Urban-rural differences in faith-based health promotion programming

Background: faith-based organizations (FBO) serve as an important social, cultural and political center of rural communities, but compared to their urban counterparts, less is known about their ability to deliver health and wellness programming (HWP). This study's purpose was to examine differences in factors related to HWP between urban and rural FBOs. Methods: A convenience sample of faith-leaders (N = 824) completed an online survey assessing faith leader demographics (age, sex, education, body mass index, race), FBO demographics (denomination, location), types of HWP, and barriers to HWP. Results: Respondents were primarily White (93%), male (72%), middle aged (53.2+ 12.1 yrs), with Methodist (42.5%) or Lutheran (20.2%) affiliations. Compared to urban faith leaders (n=497), rural faith leaders reported lower education levels and higher rates of overweight (p's<0.05). Compared to urban FBOs, rural FBOs were more likely to report offering no HWP (χ2=3.0, df=1, p=0.04). Of those offering HWP, rural FBOs offered fewer HWP (4.11±3.08) than urban FBOs (4.98±3.25). Urban FBOs were more likely to offer educational health classes, health fairs & screenings, and physical activity groups/sports compared with rural FBOs (ps<0.05). Rural FBOs were more likely to report a lack of congregational interest and lack of lay leadership as barriers to HWP, whereas urban FBOs indicated that other FBO activities conflicted with HWP (ps<0.05). Conclusions: This study revealed important differences in factors related to HWP in urban and rural areas. These results provide insight on important areas to target for health promotion with future faith-based initiatives.