Abstract
Despite the success of health programs conducted within African American (AA) churches, research has been limited in understanding the facilitators and barriers of conducting adult health programs in churches led by female AA pastors/leaders. In addition, research has yet to analyze the effect of policy on these church-based health programs. Thus, this pilot study’s objective is to use the socio-ecological model (SEM) as a framework to explore female AA pastors’ and church leaders’ perspectives, in the U.S., on facilitators and barriers that exist when conducting adult health programs within their congregations. Using snowball sampling to recruit AA female church leaders and pastors (n = 6), semi-structured interviews were conducted with study participants. Data were then transcribed and analyzed using First and Second Cycle coding to identify themes. Nine themes emerged from the data, and after stratifying the themes according to the SEM, this study found that facilitators and barriers exist at the intrapersonal, organizational, community, and policy levels of the SEM. It is important for these factors to be considered to ensure that health programs led by AA women pastors/leaders are successful within AA churches. Study limitations and the need for further research are also noted.
Similar content being viewed by others
Data and/or Code Availability
The data and materials presented in this article comply with field standards.
References
Abara, W., Coleman, J. D., Fairchild, A., Gaddist, B., & White, J. (2015). A faith-based community partnership to address HIV/AIDS in the Southern United States: Implementation, challenges, and lessons learned”. Journal of Religion and Health, 54(1), 122–133. https://doi.org/10.1007/s10943-013-9789-8
Alio, A. P., Lewis, C. A., Bunce, C. A., Wakefield, S., Thomas, W. G., Sanders, E., & Keefer, M. C. (2014). Capacity building among African American faith leaders to promote HIV prevention and vaccine research. Progress in Community Health Partnerships: Research, Education, and Action, 8(3), 305–316. https://doi.org/10.1353/cpr.2014.0050
Ammerman, A., Corbie-Smith, G., St. George, D. M. M., Washington, C., Weathers, B., & Jackson-Christian, B. (2003). Research expectations among African American church leaders in the PRAISE! project: A randomized trial guided by community-based participatory research. American Journal of Public Health, 93(10), 1720–1727. https://doi.org/10.2105/AJPH.93.10.1720
Barnes, S. L. (2006). Whosoever will let her come: Social activism and gender inclusivity in the Black Church. Journal for the Scientific Study of Religion, 45(3), 371–387. https://doi.org/10.1111/j.1468-5906.2006.00312.x
Baruth, M., Bopp, M., Webb, B. L., & Peterson, J. A. (2015). The role and influence of faith leaders on health-related issues and programs in their congregation. Journal of Religion and Health, 54(5), 1747–1759. https://doi.org/10.1007/s10943-014-9924-1
Berchick, E.R., Hood, E., & Barnett, J. C. (2018). Health insurance coverage in the United States: 2017. U.S. Census Bureau. https://www.census.gov/content/dam/Census/library/publications/2018/demo/p60-264.pdf
Billingsley, A., & Caldwell, C. H. (1991). The church, the family, and the school in the African American community. The Journal of Negro Education, 60(3), 427–440. https://doi.org/10.2307/2295494
Brand, D. J., & Alston, R. J. (2017). The Brand’s PREACH model: Predicting readiness to engage African American churches in health. Health Promotion Practice, 18(5), 763–771. https://doi.org/10.1177/1524839916653610
Campbell, M. K., Demark-Wahnefried, W., Symons, M., Kalsbeek, W. D., Dodds, J., Cowan, A., Jackson, B., Motsinger, B., Hoben, K., Lashley, J., Demissie, S., & McClelland, J. W. (1999). Fruit and vegetable consumption and prevention of cancer: The Black Churches United for Better Health project. American Journal of Public Health, 89(9), 1390–1396. https://doi.org/10.2105/AJPH.89.9.1390
Campbell, M., James, A., Hudson, M. A., Carr, C., Jackson, E., Oakes, V., Demissie, S., Farrell, D., & Tessaro, I. (2004). Improving multiple behaviors for colorectal cancer prevention among African American church members. Health Psychology, 23(5), 492–502. https://doi.org/10.1037/0278-6133.23.5.492
Carter-Edwards, L., Hooten, E. G., Bruce, M. A., Toms, F., Lloyd, C. L., & Ellison, C. (2012). Pilgrimage to wellness: An exploratory report of rural African American clergy perceptions of church health promotion capacity. Journal of Prevention & Intervention in the Community, 40(3), 194–207. https://doi.org/10.1080/10852352.2012.680411
Carter-Edwards, L., Johnson, J. H., Jr., Whitt-Glover, M. C., Bruce, M., & Goldmon, M. V. (2011). Health promotion for the elderly: Training Black clergy in entrepreneurial spirituality. Journal of Religion, Spirituality & Aging, 23(1–2), 139–154. https://doi.org/10.1080/15528030.2011.533356
Carter-Edwards, L., Lindquist, R., Redmond, N., Turner, C. M., Harding, C., Oliver, J., West, L. B., Ravenell, J., & Shikany, J. M. (2018). Designing faith-based blood pressure interventions to reach young Black men. American Journal of Preventive Medicine, 55(5), S49–S58. https://doi.org/10.1016/j.amepre.2018.05.009
Coleman, J. D., Lindley, L. L., Annang, L., Saunders, R. P., & Gaddist, B. (2012). Development of a framework for HIV/AIDS prevention programs in African American churches. AIDS Patient Care and STDs, 26(2), 116–124. https://doi.org/10.1089/apc.2011.0163
Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (3rd ed.). SAGE.
Foster, P. P., Cooper, K., Parton, J. M., & Meeks, J. O. (2011). Assessment of HIV/AIDS prevention of rural African American Baptist leaders: Implications for effective partnerships for capacity building in American communities. Journal of the National Medical Association, 103(4), 323–331. https://doi.org/10.1016/S0027-9684(15)30313-8
Gandara, E., Harvey, I. S., Foster, M., Luo, W., McKyer, L., Burdine, J., & Martinez, D. (2022). Facilitators and barriers when conducting adult health programs within the African American church: A systematic review. Journal of Religion and Health. https://doi.org/10.1007/s10943-022-01532-6
Gross, T. T., Story, C. R., Harvey, I. S., Allsopp, M., & Whitt-Glover, M. (2018). “As a community, we need to be more health conscious”: Pastors’ perceptions on the health status of the black church and African American communities. Journal of Racial and Ethnic Health Disparities, 5(3), 570–579. https://doi.org/10.1007/s40615-017-0401-x
Hankerson, S. H., Watson, K. T., Lukachko, A., Fullilove, M. T., & Weissman, M. (2013). Ministers’ perceptions of church-based programs to provide depression care for African Americans. Journal of Urban Health, 90(4), 685–698. https://doi.org/10.1007/s11524-013-9794-y
Higginbotham, E. B. (1994). Righteous discontent: The women’s movement in the Black Baptist church, 1880–1920. Harvard University Press.
Holt, C. L., Shelton, R. C., Allen, J. D., Bowie, J., Jandorf, L., Santos, S. L. Z., & Slade, J. (2018). Development of tailored feedback reports on organizational capacity for health promotion in African American churches. Evaluation and Program Planning, 70, 99–106. https://doi.org/10.1016/j.evalprogplan.2018.07.002
Johnson, E. B. (2012). The state of female and racial/ethnic united methodist clergy in the U.S. https://www.gcfa.org/media/1322/state_of_female_and_racial-ethnic_clergy.pdf
Markens, S., Fox, S. A., Taub, B., & Gilbert, M. L. (2002). Role of Black churches in health promotion programs: Lessons from the Los Angeles mammography promotion in churches program. American Journal of Public Health, 92(5), 805–810. https://doi.org/10.2105/ajph.92.5.805
Masci, D., Mohamed, B., & Smith, G. A. (2018, April 23). Black Americans are more likely than overall public to be Christian, Protestant. Pew Research Center. https://www.pewresearch.org/fact-tank/2018/04/23/black-americans-are-more-likely-than-overall-public-to-be-christian-protestant/
Matthews, A. K., Berrios, N., Darnell, J. S., & Calhoun, E. (2006). A qualitative evaluation of a faith-based breast and cervical cancer screening intervention for African American women. Health Education & Behavior, 33(5), 643–663. https://doi.org/10.1177/1090198106288498
Maxwell, A. E., Santifer, R., Chang, L. C., Gatson, J., Crespi, C. M., & Lucas-Wright, A. (2019). Organizational readiness for wellness promotion—A survey of 100 African American church leaders in South Los Angeles. BMC Public Health, 19(1), 593. https://doi.org/10.1186/s12889-019-6895-x
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15(4), 351–377. https://doi.org/10.1177/109019818801500401
McNabb, W., Quinn, M., Kerver, J., Cook, S., & Karrison, T. (1997). The PATHWAYS church-based weight loss program for urban African American women at risk for diabetes. Diabetes Care, 20(10), 1518–1523. https://doi.org/10.2337/diacare.20.10.1518
Merriam, S. B., & Grenier, R. S. (2019). Qualitative research in practice: Examples for discussion and analysis. Wiley.
Miles, M. B., Huberman, M. A., & Saldaña, J. (2014). Qualitative data analysis: A methods sourcebook. SAGE.
Mohamed, B., Cox, K., Diamant, J., & Gecewicz, J. (2021). Interviews with Black Pastors. Pew Research Center. https://www.pewresearch.org/religion/2021/02/16/interviews-with-black-pastors/
Pichon, L. C., Powell, T. W., Ogg, S. A., Williams, A. L., & Becton-Odum, N. (2016). Factors influencing Black churches’ readiness to address HIV. Journal of Religion and Health, 55(3), 918–927. https://doi.org/10.1007/s10943-015-0117-3
Resnicow, K., Campbell, M. K., Carr, C., McCarty, F., Wang, T., Periasamy, S., Rahotep, S., Doyle, C., Williams, A., & Stables, G. (2004). Body and soul: A dietary intervention conducted through African American churches. American Journal of Preventive Medicine, 27(2), 97–105. https://doi.org/10.1016/j.amepre.2004.04.009
Resnicow, K., Jackson, A., Wang, T., De, A. K., McCarty, F., Dudley, W. N., & Baranowski, T. (2001). A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: Results of the eat for life trial. American Journal of Public Health, 91(10), 1686–1693. https://doi.org/10.2105/AJPH.91.10.1686
Robinson, T. (2008). Applying the socio-ecological model to improving fruit and vegetable intake among low-income African Americans. Journal of Community Health, 33(6), 395–406. https://doi.org/10.1007/s10900-008-9109-5
Rodriguez, E. M., Bowie, J. V., Frattaroli, S., & Gielen, A. (2009). A qualitative exploration of the community partner experience in a faith-based breast cancer educational intervention. Health Education Research, 24(5), 760–771. https://doi.org/10.1093/her/cyp010
Roulston, K. (2010). Reflective interviewing: A guide to theory and practice. SAGE.
Rowland, M. L., & Isaac-Savage, E. P. (2013). As I see it: A study of African American pastors’ views on health and health education in the Black church. Journal of Religion and Health, 53(4), 1091–1101. https://doi.org/10.1007/s10943-013-9705-2
Stewart, J. (2015). A multi-level approach for promoting HIV testing within African American church settings. AIDS Patient Care and STDs, 29(2), 69–76. https://doi.org/10.1089/apc.2014.0160
Stewart, J., & Thompson, K. (2016). Readiness to implement HIV testing in African American church settings. Journal of Religion and Health, 55(2), 631–640. https://doi.org/10.1007/s10943-015-0068-8
Taylor, R. J., Thornton, M. C., & Chatters, L. M. (1987). Black Americans’ perceptions of the sociohistorical role of the church. Journal of Black Studies, 18(2), 123–138. https://doi.org/10.1177/002193478701800201
Tuggle 2nd, M. B. (1995). New insights and challenges about churches as intervention sites to reach the African-American Community with health information. Journal of the National Medical Association, 87(8 Suppl), 635.
Wasserman, J., Palmer, R. C., Gomez, M. M., Berzon, R., Ibrahim, S. A., & Ayanian, J. Z. (2019). Advancing health services research to eliminate health care disparities. American Journal of Public Health, 109(S1), S64–S69. https://doi.org/10.2105/AJPH.2018.304922
Wilcox, S., Laken, M., Bopp, M., Gethers, O., Huang, P., McClorin, L., Parrott, A. W., Swinton, R., & Yancey, A. (2007). Increasing physical activity among church members: Community-based participatory research. American Journal of Preventive Medicine, 32(2), 131–138. https://doi.org/10.1016/j.amepre.2006.10.009
Williams, D. K. (2004). An end to this strife: The politics of gender in African American churches. Fortress Press.
Yanek, L. R., Becker, D. M., Moy, T. F., Gittelsohn, J., & Koffman, D. M. (2001). Project Joy: Faith based cardiovascular health promotion for African American women. Public Health Reports. https://doi.org/10.1093/phr/116.S1.68
Funding
The authors did not receive support from any organization for the submitted work.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Interview guide preparation, data collection and analysis were performed by Dr. EG as well as Dr. ISH. The first draft of the manuscript was written by Dr. EG and Dr. ISH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare that are relevant to the content of this article.
Ethical Approval
In order to conduct this study, ethical approval was obtained from the Institutional Review Board (IRB: 2020-0623).
Consent to Participate
In this study, informed consent to participate was attained from each participant before data were collected.
Consent to Publish
In this study, informed consent to publish findings was attained from each participant.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Gandara, E., Harvey, I.S., McKyer, L. et al. Qualitative Inquiry of African American Female Church Leaders on Facilitators and Barriers of Conducting Adult Health Programs Within African American Churches: A Pilot Study Using a Socioecological Perspective Within the United States. J Relig Health 62, 3430–3452 (2023). https://doi.org/10.1007/s10943-023-01852-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-023-01852-1