Churches as Cornerstones of Cardiovascular Health Promotion

Faith-based cardiovascular health initiatives have become a powerful approach to addressing health disparities in underserved communities. Churches, particularly within African American communities, play a crucial role in promoting heart health through structured interventions, education, and support programs. As trusted institutions, they provide not only spiritual guidance but also essential health resources, making them ideal partners in cardiovascular disease prevention and management.^1-4 This article explores recent studies highlighting the effectiveness of church-led health initiatives and the vital role faith-based organizations play in improving cardiovascular outcomes.

Faith-Based Communities Addressing Health Disparities

This brief collection of studies below underscores the influential role churches play in addressing health disparities and promoting wellness in underserved communities, particularly through partnerships with African American congregations. By leveraging their influence across a range of health domains—including mental health,¹⁰ nutrition, and physical activity,¹¹ COVID-19 vaccination,¹² diabetes,¹³ and cancer¹⁴—churches have proven to be pivotal in tackling diverse health challenges.

Pilot Study of a Church-based Community Health Worker Intervention for African Americans with Hypertension

• Authors: Lynch et al.⁶ (2024)
• Study Design: Single arm pilot study
• Participants: African Americans with Hypertension; Mean age: 63.4 years
• Intervention: Biweekly visits at home or church from church community health workers (CHW). Participants self-monitor and log blood pressure (BP) daily. Each visit with CHW included:
  • Setting a SMART goal for behavior change.
  • Reviewing BP logs, identifying issues, and updating the action plan if needed.
  • Engaging in diet activities and applying lessons to an action plan.
  • Tracking progress on previous goals and refining strategies using motivational interviewing.
• Key Findings:
  • Average blood pressure reduction of -5 mm Hg
  • Improved medication adherence
  • Decrease in DASH diet adherence

Design and Methods of a Church-based Physical Activity Program to Improve Physical Function among Midlife and Older Black Adults

• Authors: Lange-Maia et al.⁷ (2024)
• Study Design: Cluster randomized controlled trial
• Participants: Older Black adults in 24 churches
• Intervention: Church-Wide Walking Program – All churches participate in a virtual step-tracking program via the Be Well app.
  • Intervention Arm (“Stronger4Longer”)
    • Weekly 90-minute group sessions for 24 weeks comprised of health-related discussions and structured physical activity, which are led by a certified instructor
  • Comparator Arm (“GetFit4Life”)
    • Participants receive educational materials promoting safe physical activity.
    • Participants follow a self-guided exercise routine using study-provided timelines and instructions.
    • Church coordinators support engagement and retention through regular communication.
• Key Findings: Ongoing study; 24-week intervention

Community Health Workers United to Reduce Colorectal Cancer and Cardiovascular Disease among People at Higher Risk (CHURCH): Study protocol for a randomized controlled trial

• Authors: William et al.⁸ (2024)
• Study Design: Cluster randomized controlled trial
• Participants: African Americans in 22 churches
• Intervention:
  • Increase Colorectal Cancer Screening: Train church-based community health workers to promote screening using motivational interviewing and referral to treatment.
  • Improve Diet: Adapt a culturally relevant web-based lifestyle program (Alive!) to reduce inflammatory dietary patterns linked to CRC.
  • Churches will be randomized into either:
    • A dual intervention group (CHW-led screening support + Alive! program).
    • A usual care group (educational pamphlets + screening site list)
• Key Findings: Ongoing study; Assessments at 3, 6, and 12 months to determine effectiveness

Community-based, Cluster-randomized Pilot Trial of a Cardiovascular Mobile Health Intervention: Preliminary findings of the FAITH! Trial

• Authors: Brewer at al.⁹ (2022)
• Study Design: Cluster randomized controlled trial
• Participants: African Americans in 16 churches Mean age: 54.2 years
• Intervention: Fostering African American Improvement in Total Health (FAITH! App)
  • 10-week intervention
  • Group 1 – immediate intervention
  • Group 2 – delayed intervention (control group)
  • Participants chose to focus on either diet or physical activity throughout the intervention. The core intervention features included:
    • Weekly education modules on Life’s Simple 7 health behaviors.
    • Self-monitoring tools for tracking diet and physical activity.
    • Community support through interactive sharing boards.
• Key Findings: The intervention group’s Life’s Simple 7 score increased by 1.9 points compared to the control group’s by 0.7 points.
  • 100% of the Group 1 participants engaged with the app
  • 40% of participants completed at least half of the 10 education modules
  • 75% consistently tracked diet and physical activity.

Implications for Nurses

Partnerships with churches offer the nursing profession an excellent opportunity to extend care beyond the hospital setting and into the community.

Nurses in Health Care Systems

Nurses can collaborate with churches to enhance patient care through initiatives focused on transition support and chronic disease management. By working closely with discharge planning teams, patients can be referred to church-based health ministries for post-hospitalization support. These ministries can assist with follow-ups on medication adherence helping patients navigate their recovery effectively. Additionally, partnerships with churches can facilitate ongoing group-based programs, such as hypertension management classes or faith-based exercise programs. These initiatives ensure that patients receive continuous support and resources for managing chronic conditions long after leaving the clinical setting.

Nurses Working in Community Organizations

Nurses working in community organizations, such as nonprofits, federally qualified health centers, or faith-based clinics can develop and implement church-centered health initiatives, including CVD workshops, group – based exercise activities, and stress management seminars, to encourage healthier lifestyles within the community. Additionally, these nurses can empower church leaders by providing them with resources to advocate for cardiovascular health.

Nursing Faculty and Researchers

Nursing faculty can engage nursing students in clinical placements or service-learning projects that involve collaborating with churches to deliver health education while fostering interdisciplinary partnerships with public health, social work, and theology programs to implement faith-based strategies. Nurse researchers can contribute by conducting studies to evaluate the effectiveness of church-based cardiovascular health interventions, particularly in underserved communities, and using participatory methods to involve church leaders and members in program design and evaluation. Additionally, they can leverage research findings to advocate for policies that fund and support church-based health initiatives as part of broader public health efforts.

By aligning efforts with churches, nurses across these roles can maximize their impact on cardiovascular health, particularly among vulnerable populations.

References

1. Blankinship LA, Rouse WA, Bernstein J, Kruk J, Aboul-Enein BH. A narrative review of ethnic minority studies for faith-based health promotion interventions with special reference to the contemporary christian nurse. J Relig Health. 2021;60(2):1375-1387. doi:10.1007/s10943-020-01150-0
2. Stewart JM. Faith-based interventions: Pathways to health promotion. West J Nurs Res. 2016;38(7):787-789. doi:10.1177/0193945916643957
3. Campbell MK, Hudson MA, Resnicow K, Blakeney N, Paxton A, Baskin M. Church-based health promotion interventions: Evidence and lessons learned. Annu Rev Public Health. 2007;28:213-234. doi:10.1146/annurev.publhealth.28.021406.144016
4. Gwathmey T. How can churches promote health equity in African American communities? (PDF) Futurum. November 28, 2024. Accessed January 6, 2025. https://futurumcareers.com/health-promotion-with-dr-tanya-gwathmey
5. Schoenthaler AM, Lancaster KJ, Chaplin W, Butler M, Forsyth J, Ogedegbe G. Cluster randomized clinical trial of FAITH (Faith-Based Approaches in the Treatment of Hypertension) in Blacks. Circ Cardiovasc Qual Outcomes. 2018;11(10):e004691. doi:10.1161/CIRCOUTCOMES.118.004691
6. Lynch EB, Tangney C, Ruppar T, et al. Heart 2 Heart: Pilot study of a church-based community health worker intervention for African Americans with hypertension. Prev Sci Off J Soc Prev Res. 2024;25(Suppl 1):22-33. doi:10.1007/s11121-023-01553-x
7. Lange-Maia BS, Deckard A, Dugan SA, et al. Keep it Movin’: Design and methods of a church-based physical activity program to improve physical function among midlife and older black adults. Contemp Clin Trials. 2024;147:107742. doi:10.1016/j.cct.2024.107742
8. Williams O, Ting T, Matthews L, et al. Community health workers united to reduce colorectal cancer and cardiovascular disease among people at higher risk (CHURCH): Study protocol for a randomized controlled trial. Trials. 2024;25(1):283. doi:10.1186/s13063-024-08110-z
9. Brewer LC, Jenkins S, Hayes SN, et al. Community-based, cluster-randomized pilot trial of a cardiovascular mobile health intervention: Preliminary findings of the FAITH! Trial. Circulation. 2022;146(3):175-190. doi:10.1161/CIRCULATIONAHA.122.059046
10. Berkley-Patton J, Thompson CB, Williams J, et al. Engaging the faith community in designing a church-based mental health screening and linkage to care intervention. (PDF) Metrop Univ. 2021;32(1):104-123. doi:10.18060/24059
11. Day KR, Bernhart JA, Wilcox S. Barriers and facilitators to 24-month maintenance of the faith, activity, and nutrition program in the U.S. J Relig Health. 2024;63(4):3134-3157. doi:10.1007/s10943-024-02012-9
12. Bateman LB, Hall A, Hannon L, et al. Partnering with churches to address COVID-19 vaccine hesitancy and uptake in trustworthy contexts. Am J Public Health. 2024;114(S5):S392-S395. doi:10.2105/AJPH.2024.307683
13. Weeks CE, Waldrop J, Jessup A. Tailoring African American faith community-based diabetes self-management education. J Christ Nurs Q Publ Nurses Christ Fellowsh. 2024;41(2):96-102. doi:10.1097/CNJ.0000000000001152
14. Huq MR, He X, Woodard N, Chen C, Knott CL. The role of community health advisors’ cancer history in implementation and efficacy of a cancer control intervention. Health Educ Res. 2023;38(4):350-361. doi:10.1093/her/cyad011