)__ or 301-295-0864_.

| Table 1. Cardiovascular Disease-related Health Problems Told by Doctors and Health Information Interests |  |  |
| --- | --- | --- |
|  | % with Health Problem Told by MD
% (rank) | % Interested in Health Topics 
% (rank) |
| Hypertension | 53.1% (1) | 49.1% (1) |
| High Cholesterol | 37.7% (2) | 42.5% (2) |
| Overweight/Obesity | 31.6% (3) | 42.1% (3) |
| Diabetes | 19.7% (4) | 36.0% (4) |
| Stress/Anxiety | 12.3% (5) | 30.7% (5) |
| Depression | 9.6% (6) | 24.1% (7) |
| Heart Problems | 7.0% (7) | 25.4% (6) |
| Stroke | 6.1% (8) | 18.4% (8) |
|  |  |  |

- G.O.S.P.E.L. program outreach workers at a monthly meeting

## Continued Outreach Worker Training

- Nutrition Training
- Asthma
- Tobacco Prevention
- Toxic Soup
- Cessation Coaching
- Motivation
- Blood Pressure Measurement

## Creative Approaches

- Smoking Jeopardy
- Blood Pressure Jeopardy
- FAITH Bingo
- Wheel of Faith

## FAITH Bingo

## EVENTS

- Great American Smokeout
- Nutrition Demonstrations
- Grocery Store Diabetes Education Tours
- Heart Health Symposium
- Diabetes Symposium
- Walking Clubs
- Quit Kit Distribution
- Brown Bag Event

## For More information

- Debbie Gold
- Program Manager
- Office of Health Promotion & Substance Abuse Prevention
- Montgomery County Department of
- Health & Human Services
- debbie.gold@montgomerycountymd.gov
- 240-777-1772