Jannette Berkley-Patton

Taking it to the Pews: A CBPR-Guided HIV Awareness and Screening Project with Black Churches

Utilizing a community-based participatory research (CBPR) approach is a potentially effective strategy for exploring the development, implementation, and evaluation of HIV interventions in African American churches. This CBPR-guided study describes a church-based HIV awareness and screening intervention (Taking It to the Pews [TIPS]) that fully involved African American church leaders in all phases of the research project. Findings from the implementation and evaluation phases indicated that church leaders delivered TIPS Tool Kit activities on an ongoing basis (about twice a month) over a 9-month period. TIPS church members were highly exposed to TIPS activities (e.g., 91% reported receiving HIV educational brochures, 84% heard a sermon about HIV). Most (87%) believed that the church should talk about HIV, and 77% believed that the church should offer HIV screening. These findings suggest that implementing an HIV intervention in Black church settings is achievable, particularly when a CBPR approach is used.

Assessment of HIV-related stigma in a US faith-based HIV education and testing intervention

The African American church is a highly influential institution with the potential to greatly increase the reach of HIV prevention interventions and address HIV‐related stigma in US African American communities. However, there are few studies on HIV‐related stigma and African American church populations. This study explored HIV‐related stigma among church and community members participating in an HIV education and testing intervention pilot study in African American churches, named Taking It to the Pews.

FACTORS RELATED TO HIV TESTING AMONG AN AFRICAN AMERICAN CHURCH-AFFILIATED POPULATION

HIV continues to disproportionately impact communities of color, and more calls are being extended to African American churches to assist in HIV education and screening efforts. However, no studies have reported on the HIV testing practices of African American church-affiliated persons. This study examines demographic, social, and behavioral factors associated with ever receiving an HIV test and last 12-month HIV testing. Findings indicated not having insurance and condom use were predictors of ever receiving an HIV test. Predictors of HIV testing in the last 12 months included marital status (i.e., single, divorced, separated, or widowed) and intentions to get tested for HIV in the near future. These predictors should be considered when designing HIV education and screening interventions for African American church settings.

Patient communication tools to enhance ART adherence counseling in low and high resource settings

OBJECTIVE Few articles have examined specific counseling tools used to increase antiretroviral therapy (ART) adherence. We present communication tools used in the context of Project MOTIV8, a randomized clinical trial. METHODS We developed, piloted, and evaluated pictorial images to communicate the importance of consistent dose timing and the concept of drug resistance. Electronic drug monitoring (EDM) review was also used to provide visual feedback and facilitate problem solving discussions. Adherence knowledge of all participants (n=204) was assessed at baseline and 48 weeks. Participant satisfaction with counseling was also assessed. RESULTS Adherence knowledge did not differ at baseline, however, at 48 weeks, intervention participants demonstrated significantly increased knowledge compared to controls F(1, 172)=10.76, p=0.001 (12.4% increase among intervention participants and 1.8% decrease among controls). Counselors reported that the tools were well-received, and 80% of participants felt the counseling helped them adhere to their medications. CONCLUSIONS Counseling tools were both positively received and effective in increasing ART adherence knowledge among a diverse population. PRACTICE IMPLICATIONS While developed for research, these counseling tools can be implemented into clinical practice to help patients; particularly those with lower levels of education or limited abstract thinking skills to understand medical concepts related to ART adherence.

Religiosity and risky sexual behaviors among an African American church-based population.

African Americans are disproportionately burdened by STDs and HIV in the US. This study examined the relationships between demographics, religiosity, and sexual risk behaviors among 255 adult African American church-based participants. Although participants were highly religious, they reported an average of seven lifetime sex partners and most inconsistently used condoms. Several demographic variables and religiosity significantly predicted lifetime HIV-related risk factors. Taken together, findings indicated that this population is at risk for HIV. Future research should continue to identify correlates of risky sexual behavior among African American parishioners to facilitate the development of HIV risk reduction interventions in their church settings.

African American smokers' intention to use pharmacotherapy for cessation

OBJECTIVES To use the theory of planned behavior to identify predictors of intentions to use cessation aids when quitting smoking. METHODS African American smokers completed a survey to assess intentions, attitudes, and normative and control beliefs regarding the use of smoking cessation aids. RESULTS Participants held mildly positive attitudes regarding the use of cessation aids. Beliefs related to the utility of aids, support of referents, and accessibility of a doctor were most strongly associated with intention to use cessation aids. CONCLUSIONS African American smokers may be amenable to the use of cessation aids, and specific beliefs may be targets for intervention.

An HIV Testing Intervention in African American Churches: Pilot Study Findings

Background African Americans are disproportionately burdened by HIV. The African American church is an influential institution with potential to increase reach of HIV prevention interventions in Black communities. Purpose This study examined HIV testing rates in African American churches in the Taking It to the Pews pilot project. Using a community-engaged approach, church leaders delivered religiously-tailored HIV education and testing materials/activities (e.g., sermons, brochures/bulletins, testimonials) to church and community members. Methods Four African American churches (N=543 participants) located in the Kansas City metropolitan area were randomized to intervention and comparison groups. Receipt of an HIV test was assessed at baseline and 6 months. Results Findings indicated intervention participants were 2.2 times more likely to receive an HIV test than comparisons at 6 months. Church leaders delivered about 2 tools per month. Conclusions Church-based HIV testing interventions are feasible and have potential to increase HIV testing rates in African American communities.

Identifying Health Conditions, Priorities, and Relevant Multilevel Health Promotion Intervention Strategies in African American Churches: A Faith Community Health Needs Assessment

•African American churches have many strengths to address health disparity issues.•African American faith leaders were engaged in a health needs assessment (HNA).•Diabetes and heart disease/stroke were identified as priority health issues.•Important/feasible health promotion church intervention strategies were identified.•A multilevel health promotion church intervention was designed from HNA findings.

Do Black Women’s Religious Beliefs About Body Image Influence Their Confidence in Their Ability to Lose Weight?

Introduction Black women are disproportionately burdened by obesity but maintain body satisfaction and strong religious commitment. Although faith-based weight-loss interventions have been effective at promoting weight loss among blacks, little is known about how body image and religious views contribute to weight-related beliefs among religious black women. The purpose of this study was to examine whether demographic and health history factors, religious involvement, and beliefs about body image could explain motivation and confidence to lose weight among a church-affiliated sample of black women. Methods We recruited 240 church-affiliated black women aged 18 to 80 years (average age, 55 y; SD, 12.3) in 2014 from 6 black churches that participated in a larger study, Project FIT (Faith Influencing Transformation), a clustered, diabetes/heart disease/stroke intervention among black women and men. We used baseline data from Project FIT to conduct a cross-sectional study consisting of a survey. Variables approaching significance in preliminary correlation and χ2 analyses were included in 2 multiple linear regression models examining motivation and confidence in ability to lose weight. Results In final regression models, body mass index was associated with motivation to lose weight (β = 0.283, P < .001), and beliefs about body image in relation to God predicted confidence to lose weight (β = 0.180, P = .01). Conclusion Faith-based, weight-loss interventions targeting black women should emphasize physical well-being and highlight the health benefits of weight management rather than the benefits of altering physical appearance and should promote positive beliefs about body image, particularly relating to God.

Exploring HIV Risk and Ex-Offender Status Among African American Church Populations: Considerations for Faith-Based Settings

Studies with the general population indicate that involvement in the correctional system is strongly associated with the risk of contracting HIV and other sexually transmitted infections. However, limited studies have examined ex-offender status and HIV risk among African Americans—a population disproportionately impacted by incarceration and HIV—and even fewer have examined these risks among African American church-affiliated populations. This study examined ex-offender status, HIV risks, and perceptions of church involvement in HIV prevention strategies among 484 participants affiliated with African American churches. Findings indicate ex-offender participants were more likely to have been tested for HIV and believed the church should be involved in HIV prevention strategies. Future research, practice, and recommendations on the design of culturally and religiously tailored interventions for ex-offender HIV prevention, screening, and linkage to care in African American church settings are discussed.