Potential Public Health Impact
Faithful Families Eating Smart and Moving More has potential for broad reach, adoption, implementation, and maintenance over time.
Reach: The policy and environmental components of the intervention have potential for broad reach to all members of the faith community. Because this intervention is tailored for low-income faith communities, reach to those at greatest risk is promising.
The classes have much more limited reach as enrollment was capped at 15 individuals per congregation and the drop-out rate was fairly high (36%).
Data collected on members of participating faith communities indicate that they serve a population at high risk of obesity.
From July 2008 to July 2010, 737 individuals across four North Carolina counties (Harnett, Lee, Durham and Moore) had provided data. Of those individuals, 10.2% had less than a high school education; 72.2% were African American; and 76.4% were overweight or obese. Of the 476 individuals who opted to provide income information, 261 (46.6%) were designated as low-income (at or below 200% of federal poverty level).
Effectiveness: Findings from initial evaluations of the intervention found that most involved faith communities made multiple positive changes to their food and physical activity policies and environments. From July 2008 to July 2010, 14 Eat Smart policies, nine Move More policies, and five environmental change policies had been passed across 24 faith communities and in four counties. Twenty-three of the 24 faith communities have passed multiple policies.
Findings suggest that the FFESMM nutrition classes may have an effect on individual behavior change. Of the 59 graduates from the FFESMM nutrition/physical activity sessions, 43% reported an increase in fruit consumption; 47% reported an increase in vegetable consumption; and 35% reported an increase in the amount of their physical activity.
Adoption: From July 2008 to July 2010, 24 of the 35 (68.6%) faith communities participating in the FFESMM intervention across four counties had completed all elements of the program. Through the Eat Smart Move More NC website, faith communities may also download a full Eating Smart and Moving More Planning Guide for Faith Communities; this allows them to take a more active leadership role in promoting, enhancing and sustaining their own health programs, along with policy and environmental changes.
Implementation: The capacity to implement this program depends on motivation of lay leaders and nutrition/physical activity educators with the faith community. In North Carolina, the leadership of the state-funded Faithful Families program coordinator is also key to implementation. The program is designed to bring together resources from NC Cooperative Extension and the NC Division of Public Health, both of which provide support for local faith communities’ implementation of the program. Intervention materials provided for lay leaders are organized and well done. Thus, once a faith community adopts the intervention, implementation is relatively straightforward, given assistance from the program coordinator, nutrition/physical activity educators and lay leaders.
Maintenance: Maintenance is supported by systems that have been set in place to monitor progress, such as the Progress Monitoring and Reporting System (PMR)1. These systems were put in place once faith communities adopted new policies to promote healthy eating and increased physical activity.
1 The Progress Monitoring and Reporting System (PMR) is an evaluation system used by the Physical Activity and Nutrition (PAN) Branch of the NC Division of Public Health to document and evaluate local efforts toward environmental and policy changes related to physical activity and healthy eating.