Original Article

Rural Religious Leaders’ Perspectives on their Communities’ Health Priorities and Health

Authors: Nancy E. Schoenberg, PhD, Mark Swanson, PhD

Abstract

Objectives: In traditionally underserved communities, faith-based interventions have been shown to be effective for health promotion. Religious leaders—generally the major partner in such interventions—however, are seldom are consulted about community health priorities and health promotion preferences. These insights are critical to ensure productive partnerships, effective programming, and sustainability.

Methods: Mixed-methods surveys were administered in one of the nation’s most under-resourced regions: rural Appalachia. A sample of 60 religious leaders, representing the main denominations in central Appalachia, participated. Measures included closed- and open-ended survey questions on health priorities and recommendations for health promotion. Descriptive statistics were used for closed-ended survey items and conventional qualitative content analysis was used for open-ended responses.

Results: Substance abuse, diabetes mellitus, suboptimal dietary intake and obesity/overweight, and cardiovascular and respiratory illnesses constitute major health concerns. Addressing these challenging conditions requires realistically acknowledging sparse community resources (particularly healthcare provider shortages); building in accountability; and leveraging local assets and traditions such as testimonials, intergenerational support, and witnessing.

Conclusions: With their extensive reach within the community and their accurate understanding of community health threats, practitioners and researchers may find religious leaders to be natural allies in health-promotion and disease-prevention activities.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Trinh-Shevrin C, Islam NS, Nadkarni S, et al. Defining an integrative approach for health promotion and disease prevention: a population health equity framework. J Health Care Poor Underserved 2015;26(2 Suppl):146-163.
 
2. Frieden TR. A framework for public health action: the health impact pyramid. Am J Public Health 2010;100:590-595.
 
3. Levin J. Faith-based initiatives in health promotion: history, challenges, and current partnerships. Am J Health Promot 2014;28:139-141.
 
4. Harmon BE, Kim SH, Blake CE, et al. Health care information in African American churches. J Health Care Poor Underserved 2014;2:242-256.
 
5. Chatters LM, Levin JS, Ellison CG. Public health and health education in faith communities. Health Educ Behav 1998;25:689-699.
 
6. Schoenberg NE, Hatcher J, Dignan MB. Appalachian women' perceptions of their community' health threats. J Rural Health 2008;24:75-83.
 
7. Kosmin BA, Keysar A. American Religious Identification Survey, Summary Report 2009. commons.trincoll.edu/aris/files/2011/08/ARIS_Report_2008.pdf. Accessed May 15, 2017.
 
8. DeHaven MM, Hunter IB, Wilder L, et al. Health programs in faith-based organizations: are they effective? Am J Public Health 2004;94:1030-1036.
 
9. Kaplan SA, Calman NS, Golub M, et al. The role of faith-based institutions in addressing health disparities: a case study of an initiative in the southwest Bronx. J Health Care Poor Underserved 2006;17(2 Suppl):9-19.
 
10. Fitzgibbon ML, Stolley MR, Ganschow P, et al. Results of a faith-based weight loss intervention for black women. J Natl Med Assoc 2005;97:1393-1402.
 
11. Catanzaro AM, Meador KG, Koenig HG, et al. Congregational health ministries: a national study of pastors' views. Public Health Nurs 2007;24:6-17.
 
12. Carter-Edwards L, Jallah YB, Goldmon MV, et al. Key attributes of health ministries in African American churches: an exploratory survey. NC Med J 2006;67:345-350.
 
13. Rakotoniana JS, Rakotomanga Jde D, Barennes H. Can churches play a role in combating the HIV/AIDS epidemic? A study of the attitudes of Christian religious leaders in Madagascar. PLoS One 2014;9:e97131.
 
14. Israel BA, Schulz AJ, Parker EA, et al. Critical issues in developing and following community based participatory research principles. In: Minkler M, Wallerstein N, , eds. Community-Based Participatory Research for Health. San Francisco:Jossey-Bass , 2003.
 
15. Association of Statisticians of American Religious Bodies. US religious census, 1952 to 2010. commons.trincoll.edu/aris/files/2011/08/ARIS_Report_2008.pdf. Published 2012. Accessed April 25, 2017.
 
16. Hacker W. Kentucky Behavioral Risk Factor Surveillance System, 2003-2004 Report. Frankfort:Kentucky Department of Public Health, 2008.
 
17. Cabinet for Health and Family Services. Kentucky diabetes report 2013. http://chfs.ky.gov/nr/rdonlyres/03f86f3b-93e2-4bea-89c0-25dd9c1fb1fc/0/reporttothelrcfinal1172013tothesecretary.pdf. Published January 10, 2013. Accessed April 25, 2017.
 
18. Harris AM, Iqbal K, Schillie S, et al. Increases in acute hepatitis B virus infections-Kentucky, Tennessee, and West Virginia, 2006-2013. MMWR Morb Mortal Wkly Rep 2016;65:47-50.
   
20. Walsh S, Christian WJ, Hopenhayn C. Place matters: health disparities in the commonwealth. A report on the Delta and Appalachian regions of Kentucky.  . Published 2012. Accessed April 25, 2017.
 
21. The Appalachian Region: A Data Overview from the 2011-2015 American Community Survey March 2017 Kelvin Pollard and Linda A. Jacobsen Population Reference Bureau. Appalachian Regional Commission. https://www.arc.gov/research/researchreportdetails.asp?REPORT_ID=132. Accessed May 15, 2017.
 
22. Schoenberg NE, Howell BM, Fields N. Community strategies to address cancer disparities in Appalachian Kentucky. Fam Community Health 2012;35:31-43.
 
23. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277-1288.
 
24. Morse J, Field P. Qualtiative Research for Health Professionals. Thousand Oaks, CA:Sage Publications , 1995.
 
25. Resnicow K, Jackson A, Wang T, et al. A motivational interviewing intervention to increase fruit and vegetable intake through black churches: results of the eat for life trial. Am J Public Health 2001;91:1686-1693.
 
26. Sandoval JA, Lucero J, Oetzel J, et al. Process and outcome constructs for evaluating community-based participatory research projects: a matrix of existing measures. Health Educ Res 2012;27:680-690.
 
27. Minkler M. Linking science and policy through community-based participatory research to study and address health disparities. Am J Public Health 2010;100( Suppl 1 ):S81-S87.
 
28. Banerjee AT, Kin R, Strachan PH, et al. Factors facilitating the implementation of church-based heart health promotion programs for older adults: a qualitative study guided by the precede-proceed model. Am J Health Promot 2015;29:365-373.
 
29. University of Wisconsin Population Health Institute. County health rankings and roadmaps, Kentucky 2016. http://www.countyhealthrankings.org/app/kentucky/2016/overview. Accessed April 25, 2017.
 
30. Cicero TJ, Ellis MS, Surratt HL, et al. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry 2014;71:821-826.