Melissa Bopp

The health-e-AME faith-based physical activity initiative: Description and baseline findings.

This article provides an overview of the development, implementation, and baseline findings from a statewide faith-based physical activity (PA) initiative. The 3-year program is training African Methodist Episcopal volunteers across South Carolina to implement programs to increase PA in their congregations. To date, 98 churches have been trained. Interviews done with a random sample (n = 39) indicated that 54% are implementing at least one PA program. The baseline telephone survey (N = 571) estimates that 27.8% of the population is regularly active, 54.9% underactive, and 17.3% sedentary. Baseline rates of regular PA were higher in those who were younger, healthier, and nonsmokers. Challenges to date have included obtaining rosters and implementing a large-scale program with limited resources. Interest in the program has been strong and supported by church leaders. Current efforts are on training additional churches and working with those already trained to support sustainability.

A Comprehensive Review of Faith-Based Physical Activity Interventions:

This review provides a summary of physical activity interventions delivered in faith-based organizations. Electronic databases were searched to identify relevant studies. After screening, a total of n = 27 articles matched our inclusion criteria; 19 were identified as faith-based interventions (some spiritual or Biblical element included in the intervention) and 8 as faith-placed interventions (no spiritual component). Among all interventions, the most common research design was a randomized controlled trial. African American women were the most commonly targeted population and predominately Black churches were the most common setting. The majority of studies used self-report measures of physical activity. Most of the interventions did not use a theoretical framework to shape the intervention and weekly group sessions were the most frequently reported intervention approach. Overall, 12 of the faith-based and 4 of the faith-placed interventions resulted in increases in physical activity. Recommendations for future faith-based physical activity interventions include more rigorous study design, improved measures of physical activity, larger sample sizes, longer study and follow-up periods, and the use of theory in design and evaluation. Although limited, literature on faith-based physical activity interventions shows significant promise for improving physical activity participation and associated health outcomes.

Correlates of Strength Training in Older Rural African American and Caucasian Women

ABSTRACT This study examined factors influencing strength training (ST) in two convenience samples of older rural women. Focus group (FG) participants were 23 Caucasian and 16 African American women aged 67.5 ± 9.2 years. Survey participants were 60 Caucasian and 42 African American women, aged 70.59 ± 9.21 years. FG participants answered questions about the risks, benefits, and barriers to ST. Survey participants completed measures of demographics, physical activity (including ST), depression and stress, decisional balance for exercise (DBE), barriers to PA, and social support (SS). Regression modeling examined correlates of ST. FG participants identified physical health gains and improved appearance as ST benefits. African American women also included mental health benefits and “feeling good.” Both Caucasian and African American groups named physical health problems as risks of ST. Caucasian women identified time constraints, lack of ST knowledge, physical health problems, lack of exercise facilities, and the cost of ST as barriers. African American women cited being “too tired,” physical health problems, lack of support, and other family and work responsibilities. The linear regression model explained 23.2% of the variance in hours per week of ST; DBE and family SS were independent positive correlates. This study identified correlates to participation in ST in older rural women and provides a basis for developing ST interventions in this population.

Active commuting influences among adults.

OBJECTIVE Active commuting (AC) is a behavior with many documented health benefits; however, influences on AC are not well understood. This paper examined a range of influences on self-reported AC behavior. METHODS Participants in Manhattan, KS, responded to an online survey (August-December 2008) with questions about walking, biking and driving patterns, influences on AC (motivators, barriers, self-efficacy, and workplace factors) and demographics. Separate logistic regression models predicted if participants walked, biked, or drove to work at least once/week according to the demographic factors and influences on AC, and significant factors were examined simultaneously in a multivariate logistic model. RESULTS Participants (n=375) were primarily young to middle aged adults, female, Caucasian, with at least a high school education, and 24.2% reported AC one or more times per week. Univariate analyses revealed several demographic variables, employment related factors, barriers, and motivators significantly associated with walking, biking, and driving. The multivariate models found multiple significant predictors associated with walking (Nagelkerke R(2)=0.685), biking (Nagelkerke R(2)=0.717), and driving (Nagelkerke R(2)=0.799). CONCLUSIONS AC is a complex behavior and this study noted a wide range of significant influences. These results provide insight for the development of policies and programs to enhance population level AC.

Community-Based Interventions to Promote Increased Physical Activity: A Primer

Current recommendations, based on an abundance of empirical data documenting the impact of physical activity (PA) on preventing morbidity and mortality associated with common chronic diseases, indicate that adults should accumulate 30 minutes of moderate-intensity PA ≥5 days per week. However, worldwide rates of PA remain low, indicating a great need for large-scale implementation of evidence-based PA interventions. We briefly present practical aspects of intervention planning, implementation and evaluation within common community settings.The first stage of intervention planning is formative research, which allows for a better understanding of the elements needed for a successful intervention. Partnering with community settings (schools, worksites, faith-based organizations and healthcare organizations) offers many benefits and the opportunity to reach specific populations. Setting-based approaches allow for multilevel strategies, ranging from individual-based programmes and educational initiatives to physical and social environmental changes. Various settings such as healthcare, worksite, and school- and community-based settings are discussed. Intervention delivery methods and strategies can range, depending on the population and setting targeted, from small-group approaches to mediated methods (e.g. print, telephone, electronic).The final phase of intervention planning and implementation is evaluation. Several objective and subjective methods of PA assessment are available to determine the effectiveness of the intervention. We have highlighted the need for process evaluation of intervention implementation to provide valuable information for the dissemination and sustainability of successful interventions. Although there are numerous considerations for the design, implementation, assessment and evaluation of PA interventions, the potential for positive impact on the overall health of the public indicates the necessity for programmes designed to increase PA.

Active commuting patterns at a large, midwestern college campus.

Abstract Objective: To understand patterns and influences on active commuting (AC) behavior. Participants: Students and faculty/staff at a university campus. Methods: In April–May 2008, respondents answered an online survey about mode of travel to campus and influences on commuting decisions. Hierarchical regression analyses predicted variance in walking and biking using sets of demographic, psychological, and environmental variables. Results: Of 898 respondents, 55.7% were female, 457 were students (50.4%). Students reported more AC than faculty/staff. For students, the models explained 36.2% and 29.1% of the variance in walking and biking, respectively. Among faculty/staff, the models explained 45% and 25.8% of the variance in walking and biking. For all models, the psychological set explained the greatest amount of variance. Conclusions: With current economic and ecological concerns, AC should be considered a behavior to target for campus health promotion.

The Tug-of-War: Fidelity Versus Adaptation Throughout the Health Promotion Program Life Cycle

Researchers across multiple fields have described the iterative and nonlinear phases of the translational research process from program development to dissemination. This process can be conceptualized within a “program life cycle” framework that includes overlapping and nonlinear phases: development, adoption, implementation, maintenance, sustainability or termination, and dissemination or diffusion, characterized by tensions between fidelity to the original plan and adaptation for the setting and population. In this article, we describe the life cycle (phases) for research-based health promotion programs, the key influences at each phase, and the issues related to the tug-of-war between fidelity and adaptation throughout the process using a fictionalized case study based on our previous research. This article suggests the importance of reconceptualizing intervention design, involving stakeholders, and monitoring fidelity and adaptation throughout all phases to maintain implementation fidelity and completeness. Intervention fidelity should be based on causal mechanisms to ensure effectiveness, while allowing for appropriate adaption to ensure maximum implementation and sustainability. Recommendations for future interventions include considering the determinants of implementation including contextual factors at each phase, the roles of stakeholders, and the importance of developing a rigorous, adaptive, and flexible definition of implementation fidelity and completeness.

Health and Wellness Programming in Faith-Based Organizations: A Description of a Nationwide Sample

Introduction. Most of the U.S. population is affiliated with faith-based organizations (FBOs) and regularly attends services. Health and wellness activities (HWA) delivered through FBOs have great potential for reach, but the number of FBOs offering health programs and the characteristics of these programs are currently unknown. The purpose of this study was to better understand rates, characteristics, and factors influencing faith-based HWA across the United States. Method. Faith leaders (N = 844) completed an online survey assessing faith leader demographics and health, FBO demographics (e.g., denomination, size, location, diversity), and details of HWA within their FBO. Results. Respondents were primarily White (93%), male (72%), middle-aged (53.2 ± 12.1 years), and affiliated with Methodist (42.5%) or Lutheran (20.2%) denominations. Although most faith leaders report meeting physical activity recommendations (56.5%), most were overweight/obese (77.4%), did not meet fruit and vegetable recommendations (65.9%), and had been diagnosed with 1.25 ± 1.36 chronic diseases. Respondents reported offering 4.8 ± 3 HWA within their FBO over the past 12 months. Most common HWA included clubs/teams related to physical activity (54.8%), individual-level health counseling (54%), and providing health/wellness pamphlets. Leaders cited a lack of lay leadership (48.1%) and financial resources for staff time (47.8%) as the most common barriers to HWA. An increase in interest/awareness in health topics from FBO members was the most common facilitator for HWA (66.5%). Conclusion. Although faith-based HWA are prevalent nationally, types of HWA and the factors influencing HWA are dependent on FBO characteristics. Future faith-based interventions should consider existing capabilities and moderating factors for HWA.

Factors influencing the implementation of organized physical activity and fruit and vegetable snacks in the HOP’N After-School Obesity Prevention Program

OBJECTIVE To identify barriers and facilitators for improving the after-school organized physical activity (PA) and snack quality. METHODS After-school staff (Year 1, n = 20; Year 2, n = 17) participated in qualitative, semistructured interviews about the implementation of an after-school obesity prevention intervention. Interviews were recorded, transcribed, coded for common themes, and analyzed using NVivo software. RESULTS Several factors influencing implementation of PA and fruit and vegetable (FV) consumption were revealed. Facilitators for PA included: staff training, equipment/gym space, and scheduling organized PA. Physical activity barriers included prioritizing PA and lack of school administration support. Fruit and vegetable facilitators included requesting healthier snacks. Fruit and vegetable barriers included cost and low priority of snack. CONCLUSIONS AND IMPLICATIONS The success of improving after-school PA and FV snack quality is dependent on many factors, including several organizational system and staff variables. Future research should focus on systemic changes in the after-school environment to increase the priority of daily PA and a healthy snack.

Health-Related Factors Associated with Mode of Travel to Work

Active commuting (AC) to the workplace is a potential strategy for incorporating physical activity into daily life and is associated with health benefits. This study examined the association between health-related factors and mode of travel to the workplace. Methods. A volunteer convenience sample of employed adults completed an online survey regarding demographics, health-related factors, and the number of times/week walking, biking, driving, and using public transit to work (dichotomized as no walk/bike/drive/PT and walk/bike/drive/PT 1 + x/week). Logistic regression was used to predict the likelihood of each mode of transport and meeting PA recommendations from AC according to demographics and health-related factors. Results. The sample (n = 1175) was aged 43.5 ± 11.4 years and was primarily White (92.7%) and female (67.9%). Respondents reported walking (7.3%), biking (14.4%), taking public transit (20.3%), and driving (78.3%) to work at least one time/week. Among those reporting AC, 9.6% met PA recommendations from AC alone. Mode of travel to work was associated with several demographic and health-related factors, including age, number of chronic diseases, weight status, and AC beliefs. Discussion. Mode of transportation to the workplace and health-related factors such as disease or weight status should be considered in future interventions targeting AC.