“I am not obese just a little fat” understanding the way in which culture affects how health risks are perceived among a population of rural African americans: Results from a faith-based community-engaged health promotion intervention

BACKGROUND: Despite significant advances in medical research across the spectrum of chronic diseases, African Americans continue to shoulder a disproportionate share of mortality and morbidity. This disparity in the burden of disease is often exacerbated by higher poverty rates, limited access to health resources and low response rates to health promotion interventions. While many African Americans in both urban and rural locations are confronted with the confounding effects of poverty and unequal burden of disease, the collective impact on health outcomes is particularly pronounced in rural communities. Health promotion programs targeted at improving the health outcomes of African Americans in rural communities must consider the social and cultural contexts that influence health behaviors. We will present findings from a community-engaged faith-based health promotion intervention—Project LIFE! conducted in a rural area of Virginia designed to reduce the risks of cancer and obesity. METHODS: Three historically black churches (HBCs) were selected to participate in this eight-month health promotion program using lay health educators (LIFE! coaches) as front line health promoters. Data were collected using a pre and post community survey, gender-stratified focus groups, LIFE! coaches questionnaires and health promotion activities evaluations and logs. RESULTS: The major findings from this faith-based health promotion intervention underscore the importance of considering the influence of cultural norms on how health risks are conceptualized and how health promotive behaviors are adapted.