Progress 03/01/24 to 02/28/25
Outputs
Target Audience:No additional target audiences were reached during this reporting period. Analysis of data from21 interview participants; 265 focus group participants in 53 focus group discussion at 18 churches; 527 survey participants at 17 churches is ongoing. Changes/Problems:There have been no major changes or problems since the last progress report. A final no-cost extension period was requested and granted to allow sufficient time for robust dataanalysis and development of dissemination products for community and scientific audiences. What opportunities for training and professional development has the project provided?The lead graduate student and senior scientist for the project have developed leadership skills through this project.The lead graduate research assistant received mentorship in leading aresearch team from the project coordinator who recently completed PhD and MPH degrees. They have expressed that being a part of a research team hasbeen empowering. The lead graduate research assistant developed a complementary project for her doctoral dissertationresearch with guidance from the project director, project manager and members of the research team. How have the results been disseminated to communities of interest?Qualitative analysis of focus group discussions and interviews and analysis of surveys is ongoing; results are not ready todisseminate. Once results are ready, they will be disseminated to congregations that participated in the project through in personpresentations and written material to be distributed via church bulletins, newsletters, website, etc. Results will also be disseminated to the scientific community through additional peer-reviewed conference presentations and peer-reviewed publications. What do you plan to do during the next reporting period to accomplish the goals?Data analysis will be completed during the next reporting period.Qualitative data analysis for interviews and focus group discussions will be triangulated with results from surveys. Results will be disseminated as described above.
Impacts
What was accomplished under these goals?
No new accomplishments were achieved for Objectives #1 - #6 during the reporting period because the original study was closed as noted earlier. Objectives # 7 and #8: Fivegraduate students (fourMaster of Public Health and one PhD student in the Virginia Tech Translational Biology, Medicine and Health graduate program) participated in qualitative data analysis from interviews and focus group discussions conducted for the revised study protocol. Conversations with these students indicate that their interactions withthe project team during qualitative analysis has increased their perceived competence in health education planning and implementation and program evaluationand understanding of the value of Extension in collaborative community-based health programming and future career opportunities. Two of the MPH students arenow in the Translational Biology, Medicine and Health doctoral program, and another has applied to the program. All three of these students have discussed the value of Extension in translational research.
Publications
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Progress 03/01/23 to 02/29/24
Outputs
Target Audience:Recruitment of churches for the original study was closed in the Fall of 2023 due to inability of churches to recruit families. Recruitment of churches for the mixed methodsstudy conducted in lieu of the original studyhas been much more successful. 29 churches agreed to participate in the mixed methods study, and 21 churches participated in at least one component (interview with church health coordinator, focus group discussions with congregation members, survey with congregation members). Total number of participants during the reporting period was 792in the following ways (interview participants also completed the survey but did not participate in focus group discussions): 21 interview participants; 265 focus group participants in 53 focus group discussion at 18 churches; 527 survey participants at 17 churches. Changes/Problems:There have been no major changes or problems since the last progress report. Recruitment of churches to participate in interviews, focus group discussions and surveys was slower than anticipated, but a total of 21 churches completed at least one component, and most completed all three components. Qualitative analysis for interviews and focus group discussions will take longer than anticipated due to the nuanced and rich data that they have produced. An additional no-cost extension will be requested to allow sufficient time for robust data analysis and development of dissemination products for community and scientific audiences. What opportunities for training and professional development has the project provided?The graduate students involved in the project received training and experiencein research methods and qualitative data collection and analysis as part of theresearch team. The leadgraduate research assistantreceived mentorship in leading a research team from the project coordinatorwho recently completed PhD and MPH degrees. All research team members are black. They have expressed that being a part of a black research team that is conducting research with black participants has been empowering. The leadgraduate research assistant developed a complementary project for her doctoral dissertation research.The project coordinator and leadgraduate reasearch assistant were lead authors forabstracts for the American Public Health Association annual meeting that were accepted for presentation; they presented their work at the 2024 annual meeting. Focus group participants expressed that participating in the focus group discussions changed their perspective on how their churches can engage with congregation members and communities in terms of health programming. Preliminary qualitative analysis indicates that focus group participation sparked conversation about using focus group discussions and conversations with subgroups of congregations such as youth and families to better tailor efforts. How have the results been disseminated to communities of interest?Qualitative analysis of focus group discussions and interviews and analysis of surveysis ongoing; results are not ready to disseminate. Once results are ready, they will be disseminated to congregations that participated in the project through in person presentations and written material to be distributed via church bulletins, newsletters, website, etc. What do you plan to do during the next reporting period to accomplish the goals?The next reporting period will be used to complete data collection (interviews, focus group discussions, and surveys) and analysis. Qualitative data analysis for interviews and focus group discussions will be triangulated with results from surveys. Results will be submitted for presentation at the American Public Health Association annual conference and for publication in peer-reviewed journals.
Impacts
What was accomplished under these goals?
No new accomplishments were achieved for Objectives #1 - #6 during the reporting period because the original study was closed as noted earlier. Objectives # 7 and #8: Four graduate students (three Master of Public Health and one PhD student in the Virginia Tech Translational Biology, Medicine and Health graduate program) participated in interviews with church health coordinators and surveys with church congregation members. Conversations with these students indicate that their interactions with study participants and with the project team during qualitative analysis has increased their perceived competence in addressing health disparities and understanding of the valueof Extension in collaborative community-based health programming and future career opportunities. One of the three MPH students is now in the Translational Biology, Medicine and Health doctoral program, and another has applied to the program.
Publications
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Progress 03/01/22 to 02/28/23
Outputs
Target Audience:Four churches were recruited during the reporting period to participate in the project. All four identify as Black churches. Twoof the four churches were only able to recruit two or fewer families to enroll in the study. Two churches combined in an attempt to recruit a sufficient number of families. A total of five families were scheduled to participate in baseline data collection for these two churches. Baseline data collection was delayed when two families were not available due to unexpected travel. The churches subsequently decided that they were not able to participate because the families they had recruited were not certain that they would be able to fully engage in the program. Changes/Problems:As noted earlier, churches continue to struggle to recruit families with young children to participate in the study. Pastors and church leaders are enthusiastic about the study initially and work diligently to identify families from their church, other churches in the area, and the community. The qualitative study described above to be carried out during the no-cost extension periodis designed to explore the challenges that churches are facing to engage young families in the church in generaland in health programs and initiatives in particular. Members of the Project Advisory Board and staff of the Baptist General Convention strongly endorse the value of this work to the association and to churches. The qualitative study was initiated in February of 2023. Recruitment of churches and participants for interviews and focus group discussions is progressing well. Participants are highly engaged and extremely positive regarding potential value of the findings for the faith-based community. An additional no-cost extension period of approximately 6 to 8 months may be requested to allow sufficient time for in-depth qualitative analysis once all interviews and focus group discussions have been completed and fordevelopment of dissemination products tailored to faith-based organizations and the scientific community. What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?Project Advisory Board meetings are heldto disseminate project results and well as get input from advisory membersregarding program design and improvements. A Project Advisory Board Meeting was held in Septemberof 2022. Membersrepresenting stakeholder groups from Extension, the statewide association of churches, and the Virginia Family NutritionProgram attended the meetings. Discussion included updates from the virtual "pilot" of the program and participation rates,lessons learned from the virtual pilot, feedback from church team members about the program, and continued strategies tooffer the EHF program virtually in response to continued COVID-19 disparities-particularly in the Black community. The Advisory Board also discussed strategies to implement a qualitative study to be proposed for a no-cost extension period of the study, including interviews with health ministry coordinators and focus group discussions with congregation members. An EHF team member participatedin theannual conference (June 2022) hosted by project partner Baptist General Convention of Virginia, a statewide association of churches, to disseminateinformation about the EHF program to more than 200+ attendees representing Black churches from around the state. The project website provides current project information to communities of interest to include congregation"features" to highlight congregational efforts throughout the state. The web address is:https://cphpr.publichealth.vt.edu/ehf.html. What do you plan to do during the next reporting period to accomplish the goals?A 12-month no-cost extension request was approved as follows: The no-cost extension will leverage remaining funds to explore in-depth whether and how the decline in religiously affiliated Americans and church attendance in recent decades, particularly during the COVID-19 pandemic, may affect the ability of churches to prioritize and engage in health promotion initiatives and programs. Strategies to better position churches to support health-related needs of congregation members and to partner with community-based organizations such as Cooperative Extension that provide health programs will also be addressed. A mixed method approach will include semi-structured interviews (n~ 180) with pastors, church leaders, and congregation members from approximately 30 Black Baptist churches in the Baptist General Convention of Virginia (BGCVA). Six participants from each church will include at least two leaders of church ministries and both male and female congregation members. The 30 churches will include churches that have partnered with the current project or other Cooperative Extension programs, churches that have indicated interest in partnering but been unable to do so, and churches that have not indicated interest in partnering. The churches will represent an approximately even mix of rural and urban locations and small, medium and large congregations. A survey (hard copy and online) will be offered to adult congregation members in churches throughout BGCVA (n~ 900), with a target of 1,000 responses. Interview and survey questions will be drawn from peer-reviewed literature and/or co-developed with the Community Advisory Board for the project.
Impacts
What was accomplished under these goals?
Objectives #1 - #4 and # 6: No new accomplishments were achieved during the reporting period because no new churches participated in the study. Objective #5: Four congregation members were trained to deliver both the Money Smart curriculum for children and the child curricula for obesity prevention (Choose Health - Food, Fun & Fitness and Pick a Better Snack) via Zoom. Objectives #7 and #8:Two students (one Master of Public Health and one PhD student in the Virginia Tech TranslationalBiology, Medicine and Health graduate program) participated in the project and will compelte a post-participation assessmentrelated to addressing health inequities, health education planning and implementation, program evaluation and the value ofExtension in collaborative community-based health education and advancing career potential.
Publications
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Progress 03/01/21 to 02/28/22
Outputs
Target Audience:One new church was recruited during the reporting period to participate in the project. This church identifies as a Black church. It was randomly assigned to the treatment (lifestyle education for obesity prevention) condition. A total of four families enrolled in the study. Baseline data collection was conducted, the intervention was completed, and post-program data were collected. The total number of adult participants in the new church church was four. Of these, three were female and one was male. All participants identified as Black/African American, and none identified as Hispanic. The total number of child participants in the new church was four. Of these, three were female and one was male. All child participants identified as Black/African American, and none identified as Hispanic. Changes/Problems:Upgrades to the program approach have been outlined above. Triangulating process data from EHF personnel, program participants, church teams, and the advisory board has provided insightful recommendations to improve challenges named in previous reports. Additional improvements have been made such as creating an "Open Enrollment" initiative which formalizes the "90 day" recruitment process that includes pre-scheduled information sessions, pre-screening enrollment registration, expanded technical assistance, streamlined church paperwork systems, and church partnership assistance for enthusiastic congregations needing assistance to meet eligibility requirements. The project website also continues to ensure transparent and clear communication regarding expectations for churches and participants. COVID-19 continues to impact project recruitment and church capacity and readiness. It also affects additional partnerships staffing, travel, and logistics. However, three virtual pilots of the EHF program (Fall 2021/Spring 2022) were successfully completed with a new and returner church. A focus group of church team members and participants (youth/adults) was hosted on December 8, 2021, to explore program satisfaction, virtual class experiences, and virtual program preparation. Yielding data revealed that participants and church team members liked the virtual option and the flexibility to participate from the comforts of home, the office, car, etc. E-learning equipment (e.g., tablets, hotspots, headphones) that participants and teams could check out reduced significant barriers to participate in the program. Curriculum support tools and binders also ensured folks could learn with e-equipment as well as hands on supplies. Church teams also agreed that the following process should continue as it made the preparation and launch process efficient and pleasurable: Every church team member (including the Coordinator) is trained to deliver all children's curriculum and the adult curriculum in regions with limited Cooperative Extension staffing Information and prep sessions to clearly outline the launch process Video orientation recordings and website updates to further guide congregations Digitized (e.g., training materials, attendance sheets, supplies checkout, compensation forms, etc.) to further reduce unnecessary church preparation challenges as well as improved church team capacity and preparedness to successfully deliver program protocol. The Project Director (Hosig) plans to contact Program Officer Koenings to discuss how to request a no-cost extension to continue to build on lessons learned, more fully meet project goals and objectives and provide additional insights to the research community regarding remote program delivery and evaluation in context of a group-randomized control trial using virtual technology. Dr. Hosig presented preliminary lessons learned at the National Health Outreach Conference in May 2022 (to be reported in Year 5 report), and there was siginficant interest in remote program delivery and evaluation in partnership with churches. What opportunities for training and professional development has the project provided?Three project staff members were trained to deliver all five curricula (two adult and three child curricula) remotely. The purpose of this training was to enable project staff to most fully support congregation members who are trained to deliver these curricula in person and remotely and to increase staff capacity to deliver programs when insufficient numbers of congregation members or Extension staff are available to deliver the curricula. One Extension staff member was trained to implement the Money Smart curriculum for adults. Five congregation members were trained to deliver the Money Smart curriculum for children via Zoom. One congregation member was trained to deliver the child curricula for obesity prevention (Choose Health - Food, Fun and Fitness and Pick a Better Snack) via Zoom. The graduate research assistant for the project began participation in the 10-week Accessibility Professional Certification Grant Program for the Certified Professional in Accessibility Core Competencies (CPACC) certification in February of 2022. The program is administered by Virginia Tech Technology-Enhanced Learning and Online Strategies. How have the results been disseminated to communities of interest?Project Advisory Board meetings are hosted to disseminate project results and well as get input from advisory members regarding program design and improvements. A Project Advisory Meeting was held on December 10, 2021. Members representing stakeholder groups from Extension, the statewide association of churches, and the Virginia Family Nutrition Program attended the meetings. Discussion included updates from the virtual "pilot" of the program and participation rates, lessons learned from the virtual pilot, feedback from church team members about the program, and continued strategies to offer the EHF program virtually in response to continued COVID-19 disparities-particularly in the Black community. Additional discussion included the desire to continue providing EHF churches with consistent and updated information about COVID-19 state regulations, faith-based support tools and community information sessions, mental and emotional health support services, anti-racism and social justice resources and support tools, along with updates regarding the EHF program. Updates were received very well by our partners and congregations as it was noted that the public health needs of the community were prioritized while finding innovative ways to offer the EHF program to the community. Additionally, each year since its launch, the EHF team participates in an annual conference, hosted by the statewide association of churches, to disseminate information about the EHF program to more than 200+ attendees representing Black churches from around the state. More specifically, a two-day workshop is offered for attendees to get an in-depth understanding of the program design as well as register to participate. The project website continues to provide current project information to communities of interest to include congregation "features" to highlight congregational efforts throughout the state. The web address is: https://cphpr.publichealth.vt.edu/ehf.html. What do you plan to do during the next reporting period to accomplish the goals?Process and outcome data are used to address any challenges related to each objective. For example, recruitment and participation of churches from February 2020-May 2021 was very difficult due to COVID-19. Hosting in-person programs continues to be limited, as well as varies from congregation to congregation. Additionally, churches continue to function largely online with some even closing due to financial difficulty with the pandemic. Similar to many organizations, EHF decided to go virtual to offer the program as a much-needed resource due to the financial and health strain COVID-19 created. EHF was updated to include a virtual implementation process, and adjustments to improve congregation on-boarding, participant recruitment, etc. continued. More information is provided below and in the "Changes/Problems" section. Staffing: Initial Protocol Role-specific training only Extension adult educators only Current Protocol Cross-training for church team Exansion of church team roles Recruitment Initial Protocol In-person, email and telephone recruitment No pre-screening for potential to recruit at least 10 families with children in elementary school Current Protocol In-person and/or Zoom orientation for church leaders Empowering Healthy Families website Randomization to treatment condition Initial Protocol Randomize at/after baseline data collection Current Protocol Randomize ~ 3 to 4 weeks priro to program launch to allow educators (church and Extension) time to train and prepare (church coordinators and congregration not informed of condition until baseline data collection is complete) Program Flow Initial Protocol Preparation process and timing determined by church coordinator In-person training only Self-guided paperwork process Current Protocol 90-day church onboarding process with pre-determined timing for major milestones Culturally sensitive and time-specific paperwork process (digitized) Program Implementation In-Person Protocol 8-week program In-person paperwork (background check, fw9, notary, etc.) Program implemenation in-person, indoors Virtual Protocol 6-week option Electronic services/platforms for church and educator onboarding COVID-adjusted data collection (social distancing, electronic/virtual consent process, questionnaire Training In-Person Protocol Hybrid format Onsite supplies and materials in-person interaction for engagement Societal awareness Virtual Protocol Practice with technology Families and educators provided with e-leaning equipment (tablets, hotspots) as needed Engagement via virtual technology Societal awareness Technology In-Person Protocol Paper/hard copy suveys and documents Hybrid electronic platforms for communication Primarily in-person support Virtual Protocol Focus on adaptabilty and flexibility Additional support for IT needs Person-centered support Feedback via Focus Group Discussions with Virtual Participants Virtual implementation provided accessibility in comfort of home Technology to participate from home appreciated Relatively few technological issues overall Availabilty of virtual participation allowed some families to participate and allowed families to join sessions more readily and often even with time conflicts Some participants were more comfortable providing feedback and answering questions remotely than typcially in person
Impacts
What was accomplished under these goals?
Objectives #1 and #2: Baseline data collection was completed at one church (n=11), post-intervention data collection was completed at two churches (n=42), and 12-month data collection was completed at two churches (n=21). Objective #3: No churches completed the Church Readiness and Capacity Health Assessment (CRCHA) during the reporting period due to remote program delivery. The CRCHA is being updated to include virtual health and wellness activities and resources. Objective #4: One Extension staff member participated in the project during the reporting period and will complete the partnership synergy assessment. Objective #5: Congregation members continue to be trained to deliver educaiton and will be invited to provide feedback related to self-efficacy, satisfaction, barriers, feasibility, and sustainability to deliver these programs. Five congregation members were trained to deliver the Money Smart curriculum for children via Zoom. One congregation member was trained to deliver the child curricula for obesity prevention (Choose Health - Food, Fun and Fitness and Pick a Better Snack) via Zoom. Objective #6: This objective was not addressed this year due to continued adjustments to COVID-19 and its effect on 4H staffing, as well as programs still being updated to be taught virtually. Extension personnel from the Family Nutrition Program did implement the 4H Teen Cuisine curriculum at one church (Tabernacle of Zion) for two children who were older than elementary school age (not eligible to participate in the research study, as they aged out of the program as 6th graders). Objectives #7 and #8: Two students (one Master of Public Health and one PhD student in the Virginia Tech Translational Biology, Medicine and Health graduate program) participated in the project and will compelte a post-participation assessment related to addressing health inequities, health education planning and implementation, program evaluation and the value of Extension in collaborative community-based health education and advancing career potential.
Publications
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Progress 03/01/20 to 02/28/21
Outputs
Target Audience:Fournew churches were recruited during the project period to participate in the study. All identified as Black churches.Allfourwere randomized to treatment condition (two to the obesity prevention intervention andtwo to the attention control financial management program). Only one church began baseline data collection before in-person research activities were paused due to the COVID-19 pandemic. Only one family attended baseline data collection on the first data collection session inFebruary of 2020, and data collection was paused after that session. Twelve-month data were collected from participants at one church in February of 2020 (n=11; 10Black, 1 White). Changes/Problems:Recruitment of churches has been refined through better communication with and screening of churches to ensure that a sufficient number of families with children in elementary school are available from which to recruit. The project website also serves to ensure transparent and clear communication regarding expectations for churches and participants. Staffing for the financial management program has been addressed by training church members to teach the adult curriculum. This approach will enhance capacity-building and sustainability for the churches. Timing for randomization has been shifted earlier, prior to baseline data collection, to allow more time for training educators and scheduling day/time for Extension staff to include in their planning calendars. Churches (coordinators, implementation staff and prospective participants) are still blinded to condition until baseline data collection is complete to avoid potential selection bias. An additional challenge to participant recruitment arose during February of 2020. The COVID-19 pandemic was in the early stages, but church coordinators at four churches that were already having difficulty recruiting participants decided to delay participation until the next program cycle (Fall 2021). This may help to expedite involvement of these churches, pending control of the pandemic. In the meantime, EHF has utilized this as an opportunity to further improve the project preparation and delivery process. For example, church size and congregational make-up influenced the Church Coordinators' ability to recruit Child Educators. Additionally, personal and professional schedules created varying schedule conflicts on program days. Therefore, every church team member (including the Coordinator) was trained to deliver all children's curriculum and the adult curriculum in regions with limited Cooperative Extension staffing. This specific adjustment decreased project launch delays, improved church team/educator recruitment, and enhanced capacity of the church to utilize curriculum in future efforts. Lastly, a "60 and 90 Day" onboarding process was created to systematically guide churches through a six-step launch to close process. Video orientation recordings further guide congregations through this process. Additionally, paper-based forms (e.g. training materials, attendance sheets, supplies checkout, compensation forms, etc.) have now been digitized to further reduce unnecessary church preparation challenges as well as improved church team capacity and preparedness to successfully deliver program protocol. To position the project for success given the uncertainty related to control of the pandemic and hesitation of some churches to consider in-person programming in the near future, plans are in place to shift to virtual implementation of the education programs. This decision was made in consultation with the Director for Men, Social Justice and Health for the Baptist General Convention of Virginia (BGCVA) and the BGCVA Project Assistant. Starting in Fall 2021, educational curricula for adults and children for the treatment condition (childhood obesity prevention) and attention control condition (financial management) will be delivered via Zoom through the Virginia Tech Zoom license. Program staff are preparing for virtual delivery of curricula. Data collection will be in person but outdoors, with approved safety precautions following current CDC, state and local guidance (or more restricted than current guidance). Families will participate in data collection via appointment and stay in their cars or sit at tables in covered outdoor spaces. Height and weight will be collected without personal contact, and all program staff have been fully vaccinated. Twenty-five tablet computers with hotspots were purchased with internal Virginia Tech funds for a pilot program of virtual delivery in Fall 2021. One church will participate in the pilot for the financial management curricula (adult and child), and one church will participate in the pilot for the childhood obesity prevention curricula (adult and child). Recruitment of churches for the randomized control trial willcontinue in Summer of 2021 in order to resume the RCT in Spring of 2022 with virtual program delivery. The Project Director will consult with the NIFA Program Officer regarding potential shift in project goals and objectives and target enrollment given these changes that are in response to the COVID-19 pandemic. What opportunities for training and professional development has the project provided?Four Extension staff members were trained to deliver the Cornell Healthy Children, Healthy Families curriculum. Nine congregation members were partially trained to deliver the FDIC Money Smart curriculum. Approximately 50% of the training was completed before being halted due to the COVID-19 pandemic. Nine congregation members were partially trained to deliver OrganWise Guys and Choose Health - Food, Fun and Fitness. Approximately 50% of the training was completed before being halted due to the COVID-19 pandemic. How have the results been disseminated to communities of interest?Due to COVID-19, a project advisory meeting was not scheduled in 2020. Instead, efforts switched to providing EHF churches with consistent and updated information about COVID-19 state regulations, faith-based support tools and community information sessions, mental and emotional health support services, anti-racism and social justice resources and support tools, along with updates regarding the EHF program. This transition was received very well by our partners and congregations as it was noted that the public health needs of the community were prioritized while waiting an appropriate timeframe to gently re-introduce updates with the EHF program. The project website was kept up to date to provide current project information to communities of interest to include congregation "features" to highlight congregational efforts throughout the state. The web address is: https://cphpr.publichealth.vt.edu/ehf.html. What do you plan to do during the next reporting period to accomplish the goals?Process and outcome data to address each objective will be collected during the next reporting period. Recruitment and participation of additional churches and research participants and involvement of project staff, congregation members and students will continue as planned. An additional challenge to participant recruitment arose during February of 2020. The COVID-19 pandemic was in the early stages, but church coordinators at four churches that were already having difficulty recruiting participants decided to delay participation until the next program cycle.These churches will be re-engaged again in the Fall of 2021 to gauge interest to continue with the project, pandemics pending. Additionally, the EHF team is updating the program's design and implementation processes to improve congregation on-boarding, participant recruitment, etc. More information regarding a shift to virtual implementation of the educational programsis provided in the "Changes/Problems" section. The Project Director (Hosig) will consult with the Program Officer regarding a potential shift in project goals and objectives to reflect evaluation of virtual program delivery in terms of feasibility, acceptability, reach and preliminary effectiveness.
Impacts
What was accomplished under these goals?
Objectives #1 and #2: No baseline data collection or follow up data collection were collected during the reporting period due to the COVID-19 pandemic. All in-person research activities were paused by the end of February 2020. Objective #3: Two churches that participated in the obesity prevention treatment condition completed the Church Readiness and Capacity for Health Assessment (CRCHA)and identified strategies to improve the church health environment.Both churches completed the Church Readiness and Capacity Health Assessment (CRCHA) protocol to address policy, systems, and environment.Both churches also completed the "CRCHA Strengths & Challenges Worksheet" to further plan their CRCHA project to further improve their church health environment. The following table further describes the projects each church selected along with support resources provided sustain health environmental upgrades. Unfortunately, due to COVID-19,one otherchurch was unable to launchCRCHA efforts. Strategies Support Tool(s) to Sustain Efforts Healthier Options for Church Events and Outreach Programs Written guidelines and/or policies help create expectations and standards regarding healthy choices for congregational and community outreach food and nutrition-based efforts. Cabinet to store healthy snacks and beverages for youth activities and events Fast food calculation, healthy eating, physical activity, and healthy beverage leaflets for use at church functions for youth and adults Health Promoting Messages about Nutrition and Food via guest speakers series Healthier Options for Church Events and Outreach Programs Written guidelines and/or policies help create expectations and standards regarding healthy choices for congregational and community outreach food and nutrition-based efforts. Cabinet to store healthy snacks and beverages for youth activities and events Fast food calculation and health beverage leaflets for use at church functions for youth and adults Objective #4:Four Extension staff members participated in the project during the reporting period and will complete the partnership synergy assessment. These educators were trained to deliver the Cornell Healthy Children, Healthy Families curriculum. Objective #5: Congregation members continue to be trained to deliver education and will be invited to provide feedback related to self-efficacy, satisfaction, barriers, feasibility and sustainability to deliver these programs after the project ends. Unfortunately, due to COVID-19 four churches prepared to launch their programs in March/April of 2020 were able to complete 50% of their training and unable to launch their program which is delivered in-person.Nine congregation members began training during the reporting period. Objective #6: This objective was not addressed during the reporting period because in person programming was halted due to the COVID-19 pandemic. Objectives #7 and #8: Three undergraduate students assisted with the project but were notfully engaged with overall project implementation because in person programming was halted due to the COVID-19 pandemic. They will not complete post-participation assessment related to addressing health disparities, health education planning and implementation, program evaluation and the value of Extension.
Publications
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Progress 03/01/19 to 02/29/20
Outputs
Target Audience:Five new churches were recruited during the project period to participate in the study. Allidentfied as Black churches.Three were randomized to treatment condition (two to the obesity prevention intervention and one to the attention control financial management program). Baseline data collection was conducted at three churches, but only one new church (randomized to the obesity prevention intervention)was able to recruit a sufficient number of families to begin participation in the program. The total number ofadult participants in Program #1 in the one new churchwas 13. Of these, 11 were female (2 male), and 13 identified as Black/African American (no Hispanic). The total number ofchild participants in Program # 1 in the one new church was 13. Of these,8 were female (5 male), and 13 identified as Black/African American (no Hispanic). A total of three families (4 adults and 5 children; 100% Black; 0 Hispanic) participated in baseline data collection at the two churches that deferred participation to the next program cycle due to insufficient participant numbers. One churchparticipated in the alternate program offered after 12-month data collection (Program #2). Changes/Problems:There have been no changes to the overall approach, but challenges related to recruitment of churches, staffing, and timing/blinding related to randomization have continued as described in the previous sections. As noted, recruitment of churches has been refined through better communication with and screening of churches to ensure that a sufficient number of families with children in elementary school are avaialble from which to recruit.The project website also serves to ensure transparent and clear communication regardingexpectations for church and participants. Staffing for the financial management program has been addressed by training church members to teach the adult curriculum. This approach willenhance capacity-building and sustainabilityfor the churches. Timing for randomization has been shifted earlier, prior to baseline data collection, to allow more time for training educators and scheduling day/time for Extension staff to includein their planning calendars.Churches (coordinators, implementation staff and prospective participants) are still blinded to condition until baseline data collection is complete to avoid potential selection bias. An additional challenge to participant recruitment arose during February of 2020. The COVID-19 pandemic was in the early stages, but church coordinators at four churches that were already having difficulty recruiting participants decided to delay participation until the next program cycle (Fall 2020). This may help to expedite involvement of these churches, pendingcontrol of the pandemic. What opportunities for training and professional development has the project provided?One program assistant from the Virginia Family Nutrition Program was trained to deliver the Cornell Healthy Children, Healthy Families (HCHF) curriculum. Twocongregation members were trained to deliver the Money Smart curriculum for adults Thirteen congregation members were trained to deliver the child obesity prevention curricula (OrganWise Guys and Choose Health - Food, Fun and Fitness). Five congregation members were trained to deliver the Money Smart curriculum for children. How have the results been disseminated to communities of interest?A Project Advisory Meeting was held on August 15, 2019.Twelvemembers representingstakeholder groups from Extension, thestatewide association of churches, and the Virginia Family Nutrition Program attended the meetings. Discussion included updates on program implementation and participation, summaries of presentations at national conferences, lessons learned, and strategies to recruit churches with sufficient numbers of young families. A project website was developed to provide current project informationto communities of interest. The web address is: https://cphpr.publichealth.vt.edu/ehf.html What do you plan to do during the next reporting period to accomplish the goals?Process and outcome data to address each objective will be collected during the next reporting period. Recruitment and participation of additional churches and research participants and invovlement of project staff, congregation members and students will continue as planned. An additional challenge to participant recruitment arose during February of 2020. The COVID-19 pandemic was in the early stages, but church coordinators at four churches that were already having difficulty recruiting participants decided to delay participation until the next program cycle (Fall 2020). This may help to expedite involvement of these churches, pendingcontrol of the pandemic.
Impacts
What was accomplished under these goals?
Objectives 1 and 2: Baseline data collection was completed at one church (n=26). Post-interventiondata collection was completed at four churches (n=49), and 12-month data collection was completed at one church (n=14). Objective 3: Three churches completedthe Church Readiness and Capacity Health Assessment protocol to address policy, systems and environment. All three churches selected healthy snacks for children as their primary policy change. Objective 4: Three Extension staff members participated in the project during the reporting period and will complete the partnership synergy assessent. Objective 5:Fourteencongregation memberswere trained to deliver education and will be invited to provide feedback related to self-efficacy, satisfaction, barriers, feasibility and sustainability to deliver these programs after the project ends. Objective 6: This objective was not addressed this year due to scheduling conflicts for 4H staff; Extension personnel from the Family Nutrition Program did implement the 4H Teen Cuisine curriculum at one churchfor eight children who were older than elementary school age (not eligible to participate in the research study). Objectives 7 and 8: Eight students (2 undergraduate and 6 graduate) assisted with the project and will complete post-participation assessment related to addressing health disparities, health education planning and implementation,program evaluation and the value of Extension.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2019
Citation:
Kathryn Hosig, Monica Motley, Tina Savla. Childhood obesity prevention with church, Extension and academic partners in an integrated randomized control trial. Journal of Nutrition Education and Behavior, Vol. 51, Issue 7, S22S23. https://www.jneb.org/article/S1499-4046(19)30583-4/fulltext
Published in issue: July-August, 2019.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2019
Citation:
Hosig K, Motley M, Savla T. Church, Extension and Academic Partners Empowering Healthy Families: Formative Evaluation for a Randomized Control Trial. Oral presentation at National Health Outreach Conference, Fort Worth, TX. May 2, 2019.
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Progress 03/01/18 to 02/28/19
Outputs
Target Audience:Fourchurches participated in the project during the reporting period.One served as a pilot location for the obesity prevention intervention, two were randomized toreceive the obestiy prevention intervention, and one was randomized to receive the control intervention financial management). The total number of adult participants was 38.Of these, 36 were female (2 male), and 37 identified as Black/African American (1 white). The total number of child partipants was 37. Of these, 22 were female (15 male), and 37 identified as Black/African American. Changes/Problems:Challenges There were no changes to the overall approach, but challenges arose related to coordination among Extension personnel and churches in the randomized control trial protocol. The randomized control trial protocol requires randomization of churches to treatment condition (obesity prevention or financial management) after baseline data collection. Three different Extension programs are involved in the project: Family Nutrition Program (EFNEP) and 4H for the obesity prevention intervention and Family and Consumer Sciences for the financial management (active control) intervention. Staff from these programs experienced difficulty holding the day/time in their schedules while churches recruited participants prior to baseline data collection. Recruitment of participants took longer than anticipated, particularly for the first two churches in fall of 2019. One of those churches was not able to recruit a sufficient number of participants. Delayed participant recruitment caused Extension staff to hold the day/time on their calendars longer than originally planned. This is especially burdensome for staff whose program was not randomly selected. Staff indicated that holding these times for such a long period caused them to lose the opportunity to recruit participants for other programs, reducing their participant numbers overall. The planned approach is to have churches identify the best day of the week and time of day for holding the program. This has caused problems for staffing by Extension personnel. Churches often select evenings or Saturdays to meet the needs of their families. Family Nutrition Program educators are classified staff who must have approval to work outside normal work hours and use "comp time". Other Extension staff have more flexibility regarding scheduling but have expressed concern over working on Saturdays or evenings for nine weeks in a row. This concern was exacerbated by the delay in scheduling noted above. The initial approach for recruiting churches was to have a coordinator from the statewide association of churches identify interested churches. This presented challenges in the first year because there was no Family Nutrition Program educator available to serve two of the churches, and the Family and Consumer Science agent was unavailable to teach on Saturdays for the church randomized to receive the financial management program. One church that intended to participate in this reporting period was unable to recruit a sufficient number of families. The church congregation is small, with few young families. Solutions The research team has identified solutions for the challenges that arose during the first year of the project as described below. Counties/regions with adequate Extension staffing and capacity for each program (obesity prevention and financial management) will be identified first, and then the coordinator from the statewide association of churches and project director will identify and recruit churches in those areas. The project director will work with Extension staff to identify any scheduling considerations to provide options for day/time to the churches. Churches will be randomized to treatment prior to baseline data collection using a blinded protocol. A staff member in the Center for Public Health Practice and Research who is not involved in the project will conduct the randomization and share the results only with Extension staff involved in teaching the intervention and control curricula. This will allow those staff to plan their calendars more efficiently. Church staff, participants and project staff involved in data collection and interaction with churches will be blinded to treatment condition prior to baseline data collection. This process was used successfully in the spring of 2019. The project director and project manager will workclosely with prospective churches to determine feasibility of recruiting young families before the churches begin participation. Size and age distribution of the congregation will be considered along with existing relationships with nearby churches. If feasibility of recruiting at least 10 families is uncertain, participation by that church will be delayed to a future time slot. What opportunities for training and professional development has the project provided?Eleven program assistants from the Virginia Family Nutrition Program participated in a 3-day training on the Cornell Healthy Children, Healthy Families (HCHF) curriculum. Two community members (church coordinators) were subsequently trained on the HCHF curriculum. Two project staff and one community member were trained on the Money Smart adult curriculum. Thirteen church volunteers were trained on the child obesity prevention curricula (OrganWise Guys and Choose Health - Food, Fun and Fitness. Three church volunteers were trained on the Money Smart child curriculum. How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?Outcome data to address each objective will be collected during the next reporting period. Recruitment and participation of additional churches and research participants and involvement of project staff and students will continue as planned.
Impacts
What was accomplished under these goals?
Baseline data collection for 38 adults and 37 children (Objectives 1 and 2). Three churches participated in the Church Readiness and Capacity Health Assessment protocol to address policy, systems and environment (Objective 3). Sixteen church volunteers were trained to deliver education and will be invited to provide feedback to address Objective 5. Objective 6 was not addressed this year due to scheduling conflicts for 4H staff; the three churches that received the obesity prevention intervention have all expressed interest in working with 4H, particularly for the teen curriculum entitled Teen Cuisine. Five students participated in the project and completed baseline assessment related to Objectives 7 and 8. Outcome data for each objective will be collected during the second year of the project.
Publications
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