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Healthy Eating and Living Spiritually (HEALS)

HEALS - Healthy Eating and Living Spiritually: a hypertension control and Prevention program for African American church communities

Principal Investigator: Sunita Dodani, M.B.B.S. (M.D.), M.S., Ph.D.

The purpose of the Healthy Eating and Living Spiritually (HEALS) research project is to test the effect of a faith-based, socioculturally tailored, multi-level, hypertension control and prevention intervention in minority churches. The broad, long-term goals of the program is to:

  • reduce health disparities in relation to cardiovascular diseases and stroke in Jacksonville ethnic minorities
  • help the community adopt a healthy lifestyle using faith as a backbone for the control of high blood pressure

The team is using a community-based participatory research approach in collaboration with the HEALS Community Advisory Board (CAB). The CAB consists of members from the University of Florida, University of North Florida, church pastors, church-based health ministry groups, academic investigators and external consultants.

The main goal of the CAB is to establish and strengthen partnerships with African American church communities by (a) creating a group of leaders who can advise the HEALS team and guide them towards success; and (b) work with the church members and pastors to develop the HEALS program to suit the cultural needs of the Jacksonville community.

The CAB consist of 14 members:

  • Richard Tyson, (CAB Co-Chair), Health and Wellness Chair, 100 Black Men of Jacksonville
  • Rev. Marquise Hardrick, (CAB member), Pastor, Central Metropolitan CME Church, Jacksonville (HEALS Pilot Church)
  • Rev. Dr. Jeffery Rumlin, (CAB member), Pastor, Days Spring Baptist Church, Jacksonville (HEALS Pilot Church)
  • Irvin PeDro Cohen, (CAB member), Director, New Town Success Zone, Edward Waters College, Jacksonville
  • Levi H. McIntosh, Jr., (CAB member), President, 100 Black Men of Jacksonville
  • Rev. James Wiggins, Jr., (CAB member), Pastor, Saint Paul Lutheran Church, Jacksonville
  • Rev. Elder Lee E. Harris, (CAB member), Pastor, Mt. Olive Primitive Baptist Church, Jacksonville
  • Rev. Mark L.Griffin, (CAB member), Pastor, Wayman Ministries, Jacksonville
  • Bishop Vaughn McLaughlin, (CAB member), Bishop, The Potter House Church, Jacksonville
  • Dr. Jeannette Holmes (CAB member), Pastor, Hope Chapel Ministries, Jacksonville
  • Rev. Robert A Brown, (CAB member), Pastor, Builders of Faith Christian Center, Jacksonville
  • Dr. Catherine Christie (CAB member and HEALS Nutritionist), Associate Dean, Brooks College of Health, Professor and Nutrition Graduate Program Director, University of North Florida, Jacksonville
  • Dr. Sunita Dodani (CAB Co-Chair & HEALS program Director), Associate Professor, Division of Cardiology, Department of Medicine and Center for Health Equity and Quality Control (CHEQR), University of Florida, College of Medicine, Jacksonville

Training

Church members are trained as program leaders called Church Health Advisors (CHAs). The training workshop is designed to teach the CHAs to lead study participants through the 12-week HEALS hypertension control and prevention program. This training workshop familiarizes them with all HEALS material as well as appropriate intervention measures. Specifically, CHAs are trained to accurately measure the weight, height, waist circumference and blood pressure of HEALS participants. The workshop is led by members of the HEALS team, including nutritionists from the Duval County Health Department (DCHD). As Central Metropolitan CME church volunteered to participate and be the first site for the HEALS program, the Rev. Hardrick selected four members of the congregation to receive this training. Successful completion occurred in October 2012.

Focus Groups

The team has adopted a community-based participatory research (CBPR) approach to engage the church community as partners in assessing the problem of how to best implement the faith-based HEALS. In the CBPR framework, researchers and local people work together on a study that is designed, initiated and managed by the collaborative team. The assumption was that researchers often are unaware of all of the relevant issues that need to be considered in community based studies and that CBPR could serve to engender greater commitment among all research partners to uncovering social and behavioral determinants of health and to developing innovative, long-term interventions. In this regard three focus groups have been completed in different churches.

HEALS Program Description

The proposed HEALS program is an innovative effort/concept for reducing high blood pressure (BP) and its related health disparities by empowering African American communities. HEALS is a novel, faith-based, socio-culturally-tailored, multi-level, hypertension control and prevention program for African American churches in the southern part of the US. It is a community-based program in collaboration with CAB. CAB includes leaders from the AA community with extensive experience to guide the successful completion of HEALS program.

This one-year program offered to high-risk African American church members (age 25-65 years with hypertension) of the Central Metropolitan CME church, located in the Zone 1 of Jacksonville area occupied predominantly by African Americans who are un-insured and under-served. The program is conducted by the trained church members called Church Health Advisors (CHAs) at three levels:

  • Group level (led by CHAs): Weekly sessions (90 min group session per week for 12 weeks), followed by nine months of maintenance sessions (two hour group sessions per month for nine months). Each session starts and ends with a payer.
  • Individual level (led by CHAs): Weekly contact with members to individually tailor/assess the improvement toward individual goals (using food and fitness diaries), and to “coach” them to achieve their lifestyle goals. This includes a review of individual BP, self-monitoring records, individual barriers, and a tailored, individualized plan for the next week.
  • Church-level (led by Pastor): Pastor will take the lead in endorsing the program and motivating members, and provide positive encouragement to congregants. The pastor will mention the project during the weekly sermon; enhance the scriptures and biblical references.

The first three months of the HEALS program has been completed and program has shown significant reduction in blood pressure and weight of the participants from the baseline. The program is currently in maintenance phase.

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