North Florida Area Agency on Aging

A coalition of six African American churches in Jackson County, Florida was formed in the mid-1980s, first to provide prevention services to older church and community members. Alliance services were expanded later to include alcohol, tobacco, and other drugs (ATOD) at-risk youth. Project year one (1991) (or fiscal year 1991–92) served as the baseline comparison year. Each church was of a size where all participating youth could be identified and given the opportunity to contribute data. Accordingly, these same youth were surveyed both in project years one and four (fiscal year 1994–95). Data were gathered by trained interviewers using jury validated questionnaires. Self-reports of substance use have been found to be relatively stable across time. Significance was tested using the chi-square test for equality of proportions. There is strong indication of substantial behavior change. Fifteen of the 34 target attitudes and behaviors showed statistically significant changes. In general, most of the changes were positive. In 1994 (compared to 1991) children were more likely to avoid drinking alcohol, stay away from bad situations, count on their friends for help when confronting serious problems, less likely to participate when friends “get high,” have healthier self-images, and perform better in school. Gender had no effect on responses.

The purpose of this paper is to review the literature relative to church-based health promotion programs to assist health professionals in establishing effective prevention alliances with African-American churches. While the literature describing the role of churches, particularly African-American, is limited, the available evidence supports the assertion that many churches are engaged in providing primary prevention, preventive health, and social services to at risk populations. Two mini-cases, illustrative of programs which have been reported in the literature, are presented. What each program had in common is an alliance between ministers, health professionals, and trained church volunteers. Pastors acted as gatekeepers and advocates for a health program. The health professionals served as consultants (particularly in technical design, training, and evaluation). Interested church members, once trained, conducted health programs serving themselves, fellow members, and their community.