title: Process evaluation methods, implementation fidelity results and relationship to physical activity and healthy eating in the Faith, Activity, and Nutrition (FAN) study.
abstract: Faith, Activity and Nutrition (FAN), a community-based participatory research project in African American churches, aimed to increase congregant physical activity and healthy eating. The Health-Promoting Church framework, developed collaboratively with faith-based partners, guided the intervention and a comprehensive process evaluation. The Health-Promoting Church components related to healthy eating and physical activity were getting the message out, opportunities, pastor support, and organizational policy. There was no evidence for sequential mediation for any of the healthy eating components. These results illustrate the complexity of systems change within organizational settings and the importance of conducting process evaluation. The FAN intervention resulted in increased implementation for all physical activity and most healthy eating components. Mediation analyses revealed no direct association between implementation and increased physical activity; rather, sequential mediation analysis showed that implementation of physical activity messages was associated with improved self-efficacy at the church level, which was associated with increased physical activity.
authors.affiliation: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States. Electronic address: rsaunders@sc.edu.
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Saunders
authors.affiliation: Department of Exercise Science and Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States. Electronic address: Wilcoxs@mailbox.sc.edu.
authors.forename: Sara
authors.initials: S
authors.lastname: Wilcox
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States. Electronic address: Stritesk@mailbox.sc.edu.
authors.forename: Meghan
authors.initials: M
authors.lastname: Baruth
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States. Electronic address: Mdowda@mailbox.sc.edu.
authors.forename: Marsha
authors.initials: M
authors.lastname: Dowda
mesh_terms: D001741:Black or African American; D000704:Analysis of Variance; D004032:Diet / Q000208:ethnology / Q000592:standards*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D015397:Program Evaluation; D012067:Religion; D020377:Self Efficacy; D013022:South Carolina
keywords: Faith-based setting; Implementation; Mediation analysis; Process evaluation