1 Emory University, Atlanta, GA, USA.
2 Cancer Coalition of South Georgia, Albany, GA, USA.
Health Educ Behav. 2018 Oct;45(5):672-681. doi: 10.1177/1090198118757826. Epub 2018 Mar 4.
Diet and physical activity are behavioral risk factors for many chronic diseases, which are among the most common health conditions in the United States. Yet most Americans fall short of meeting established dietary and physical activity guidelines. Faith-based organizations as settings for health promotion interventions can affect members at multiple levels of the social ecological model. The present study investigated whether change in the church social environment was associated with healthier behavior at church and in general at 1-year follow-up. Six churches received mini-grants and technical assistance for 1 year to support policy and environmental changes for healthy eating (HE) and physical activity (PA). Socioenvironmental (social support and social norms) and behavioral (HE and PA at church and in general) outcomes were derived from baseline and 1-year follow-up church member surveys ( n = 258). Three of six churches demonstrated significant improvements in all three socioenvironmental aspects of HE. Two of five churches exhibited significant socioenvironmental improvements for PA at follow-up. Church social environmental changes were related to health behaviors at church and in general ( p < .05). Change in social support for HE, social support for PA, and social norms for PA were each associated with three church-based and general behavioral outcomes. Social norms for healthy eating were related to two general behavior outcomes and social norms for unhealthy eating to one general behavioral outcome. Study findings demonstrate that socioenvironmental characteristics are essential to multilevel interventions and merit consideration in designing policy and environmental change interventions.
饮食和体育活动是许多慢性疾病的行为风险因素,而这些疾病是美国最常见的健康问题之一。然而,大多数美国人都未能达到既定的饮食和体育活动指南标准。以信仰为基础的组织作为健康促进干预的场所,可以在社会生态模式的多个层面上影响成员。本研究调查了教会社会环境的变化是否与教会和一般情况下 1 年后更健康的行为有关。六家教会获得了为期 1 年的小额赠款和技术援助,以支持健康饮食(HE)和体育活动(PA)的政策和环境变化。社会环境(社会支持和社会规范)和行为(教会和一般情况下的 HE 和 PA)结果来自于基线和 1 年随访教会成员调查(n=258)。在三个方面,有六家教会中的三家展示出了 HE 的所有三个社会环境方面的显著改善。在五个教会中有两个展示出了 PA 的社会环境显著改善。教会社会环境的变化与教会和一般情况下的健康行为有关(p<.05)。HE 的社会支持变化、PA 的社会支持变化和 PA 的社会规范变化都与三个教会和一般行为结果有关。健康饮食的社会规范与两个一般行为结果有关,而不健康饮食的社会规范与一个一般行为结果有关。研究结果表明,社会环境特征对于多层次干预至关重要,在设计政策和环境变化干预措施时值得考虑。