By Nate Hinkel
Church-going African-Americans in the Arkansas Delta are feeling the power of faith a little more than usual these days, especially around their waistlines.
Researchers at the UAMS Fay W. Boozman College of Public Health targeted that demographic to test a faith-infused weight-loss intervention that showed promising results. Participants not only lost weight, but also credit spiritual support in making healthier choices altogether.
The series of studies are led in part by Karen Hye-cheon Kim Yeary, Ph.D., associate professor in the UAMS College of Public Health’s Department of Health Behavior and Health Education.
“We know that faith plays a large role in the lives of residents there, and so creating an intervention to fit into the teachings and lifestyles of a faith-based community is where we feel we can make a difference,” Yeary said. “Basing an intervention on faith and community components shows promise for engaging this demographic to change health outcomes.”
So after having wrapped up a smaller scale National Institutes of Health-funded pilot study a year ago showing promise that a faith-based approach can work, Yeary and a team of researchers are taking those results, adding a maintenance component, and thinking big.
Research indicates that African-Americans and rural residents are disproportionately affected by obesity. Several studies have shown faith-based interventions can have some success, but they have all been done in urban settings without using a community-based participatory research approach.
The UAMS research team has worked with the Faith Task Force, a group that represents more than 30 churches and community organizations in the Delta. The Faith Task Force connects faith and health to improve lives in the communities they represent.
“Participating churches initially identified physical activity, nutrition and obesity as primary health concerns,” Yeary said. “While very few churches had existing health promotion activities, they all expressed an interest in implementing a health program.”
Given those findings, the Faith Task Force chose to focus on obesity and related health behaviors and to adapt the weight-loss program for African-American adults.
Incorporating materials and practices from similar efforts in North Carolina, the study sought to adapt a successful weight-loss program for the faith-based rural population that was also led in churches by trained community leaders.
The pilot study chose three small African-American churches in the Delta, and two members from each church were trained to lead programs at their place of worship.
“They were given knowledge about healthy weight, weight-related health behaviors, faith and health, and behavioral strategies, and then had to pass a test,” Yeary said.
Ten participants from each church took part in the 16-week intervention that included weekly lessons, a Bible study that connected faith and health, and group exercise. Yeary said a focus was put on goal setting and problem solving, with an emphasis on self-monitoring. Participants were encouraged to “spend 15 minutes per day with God” about the health program, she said.
“What we found was that participants lost about 4.5 percent of their initial weight on average and reported significantly more physical activity,” said Jerome Turner, leader of the Faith Task Force. “They also had greater encouragement to eat healthier and be more physically active from family and friends.”
Participants said the biggest motivators were the group exercise sessions and using scripture to promote health.
“They reported that the connection between faith and health motivated them to make positive behavior changes because it increased their confidence to make healthy choices and provided an incentive to do well in the program to show devotion to God,” Yeary said.
Next, the research team is planning a full-scale NIH-funded study to begin in January 2013 that will include 30 churches and about 450 participants.
“We know that weight loss can be obtained in rural African-American communities of faith,” Yeary said. “We also know that the positive effects tend to diminish unless weight loss is maintained.”
So in addition to the 16 sessions will be a 12-week maintenance period. The team thinks the previous weight-loss intervention with the added benefit of the maintenance program will result in higher weight loss maintained over a longer time period.
“We know it worked on a smaller scale, and we expect to learn a lot more this time around that will hopefully have a lasting and significant impact on health in the Arkansas Delta,” Yeary said.