A Faith-based Initiative to Promote Health in Appalachia
Residents in many Appalachian counties experience poor cancer outcomes because of a high prevalence of cancer risks factors, such as obesity and physical inactivity, and limited access to medical care and preventive health services. Although cardiovascular disease is the leading cause of death for the U.S., cancer is the leading cause of death in Appalachia. Fifty-two of the 67 counties in Pennsylvania are in Appalachia.
Church in Rural Pennsylvania
Walk by Faith & Ribbons of Faith
In 2012, the Northern Appalachia Cancer Network (NACN), along with the Appalachia Community Cancer Network (ACCN), a NCI-funded community-based research initiative, began a 5-year, group-randomized study to improve health of overweight and obese adults in Appalachia.1 Over 600 church members in 28 churches participated in the 24 month, two-arm study. The intervention arm received a multi-level, faith-based diet and physical activity intervention program (“Walk by Faith”, WbF) while the control arm received a multi-level, faith-based intervention focused on cancer awareness and screening (“Ribbons of Faith”, RoF). Compared to participants in the RoF arm, participants in the WbF arm lost more weight, and the difference was statistically significant for men. WbF participants improved fruit and vegetable intake. To facilitate the dissemination and sustainability of WbF, toolkits have been developed for use in churches throughout Appalachia.
Walk by Faith Toolkit
To address the obesity problem identified in the 2016 needs assessment of the Penn State Milton S. Hershey Medical Center, the Cancer Institute offered the WbF toolkit to 45 churches in Perry and northern Dauphin
Counties. While toolkit uptake was limited to three churches (mostly due to lack of volunteer church coordinators to implement WbF Toolkit), WbF participation and impact was very good among 219 church participants during the 4 to 6 month implementation period. As a result, 86% of participants had greater awareness of the importance of fruits and vegetable consumption, as well as importance of physical activity and walking. In addition, two churches instituted policy changes that encouraged more fruits, vegetables, and low-fat entrees be served at church and youth groups functions. More than 41 million steps were reported by 186 participants at one church. All churches reported plans to continue to promote health within their congregations.
Based upon this 2017 experience, the Cancer Institute is working during 2017 with Nutrition Educators from Penn State Cooperative Extension to implement WbF in rural churches in four counties in central Pennsylvania.
The Walk by Faith Toolkit initiatives in 2016 and 2017 were supported in part through funding from the Penn State Health Community Relations Community Health Project, the Pennsylvania Department of Health (SAP 4100073089) and the Penn State Cancer Institute.
For more information, contact:
Eugene J. Lengerich, VMD, MS
Director, Community Sciences and Health Outcomes (CSHO) Shared Resource
Associate Director, Health Disparities and Engagement
Penn State Cancer Institute
717-531-7178; elengerich@psu.edu
1. Baltic RD, Weier RC, Katz ML, et al. Study design, intervention, and baseline characteristics of a group randomized trial involving a faith-based healthy eating and physical activity intervention (Walk by Faith) to reduce weight and cancer risk among overweight and obese Appalachian adults. Contemporary Clinical Trials 2015;44:1-10.