ABSTRACT
Community health centers (CHCs) play a critical role in the primary care safety net. Partnerships between CHCs and faith-based organizations are promoted as a way to increase outreach to underserved populations and support health-promoting behaviors and effective disease management. Through six focus groups (totaling 58 participants), we explored low-income residents' perspectives (African American, Latino, and White) of their communities, the meaning of health, the role of spirituality, and their experiences with and preferences for congregation-based health programming to inform future outreach efforts of a CHC. We found that community perspectives varied based on race/ethnicity and neighborhood, but health concerns tended to cluster by race/ethnicity alone. We also found that spirituality was deemed important for health by all racial-ethnic groups, but attendance at religious services, religious affiliation, and preferences for congregation-based health programming varied across and within groups. Community health center-faith based partnerships could facilitate health care access in underserved communities but may have limited reach among certain subgroups and individuals.
Subject(s)
Community Health Centers/organization & administration , Religion and Medicine , Adolescent , Adult , Black or African American/psychology , Black or African American/statistics & numerical data , Aged , Attitude to Health , Female , Focus Groups , Health Status , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Humans , Interinstitutional Relations , Los Angeles , Male , Middle Aged , Surveys and Questionnaires , White People/psychology , White People/statistics & numerical data , Young AdultABSTRACT
OBJECTIVES: Obesity increases a person's risk for diabetes, which is becoming the most common chronic disease in the United States. Latina and African-American women in disadvantaged communities are at higher risk for becoming overweight and subsequently developing diabetes. The purpose of this focus-group study was to guide our adaptation of an evidence-based lifestyle intervention and implementation of the Community-Based Lifestyle Balance program (CLSB). DESIGN, SETTING, AND PARTICIPANTS: We conducted 11 focus-group discussions with 87 African-American and Latina women in disadvantaged communities, including schools, senior centers, subsidized housing communities, and churches. We also conducted informal key informant interviews with community service providers and leaders. RESULTS: Discussions revealed high knowledge of healthy behavior and strong interest in making lifestyle changes. However, barriers such as competing demands on these women prevented long-term practice of healthy behaviors. Women frequently expressed feelings of guilt and self-blame in their attempts and failures to make healthy changes in their daily routine. Some patterns were identified that varied by age and race/ethnicity. These findings suggest guidelines for implementing this lifestyle intervention in a variety of community settings. CONCLUSIONS: Community-level changes such as safer streets and better access to quality grocery stores or markets, with affordable, healthy, fresh food can take years to accomplish. In the interim, CLSB can provide women with skills and strategies that can help improve their health and the health of their families.
