STEPS TO A HEALTHIERUS INITIATIVE

Current Workshop Session II—Healthier People
(B2) In Faith Communities

Monday, October 24, 3:00 p.m.-4:30 p.m.

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Healthy Living Program (HLP)

Author
N. Bennett, Center for Rochester's Health, Monroe County Department of Public Health, Rochester, NY.

Background
The Healthy Living Program (HLP) is a faith/community-based initiative designed to promote healthy behaviors to prevent chronic disease, serving residents who are traditionally considered at-risk/underserved. Of the 836 participants who have completed the program, the majority were women (90%) with a mean age of 51 (range 19-92), 97% were African-American, 42% had attained a high school education or less, and 17% were uninsured or covered by Medicaid only. Overall, the participants had low levels of physical activity. The majority of participants (90%) were overweight or obese (BMI>25). Approximately 45% of the group had a history of hypertension, and 19% had diabetes.

Methods
The 12 week, 24 session program offers structured physical activity and a health promotion curriculum, delivered by peer counselors, to introduce participants to physical activity and to assist them to use existing community resources.

Results
Participants achieved improved levels of physical activity with significant improvements in BMI and physical fitness. Relative to improvements in physical activity levels, dietary pattern changes were modest. Changes were sustained at six months.

Discussion
The program was initiated through a partnership of the Monroe County Department of Public Health and the University of Rochester. It has been sustained through local funding and the development of Train to Sustain (TTS), a program to train a small number of HLP participants to become certified fitness instructors and to deliver the program in community sites, expanding access to the HLP. Graduates have become fitness instructors and/or peer health counselors for the HLP and have returned to their own churches as volunteer instructors. The aspect of fellowship among participants has been a key motivating factor in continuing the process of leading a healthier lifestyle. Although the goals and successes of the HLP are modest, they build towards sustainable and important behavior change in high risk populations.

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Provena St. Mary's Wellness Center for Special Needs Fitness Program

Author
M. Grimsley, Provena St. Mary's Hospital, Bourbonnais.

Background
The Provena St. Mary's Wellness Center entered into an agreement with the Kankakee County Training Center for the Disabled (KCTC) and the Chamness House, to provide fitness and general inclusion activities to persons with disabilities. Physical activity is important for these individuals as the disabilities they possess may affect their risk for heart disease, diabetes, and falls.

Methods
The KTC and the Chamness House refer participants to the program which targets senior populations, individuals with medical conditions, and individual with physical and mental disabilities. Groups of 6 to 15 meet with a fitness instructor twice a week for 45-minutes for cardiovascular exercise and resistance/strength training. The workouts are tailored to the special needs of each participant and instructors monitor participant workouts for safety and optimum intensity levels. The workouts are kept as structured as possible to show development with each individual.

Results
Improvements have been seen as individuals are able to exercise at a greater intensity, weight loss, reduced days missed due to illness, and Body Mass Index. Lifestyle improvements are shown by increased participation in the fitness program and inclusion with community members.

Discussion
Most wellness and fitness centers avoid working with special populations primarily because of lack of knowledge of how to deal with high-risk groups and increased liability in taking on persons with disabilities. KCTC has a nurse on staff who accompanies participants to the wellness center and alerts staff to any changes in their medical condition. The Wellness Center also has access to the Provena St. Mary's Physical and Occupational Therapy departments which provide additional individualized exercises for participants with severe conditions and assist with setting realistic individual goals.

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The Healing Zone

Author
H. Spindle, The Capital Area Agency on Aging, Richmond, VA.

Background
The National Caucus and Center on Black Aged, Inc. awarded in December 2003 a grant from the U.S. Administration on Aging to five sites to develop a three-year, faith-based, community health leadership program entitled, The Healing Zone: Community Health Action and Advocacy Training. The project is to increase community awareness about the impact of unhealthy lifestyle practices and to reduce obesity and risk factors leading to chronic diseases among African American older adults (50 and older). The objectives are weight reduction, improved nutrition, increased physical activity, and the establishment of church-based aging groups. By integrating health promotion efforts with the blend of body-mind-spirit often reflected in the African American church, we will create a replicable model program for behavior change, health promotion and advocacy.

Methods
Our Agency's program works with African American church ministers who select volunteers who serve as Senior Advocates that will receive training by our office on how to conduct the eight week sessions, provide them with materials and assist them in locating speakers. Staff support continues through the years. Participants have their weight, blood pressure and body mass index measured at the first and last session.

Results
The goal was accomplished to have 3 churches participate in the first year and 5 in the second year. Churches (rural and urban) were selected which had a membership of 1,000 or less. Churches continued their Healing Zones even after the eight weeks were completed. Ministers have also commented that they have changed their menus at church functions. One urban church located in a part of Richmond with a hilly landscape, turned the sanctuary into an "in-door track" and another brought in a fitness trainer to teach safe exercises.
DISCUSSION: External factors, such as transportation and location of site, have a bearing on the recruitment, attendance and its success. Senior volunteers within the church lead the program helped with the success.

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G.O.S.P.E.L.: A Faith-Based Initiative To Reduce Health Disparities Among African Americans

Author
D. Gold, Montgomery County Department of Health & Human Services, Wheaton, MD.

Background
Significant health disparities exist among African Americans. Meanwhile, health promotion efforts have often been hampered by difficulty reaching the community. The African American church has historically played a role in helping parishioners on many fronts. The church has the distinct advantage of being a trusted environment and an accessible way to reach many African Americans.

Methods
G.O.S.P.E.L. stands for Glorifying Our Spiritual and Physical Existence for Life. The G.O.S.P.E.L. program, initiated May 2003, represents collaboration between the Montgomery County Department of Health & Human Services and the Black Minister's Conference. The G.O.S.P.E.L. program outreaches to eleven African American churches, with a team of twenty-one community outreach workers. The program was designed to increase awareness among African Americans about tobacco related health disparities. Community outreach workers were recruited and trained to "get the word out" about health disparities and access to resources and services. Methods include: