Church Implementation of a Social Support Intervention to Increase Physical Activity in Older African American Adults

Community-Based Participatory Research to Study Church Implementation of an Evidence-Based Social Support Intervention to Increase Physical Activity Among Older African American Adults

Many effective interventions or programs are never put into practice. This quasi-experimental study will partner with AME churches in two areas of South Carolina to study how an evidence-based program is put into place by the church. The program, Walk Your Heart to Health, will include training in how churches can modify their practices to support physical activity and healthy eating. Over the five-year study, the investgiators will examine factors that predict the success of putting the program into place, things that help and get in the way of putting the program into place, and how the program can be scaled up to reach even more churches. The investigators will also examine the effect of the program (pre- to post-changes) on walking group member outcomes (physical activity and social cohesion). The investigators expect to work with approximately 26 AME churches for this study.

Physical activity (PA) plays a critical role in preventing and treating chronic disease and promoting quality of life across the age spectrum. Older adults are a priority population for increasing PA as they experience disproportionate rates of chronic disease, are underactive, and their proportion of the US population is increasing. The proposed study, which serves as the core research project for the University of South Carolina Prevention Research Center, uses a within-site pre-post study design (i.e., quasi-experimental) to study the implementation of Walk Your Heart to Health (WYHH) by AME Churches. Churches will also receive training in how to modify organizational practices to support physical activity. The study's primary focus is to study implementation outcomes. The Consolidated Framework for Implementation Research will help inform three primary questions: (1) how do contextual factors influence implementation and sustainability success or failure? (2) what barriers and facilitators to implementation exist? and (3) how can the EBI be scaled up to broader regions or populations outside the research community? Data from pastors and church implementers will come from multiple sources (surveys, interviews, etc.) and time points and will be analyzed using a matrixed multiple case study approach and rapid qualitative analysis. The investigators will work with the CAB and other partners to ensure cultural relevance of intervention strategies and support materials in Year 1, pilot the implementation strategies and measurements in Year 2 (6 churches), conduct the implementation study in Years 3 and 4 (20 churches), and focus on translation and scale up activities in Year 5. A secondary focus is to study participant-level outcomes. Increasing PA in older adults is a Healthy People 2030 goal. Churches are vital but underutilized institutions for implementing EBIs that can contribute to reaching national priorities.

Inclusion Criteria:

• Member of participating church (Charleston or Columbia Districts of the 7th Episcopal District of the AME church) or is in larger neighborhood and able to attend
• Aged 50 years and older
• Agrees to participate in in-person walking group sessions
• Not planning to move in the next year from a location that would make study visits difficult

Exclusion Criteria:

• No contraindications to exercise, as determined by the PAR-Q