Online Program

Navigating conflicting community and academic beliefs in the development of a depression intervention for rural, faith-based, African American communities

Tuesday, November 3, 2015

Jerome Turner, MDiv, Boys Girls Adult Community Development Center, Marvell, AR
Johnny Smith, Shiloh Baptist Church, Pine Bluff, AR
Keneshia Bryant, PhD, RN, APN, College of Nursing & College of Public Health, University of Arkansas for Medical Studies, Little Rock, AR
TIffany Haynes, PhD, University of Arkansas for Medical Sciences, Little Rock, AR
Dennis Kuo, MD, MHS, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
M. Kate Stewart, MD, MPH, Office of Community-Based Public Health, University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, Little Rock, AR
Kimberly Harris, PhD, University of Arkansas for Medical Sciences, Little Rock, AR
Karen Yeary, PhD, Health Behavior and Health Education Department, University of Arkansas for Medical Sciences, Little Rock, AR
OBJECTIVES: Some rural, African American, faith-based communities hold beliefs about depression that may be contrary to scientific evidence. We describe how our community-academic partnership addressed these potentially conflicting views in the context of developing a depression intervention for African American adults.

METHODS: In the context of a community-based health assessment in 30 churches (n=461) that identified depression as an issue to be addressed, our partnership designed a culturally appropriate, lay-led, evidence-based depression intervention. When developing the intervention, beliefs about depression that conflicted from a medical perspective arose, including depression’s origins (demonic, generational curse), depression’s definition (‘being crazy’), how individuals with depression were characterized (spiritual weakness), and recovery from depression (‘more faith in God’). Coming to a consensus about depression-related beliefs was essential in intervention development and delivery by lay leaders.  

RESULTS: The partnership decided to develop a more comprehensive conceptualization of depression that included both spiritual and physical factors (e.g. a generational curse can be transmitted through genetics, but can be overcome). Beliefs that could not co-exist with each other (e.g. depression as demonic possession vs. not) were respected and the team decided to acknowledge the spiritual and emphasize the physical. To ensure consistent intervention delivery by lay leaders that may hold conflicting beliefs, the team also developed a lay leader application assessing depression beliefs to engage lay leaders in a conversation about mental health.  

CONCLUSIONS: In participatory research, conflicting beliefs within a community-academic partnership are inevitable, but resolution is possible in the context of trusting and respectful relationships.

Learning Areas:

Diversity and culture
Program planning

Learning Objectives:
Describe the spiritual beliefs of some rural African American faith communities that conflict with medical beliefs regarding depression Describe how a community-academic partnership navigated and resolved conflicting beliefs about depression Describe strategies that respect both community and academic perspectives in developing a faith-based depression intervention

Keyword(s): Community-Based Research (CBPR), Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience working in communities and have led several federally funded CBPR projects.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.