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Reach and Capacity of Black Protestant Health Ministries as Sites of Community-Wide Health Promotion: A Qualitative Social Ecological Model Examination

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Abstract

Black communities in the Southeast United States experience a disproportionate burden of illness and disease. To address this inequity, public health practitioners are partnering with Black Protestant churches to deliver health promotion interventions. Yet, the reach of these programs beyond the organizational level of the Social Ecological Model (SEM) is not well defined. Thus, the aim of this study is to understand Black Protestant church leaders’ and members’ perceptions about the capacity of their ministries to reach into their communities, beyond their congregations, as providers or hosts of health education or promotion interventions. From 20 Black Protestant churches in Atlanta, GA, 92 church leaders and members participated in semi-structured interviews. Grounded theory guided data analysis and a diverse team coded the interviews. Most participating churches had health ministries. Participants saw the boundaries between their churches at the organizational level of the SEM and the broader Black community to be porous. Those who described their “community” as being broader than their congregation also tended to describe community-wide health promotion their church engaged in. They described church-based health fairs as a strategy to promote engagement in their communities. Some participants, particularly those in a health-related profession, discussed visions of how to utilize their church as a site for community-wide health promotion. We suggest these participants may be boundary leaders who can build relationships between public health professionals, pastors, and congregants. Based on the findings, we suggest that church-based health fairs may be effective sites of community-wide health promotion.

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Data are available upon reasonable request.

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Notes

  1. We refrain from using the terminology “the Black Church” in recognition of debates among historians of American religion who contest the existence of a unified or historically ontological “Black Church” [16, 17]. We choose the term “Black Protestant churches” because of greater specificity and because it still allows us to categorically conceptualize these churches in the lineage of Lincoln and Mamiya, who think about how conversations and trends can be observed across non-monolithic denominations and churches that are predominantly Black and Protestant [18].

  2. Campbell et al. differentiate between “faith-placed” interventions which are situated within church buildings and draw on church resources and “faith-based” interventions which also incorporate aspects of the religious tradition into the intervention (e.g., incorporating Bible verses into health education lessons) [35].

  3. Germond and Cochrane build their construct of the healthworld from Habermas’ construct of the “lifeworld,” such that the healthworld is understood to be a specific region of the lifeworld [50].

  4. Here, we align the public health healthworld with the World Health Organization definition of “health” [56].

  5. We draw on Gunderson and Cochrane’s work on “Religious health assets” here [47].

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Funding

The larger dissemination study, TEACH, was funded by the Agency for Healthcare Research and Quality (grant number 1R24HS022059).

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Authors and Affiliations

  1. Graduate Program in Religion, Boston University, Boston, MA, USA

    Tyler J. Fuller

  2. Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA

    Danielle N. Lambert

  3. Department of Social and Behavioral Sciences, New York University, New York, NY, USA

    Ralph J. DiClemente

  4. Department of Sociomedical Sciences, Columbia University, New York, NY, USA

    Gina M. Wingood

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  4. Gina M. Wingood
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Contributions

Conceptualization: TJF; methodology: TJF, DNL; formal analysis and investigation: TJF; writing - original draft preparation: TJF; writing - review and editing: TJF, DNL, RJD, GMW; funding acquisition: GMW; supervision: RJD, GMW

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Correspondence to Tyler J. Fuller.

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Emory University’s Institutional Review Board approved all study procedures prior to data collection.

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Fuller, T.J., Lambert, D.N., DiClemente, R.J. et al. Reach and Capacity of Black Protestant Health Ministries as Sites of Community-Wide Health Promotion: A Qualitative Social Ecological Model Examination. J. Racial and Ethnic Health Disparities (2024). https://doi.org/10.1007/s40615-024-01926-0

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