Design of a church based dietary intervention using community-based participatory research (CBPR) methods

Background: Nutrition behavior is influenced by a complex array of inter-connecting factors and heavily influenced by social networks including family, friends, church, and culture. The purpose of this pilot project was to use CBPR methods in an African-American (AA), faith-based setting to promote and encourage nutrition behavior change. Methods: At baseline, qualitative data were collected through a focus group with AA adults (ages 37-74). Participants were members of the church's repast committee as well as future participants in the intervention. The focus group session was audiotaped, transcribed verbatim, and emergent themes were identified. Coding was completed by four independent raters. Inter-rater reliability indicated adequate agreement (r= 0.88). AA church members and community leaders were involved in the analysis and interpretation of results as well as program development. Results: The following four reoccurring themes were identified. Participants desired classes focused on skill development through actual meal preparation. In addition to hands-on learning, participants were interested in having guest speakers, primarily dietitians and individuals trained in food decoration. Participants indicated they would have to overcome barriers, such as the perception that healthy cooking tastes bad, in order to motivate their congregation to adopt healthier cooking at the church level. Participants suggested intervention leaders could stress healthy eating tastes good and is important by providing recipes and taste testings. Discussion: Many times dietary interventions are didactic in nature and focused primarily on increasing knowledge often resulting in very limited success in long-term compliance. Our data suggest if dietary interventions are to be carried out in AA churches, program development should use CBPR methods and the instruction should be hands-on, focused on skill development and taste, and provide sensory as well as educational messages for the congregation.