Abstract B28: Outcomes from a statewide dissemination of an evidence-based, community-engaging wellness program for African American churches
Authors: Crookes Danielle M. , González Evelyn , Gaston Serina , Fleisher Linda 
Published: December 2010

Abstract
As more research and public attention shifts to the impact of the obesity epidemic on cancer and chronic disease rates, researchers and policy makers need to ensure that the public has access to evidence-based programs that promote healthier lifestyles. The Body & Soul Program, an evidence-based program which has previously undergone efficacy and effectiveness studies, promotes the increased consumption of fruits and vegetables in African American churches and has been shown to increase this consumption by approximately one serving per day. The program is built on four required pillars (pastoral involvement, educational activities, changes to church environment and peer counseling), and also supports church ownership and program sustainability by encouraging church autonomy over how those pillars are satisfied.
Building on this previous research, Fox Chase Cancer Center, with funding from the Pennsylvania Department of Health, has coordinated and evaluated an ongoing statewide dissemination of Body & Soul. Dubbed Pennsylvania Body & Soul, this statewide dissemination has operated in three phases - Phase 1 (2006-2008), a feasibility pilot conducted to determine technical assistance and church needs; Phase 2 (2008-2010), the primary dissemination phase which is reported here; and Phase 3 (2010 - present), which will support ongoing dissemination to additional sites.
In Phase 2, churches were linked with a community partner that could provide day-to-day program assistance, as well as were provided training, mini-grant funding, and ongoing technical assistance and training. Churches were required to conduct Body & Soul activities for six months and participate in program evaluation, which included pastor surveys, monthly activity reports and key informant interviews. Some churches also opted to administer anonymous pre-post health questionnaires to track the program's impact on congregation-level health behavior change.
At the close of Phase 2, Pennsylvania Body & Soul reached 39 churches in 13 counties, over 5 of the 6 Pennsylvania Health Districts. Churches have ranged in size (5 to 2700+ members), geographic location (rural and urban) and age (newborn to elderly). Examples of church activities have included sermon series from pastors, healthy snack giveaways at church services and the introduction of heart healthy meal options for large church gatherings. We have classified the degree of church implementation into a three-tier system based on the number of program pillars satisfied, the number of church events held and if the church established a policy change on healthy eating and living. As a result, three categories of church implementation have been identified -minimum adoption, average adoption and high-level adoption; 28% of churches were minimum-adopters, 33% were average adopters and 38% were high-level adopters. Analysis on congregation-level behavior change is ongoing.
Despite differences in implementation, a majority of churches reported liking the program and intend to continue the program at their own pace. We conclude that church adoption of the program has been facilitated by funding, training, and ongoing technical assistance. Increased success will need to be supported by a better understanding of church readiness, as well as additional in-depth, skill-building trainings for church leaders.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B28.