Multiple behavior change among church members taking part in the faith, activity, and nutrition program

Abstract

Objective: To examine the extent to which participants in a combined physical activity (PA) and dietary intervention achieved changes in multiple health behaviors.

Design: Group randomized trial; includes only participants assigned to the intervention group only.

Setting: Thirty-six churches in South Carolina.

Participants: Three hundred sixty African American church members.

Intervention: A 15-month PA and dietary intervention, guided by the structural ecological model, targeting environmental (i.e., social, cultural, physical) and organizational (ie, policies, practices) changes within the church.

Main outcome measures: Self-reported PA, fruit and vegetable consumption, fat-, and fiber-related behaviors.

Analysis: Change in each behavior was defined as unadjusted pretest-posttest improvement ≥ 0.20 of the baseline standard deviation. The total number and each combination of behaviors changed were calculated.

Results: Up to 19% changed no health behaviors as defined above, 31% changed 1 health behavior, 31% changed 2 health behaviors, 13% changed 3 health behaviors, and 5% changed all 4 of the targeted health behaviors. Combinations of multiple behavior change included PA and dietary behaviors, which suggests that both behaviors can be changed simultaneously.

Conclusions and implications: Nearly half of participants changed at least 2 health behaviors. Faith-based interventions targeting environmental and organizational change can successfully change multiple behaviors, potentially leading to greater improvements in public health.

Keywords: African Americans; diet; faith-based; multiple behavior change; physical activity.