Faith-Based Physical Activity Programs for Cardiovascular Health

Overseen By Elva Arredondo, PhD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: San Diego State University

Disqualifiers: Health condition, Cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 24

677 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on increasing physical activity among participants.

What data supports the effectiveness of the treatment Faith in Action for cardiovascular health?

Research shows that faith-based physical activity programs, like Faith in Action, can help increase physical activity levels, especially among churchgoing communities. These programs are designed to engage community members and have been shown to improve health behaviors related to physical activity. ^{1 2 3 4 5}

Is the Faith-Based Physical Activity Program safe for participants?

The available research does not provide specific safety data for the Faith-Based Physical Activity Program, but it is generally a physical activity program, which is typically safe for most people. As with any exercise program, it's important to consult with a healthcare provider before starting, especially if you have existing health conditions. ^{2 3 4 5 6}

What makes the Faith in Action treatment unique for cardiovascular health?

Faith in Action is unique because it is a faith-based physical activity program specifically designed for churchgoing Latina women, led by community health workers (promotoras), and integrates spirituality with exercise to promote cardiovascular health. ^{1 2 3 7 8}

What is the purpose of this trial?

Despite the benefits of physical activity (PA) to prevent cardiovascular disease and other chronic diseases, few adult Latinas meet PA guidelines. Given the central role of churches within the Latino community and their commitment to the well-being of their members, they are ideal settings for health promotion. Evidence-based interventions (EBIs) for increasing PA and reducing obesity exist, but few PA interventions go to scale. Investigators propose to enhance Faith in Action with three organization-level strategies designed to increase program fit and effectiveness: 1) training church leaders in health promotion; 2) tailoring messaging to enhance fit between Faith in Action and each unique church environment; and 3) empowering community health workers (promotoras) to advocate for organizational change. Given the need to improve strategies to sustain health programs in community settings, investigators will test the influence of two additional sustainment strategies: 1) strengthening community collaborations and 2) providing technical support. Thirty-two churches will be randomly assigned to a Standard EBI group (Faith in Action as originally implemented), an Enhanced group (Standard intervention + organizational-level implementation strategies), or an Enhanced + Sustainment group (Enhanced implementation group + sustainment strategies). Investigators will test the proposed implementation strategies on organization-level change and individual behavior in diverse churches for a 12-month intervention and 6-month follow-up period. The proposed study aims to: 1) Test the short and long-term impacts of organization-level implementation strategies in 2 Enhanced conditions on organizational outcomes compared to the Standard EBI condition and 2) Examine individual behavior change among Latinas (N=677) in churches in the 2 Enhanced conditions compared to the Standard EBI condition. The study's primary hypothesis is that Latina's receiving the Enhanced interventions will increase their PA levels significantly more than those receiving the Standard Faith in Action intervention, and the improvements in PA will be sustained. If successful, findings from the current study will provide evidence of organizational-level strategies for uptake, sustainment, and implementation strategies for scale-up of PA interventions to increase PA and reduce chronic disease in churches across the US.

Research Team

Elva Arredondo, PhD

Principal Investigator

San Diego State University

Eligibility Criteria

This trial is for Latina women aged 18-65 who plan to attend their church regularly for the next 18 months, engage in less than 50 minutes of moderate-to-vigorous physical activity (MVPA) per week, and have no health issues that limit physical activity. Those with cognitive impairments or other health conditions that prevent PA are excluded.

Inclusion Criteria

Self-identifying as Latina

Planning on attending the FBO for the next 18 months

Low self-reported leisure-time MVPA (<50 min of weekly leisure MVPA)

Exclusion Criteria

I do not have any cognitive issues that prevent me from participating.

Attending other churches besides the church of recruitment

I cannot complete the informed consent in English or Spanish.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Implementation of Faith in Action program with organizational-level strategies in churches

12 months

Baseline, 6 months, 12 months

Sustainment Follow-up

Additional support provided to Enhanced + Sustainment group to examine program and participant PA sustainment

6 months

18 months post-baseline

Follow-up

Participants are monitored for maintenance of physical activity and organizational outcomes

6 months

Treatment Details

Interventions

• Faith in Action
• Faith in Action+
• Faith in Action++

Trial Overview The study tests three versions of a program called Faith in Action aimed at increasing physical activity to prevent cardiovascular disease among Latinas. Churches will implement either the standard program, an enhanced version with tailored messaging and leader training, or an enhanced version plus strategies to help sustain the program long-term.

Participant Groups

Group I: Standard EBI Condition Experimental Treatment 1 Intervention

Faith in Action as originally implemented

Group II: Enhanced Condition Experimental Treatment 1 Intervention

Standard condition + organizational-level implementation strategies

Group III: Enhanced + Sustainment condition Experimental Treatment 1 Intervention

Enhanced implementation condition + maintenance strategies

Who Is Running the Clinical Trial?

San Diego State University

Lead Sponsor

Trials

182

Recruited

119,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Washington University School of Medicine

Collaborator

Trials

2,027

Recruited

2,353,000+

University of California, Berkeley

Collaborator

Trials

193

Recruited

716,000+

University of California, San Diego

Collaborator

Trials

1,215

Recruited

1,593,000+

Findings from Research

Physical activity interventions delivered in faith-based organizations can effectively increase physical activity levels and improve health and fitness measures among participants, as shown in a review of 18 studies predominantly involving female participants in the U.S.

Despite the positive outcomes, the overall quality of the evidence was very low, highlighting the need for more rigorous randomized clinical trials to better evaluate the effectiveness of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Activity Interventions in Faith-Based Organizations: A Systematic Review. Tristão Parra, M., Porfírio, GJM., Arredondo, EM., et al.[2019]

The Faith in Action program, aimed at increasing physical activity among Latina women in churches, highlights the importance of community engagement and the role of church leaders in implementing health interventions.

Interviews with 22 pastors and church staff revealed key barriers such as lack of knowledge about physical activity and competing priorities, while also identifying effective strategies like health behavior training and tailored messaging to enhance program implementation and support scale-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program. Haughton, J., Takemoto, ML., Schneider, J., et al.[2022]

The Strong for Life exercise program was successfully implemented with 105 frail, homebound older adults, showing high satisfaction rates of 100% among volunteers and 98.6% among participants after 4 months.

Participants engaged in exercise an average of 2.2 times per week, with over half exercising 2 to 4 times weekly, leading to significant improvements in social functioning without any serious adverse events reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of implementing the Strong for Life program in community settings. Etkin, CD., Prohaska, TR., Harris, BA., et al.[2019]

A systematic review of 38 faith-based interventions aimed at improving healthy eating and physical activity found that while most showed positive changes in health behaviors, none fully reported all necessary elements for effective implementation and dissemination.

The overall reporting quality was low across key intervention domains, indicating a need for future studies to provide more comprehensive data to enhance the potential for broad public health impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Healthy Eating and Physical Activity Interventions in Faith-Based Settings: A Systematic Review Using the Reach, Effectiveness/Efficacy, Adoption, Implementation, Maintenance Framework. Dunn, CG., Wilcox, S., Saunders, RP., et al.[2022]

The faith-based physical activity intervention involving 418 African-American adults from 20 churches did not lead to significant changes in physical activity behavior after one year, indicating limited efficacy of the program.

While there was a marginal increase in instrumental support from churches, the study found no significant psychosocial mediators that could explain changes in physical activity, suggesting that the intervention did not effectively target the intended factors influencing behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychosocial mediators of a faith-based physical activity intervention: implications and lessons learned from null findings. Baruth, M., Wilcox, S., Blair, S., et al.[2022]

Out of 773 U.S. Islamic centers analyzed, 206 (about 27%) advertised physical activity programs, with youth programs being the most common (44%) and sports programs the least common (23%).

Most advertised activities were led by men and primarily targeted a male audience, indicating a need for more inclusive programming, especially for women, and better promotion of these activities on their websites.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Activity Programming Advertised on Websites of U.S. Islamic Centers: A Content Analysis. Kahan, D.[2019]

The pilot faith-based physical activity intervention significantly increased awareness of health benefits and knowledge of physical activity recommendations among Latino participants, with 66% of intervention participants citing health reasons for participation compared to only 36% in the comparison group.

The study highlighted both successes and challenges in implementation, indicating that while the intervention was effective in improving knowledge, there were communication issues and difficulties in reaching a broader audience within the church community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A faith-based physical activity intervention for Latinos: outcomes and lessons. Bopp, M., Fallon, EA., Marquez, DX.[2021]

The 'Hearts To God' project is a cardiovascular health promotion program specifically designed for women, integrating spirituality and health education to address the gap in knowledge about cardiovascular disease.

Participants reported that the program was relevant and useful, as it provided tools for women to assess and create personalized heart health plans, promoting behavior change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing and implementing a Healthy Heart program for women in a parish setting. Ruesch, AC., Gilmore, GD.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Physical Activity Interventions in Faith-Based Organizations: A Systematic Review. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Feasibility of implementing the Strong for Life program in community settings. [2019]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Healthy Eating and Physical Activity Interventions in Faith-Based Settings: A Systematic Review Using the Reach, Effectiveness/Efficacy, Adoption, Implementation, Maintenance Framework. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Psychosocial mediators of a faith-based physical activity intervention: implications and lessons learned from null findings. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Physical Activity Programming Advertised on Websites of U.S. Islamic Centers: A Content Analysis. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

A faith-based physical activity intervention for Latinos: outcomes and lessons. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Developing and implementing a Healthy Heart program for women in a parish setting. [2019]