Applying a unique protocol for participant observation: Observing the role of health in African American rural churches

Issues African-American men have the highest mortality rate from cardiovascular disease (CVD) in this nation. Further, religious involvement and social support have been positively associated with a range of health outcomes, including cardiovascular functioning. This study examined African-American church contexts through participant observation.

Description A total of 20 participant observations (POs) were conducted in a variety of contexts across 4 southern, rural African-American churches including: Sunday service, Bible study, fellowship hour, men's meetings, NAACP Chapter Meeting, Sunday school, and intercessory prayer. Building from a traditional PO framework, the traditional method was enhanced by the personal experiences of the observers; the criteria for site selection and repeated visits to each participating site; and the rigorous protocol for analysis of the ethnographic data.

Lessons Learned These observations proved to be an effective strategy for better understanding possible ways to access hard-to-reach African-American men within a religious setting.

Recommendations This was a technique that offered the opportunity to gain a better understanding of the church culture and options for providing an effective church-based, social support intervention to improve CVD among African-American men in a southeast rural area. These findings identify specific themes related to ethnicity, culture, religion, and other personal and social characteristics that provide insight into the lives of these men who have historically dealt with CVD. Further, the findings also identify specific elements of our rigorous PO process and subsequent analysis that may assist future researchers to conduct effective and ethical observations in other hard-to-reach populations and/or settings.