Problem Addressed

• Cancer: African-American men were 1.4 times more likely than non-Hispanic White men to have new cases of lung and prostate cancer. African-American women were 10 percent less likely to have been diagnosed with—but 34 percent more likely to die from—breast cancer than non-Hispanic White women, suggesting that African-American women are not being adequately screened, diagnosed, and/or treated for the disease.¹
• Diabetes: African-American adults were 1.9 times more likely to have been diagnosed with, and 2.2 times more likely to die from diabetes than non-Hispanic White adults.¹
• Heart disease: African Americans were 1.4 times more likely than non-Hispanic Whites to have high blood pressure, and African-American men were 30 percent more likely to die from heart disease than non-Hispanic White men.¹
• HIV/AIDS: African-American males were seven times more likely to have AIDS than their non-Hispanic White peers, while African-American women were 21 times more likely to have the disease.¹

Description of the Innovative Activity

• Recruiting health representatives: Pastors or ministers of participating churches identify health representatives from within their congregations. The pastors select individuals they believe would be respected and persuasive voices for health awareness within the church community.
• Training for health representatives: Program staff train health representatives on disease prevention and health education topics related to chronic diseases, including the following: detrimental effects of chronic diseases for African Americans; identification of major risk factors; the disease process; diagnosis, treatment, and prevention; availability and methods of support and counseling for individuals and their families suffering from chronic diseases; and advocacy for early detection in the church. The program hosts a church orientation meeting with each new church and annual volunteer orientation sessions where new health representatives can receive the necessary training to support a congregation.
• Ongoing education: The program provides continuing education for health representatives through a resource room/library, a quarterly newsletter, and quarterly meetings that serve as a time for Christian fellowship, information exchange, and discussion of specific concerns of mutual interest.
• Educational and health screening events for congregants: Program staff work with the health representatives to implement church-based and individual church-requested activities. These events include organizing church wellness centers where health representatives can educate and counsel individual congregants, health and wellness events, and seminars led by outside speakers and educators.
• Volunteer recognition: Program staff plan and implement volunteer recognition initiatives, including a point system for activities and training designed to recognize volunteer efforts and encourage active participation and ongoing training among the health representatives.
• Community partnerships and events: The program also focuses on building and strengthening community partnerships, and working with these partners to provide education and screenings within the community through the following kinds of activities:
  • Community workshops to educate the community about the risks and effects of cancer, diabetes, cardiovascular disease, and HIV/AIDS.
  • Annual clergy orientation luncheons to educate clergy on the causes of cancer, diabetes, heart disease, and stroke; the particular needs of patients and their families; and the range of supportive care services available in the city. 
  • Outreach to community organizations both inside and outside of the health care arena, including the American Cancer Society, American Diabetes Association, American Heart Association, Community HIV Network, the Church Health Center, the Healthy Memphis Common Table, the Regional Health Council, and organizations representing local pastors/clergy and their spouses.  

References/Related Articles

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Innovator Disclosures

Results

• Enhanced access to education and screening: To date, Memphis Healthy Churches has trained more than 150 volunteer health representatives in 105 churches. These health representatives have provided approximately 40,600 educational and screening activities involving approximately 156,000 congregation members.  
• Improved health status: According to results from the program's self-reported wellness surveys conducted with parishioners, program participants report that they have lost a cumulative total of 2,543 pounds and that their average blood cholesterol, glucose, and blood pressure levels have fallen by 25 percent. 

Evidence Rating (What is this?)

Context of the Innovation

Planning and Development Process

• Initial grant: In 1988, Baptist Memorial Health Care received a 1-year grant to focus on increased access for African Americans to cancer information, screening, and treatment.
• Formation of advisory group: To determine the best way to reach the community quickly, Baptist Memorial Health Care project leaders convened a group of 10 influential faith leaders in the Memphis African-American community. Based on conversations with this group, the project leaders determined that the congregations would be receptive to serving as a base for these cancer awareness activities and that volunteers from each congregation could serve as a liaisons for the activities.
• Initial participants and activities, and expansion over time: Twenty congregations participated in the activities funded by the initial grant. Currently, 100 congregations participate. The focus of Memphis Healthy Churches activities has also expanded based on input from the participating congregations.

Resources Used and Skills Needed

• Staffing: A paid program director, program manager and administrative assistant staff the project and support the volunteer Health Representatives at each community. These staff members provide initial training and coordinate ongoing health education for the health representatives. 
• Costs: It is estimated that the project costs $2,637 annually per church, not including the in-kind contributions from the partners. Program resources cover office operational costs, health screenings, educational materials, and volunteer incentives.

Funding Sources

Tools and Other Resources

Getting Started with This Innovation

• Know the target community: Identify the target population to be served and their needs, including becoming educated on the demographics, culture, and behaviors of the local community in which the program is to be implemented. The goal is to learn where and how changes in lifestyle behaviors are most likely to be realized.
• Work closely with ministers: If the program is to be church based, make cultivation and education of ministers a top priority.
• Search broadly for funding: Seek external funding from local and national organizations to serve as a catalyst for individual churches to initially participate.
• Partner with community organizations: Cultivate relationships and partnerships with other health and community organizations to secure resources, in-kind support, and technical assistance.
• Commit staff to the project: Dedicate paid staff to the project, focusing their work on supporting the volunteers.
• Know your project's value: Become familiar with the needs within your community that only your project can impact. This level of knowledge will develop a brand position that will distinguish your project from similar projects in your area.
• Find a sponsor: Identify a sponsor with the resources and infrastructure to provide support to the program, such as trainers for clinical topics.

Sustaining This Innovation

• Ensure that volunteers feel supported and encouraged: Provide ample, sustained support to volunteers to promote successful, sustainable church programs and avoid volunteer burnout.
• Continually build and sustain partnerships: In addition to maintaining existing relationships, build new community partnerships to broaden program reach and expand knowledge about the program in the local community.
• Identify and collaborate with key community stakeholders: Build and maintain relationships with community leaders, congregational leaders, citizens, and other stakeholders who are, and can be, instrumental in the success of the project. Relationship building is paramount to the project's long-term success.
• Begin sustainability planning at the project development phase: Create a plan to become self-sustaining from the start. Funders are more likely to fund a project that has the potential to self-sustain without funding from grants, sponsorships, or any other entity.

Additional Considerations and Lessons

• Expanding beyond the current number of participating congregations (about 105) will be a challenge, even with adequate resources.

Use By Other Organizations

• The Washington County Health Partners in Washington, Pennsylvania has adopted several key elements of the project, including the training modules and volunteer recognition incentive program.